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Anterior approach to the thoracic spine

An anterior approach affords the spine surgeon excellent visualization and access to the anterior thoracic spine, the vertebral bodies, intervertebral disks, spinal canal, and nerve roots. This approach is currently used in the surgical treatment of thoracic disk disease, vertebral osteomyelitis or discitis, fractures and tumors of the vertebral bodies, allowing for proper decompression of neural elements and spine stabilization. Over a 10-year period in a single institution, a total of 142 patients with a mean age of 49.6 years underwent anterior thoracic exposure of the spine. The indication for surgery was trauma fracture in 20 patients, malignancy in 35, degenerative disease in 29 and correction of scoliosis in 58. Surgical approaches were determined based on the location and length of spinal involvement, including cervico-thoracic approach (15) thoracotomic approach (85) video-assisted thoracoscopy (10) and thoracolumbar exposure (32). Mean operative time was 334 min (range from 256 to 410 min). There was no perioperative mortality. Thirty-one patients (21.8%) developed postoperative complications. The anterior approach to the thoracic spine is safe and effective and even the presence of complications can be appropriately managed. An adequate preoperative evaluation stratifying the risk and instituting measures to reduce it, accurate surgical planning and careful surgical technique are key to yielding a good outcome and to reduce the risk of complications

Keywords : Adolescent,Adult,adverse effects,Aged,Child,complications,Female,Humans,Italy,Male,Middle Aged,mortality,Orthopedic Procedures,Patient Selection,Postoperative Complications,prevention & control,Risk Assessment,Risk Factors,Scoliosis,Spinal Canal,Spinal Diseases,Spine,surgery,Thoracic Surgery,Video-Assisted,Thoracic Vertebrae,Thoracoscopy,Thoracotomy,Time Factors,Treatment Outcome,Young Adult,, Approach,Thoracic,Spine, repetitive strain injury hand

Date of Publication : 2011 May

Authors : De GT;Francioni F;Diso D;Tarantino R;Anile M;Venuta F;Coloni GF;

Organisation : Department of Surgery and Transplantation P Stefanini, University of Rome Sapienza, Policlinico Umberto I, 00161 Rome, Italy. tiziano.degiacomo@tin.it

Journal of Publication : Interact Cardiovasc Thorac Surg

Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/21303868

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This surgical technique consists of a percutaneous approach for the treatment of small to medium size hernias of the intervertebral disc by laser energy. The main objective is to reduce the intradiscal pressure in the nucleus pulposus

Laser Disc Surgery can be performed under local anaesthetic as a day case at our centre on the prestigious Harley Street.
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