HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Anderson, T. M. Articles by Miller, J. I. Search for Related Content PubMed PubMed Citation Articles by Anderson, T. M. Articles by Miller, J. I., Jr

The Annals of Thoracic Surgery, Vol 55, 1447-1451, Copyright © 1993 by The Society of Thoracic Surgeons

ARTICLES

Thoracic approaches to anterior spinal operations: anterior thoracic approaches

TM Anderson, KA Mansour and JI Miller Jr
Cardiothoracic Surgery, Emory University School of Medicine, Emory Clinic, Atlanta, Georgia 30308.

We performed a retrospective review of 36 patients aged 23 to 71 years (mean age, 52 years) who underwent 46 operations through a thoracic or thoracolumbar approach for orthopedic or neurosurgical procedures at Emory University Affiliated Hospitals. Pathologic indications for operation were metastatic disc disease in 10, herniated nucleus pulposus in 11, osteomyelitis in 6, vertebral fracture in 2, spinal deformities in 4, spinal abscess in 1, Pott's disease in 1, and liposarcoma in 1. Major indications for operation were infection and progressive paraparesis or paresthesias. Surgical approach consisted of a posterior lateral thoracotomy in 23, thoracotomy with retroperitoneal exposure in 6, thoracoabdominal exposure in 4, and cervical/upper sternotomy in 3. Diaphragmatic mobilization was required in 12. Surgical approach is dictated by the level of the lesion and its length. Lesions of T1 to T6 are approached through an upper sternotomy or right thoracotomy; lesions of T6 to L3, through a left thoracotomy with or without diaphragmatic mobilization. Specific techniques of segmental vessel division, diaphragmatic mobilization, and evaluation of artery of Adamkiewicz are emphasized. Rib grafts are harvested as needed. The thoracic surgeon can greatly enhance preoperative assessment, operative exposure and closure, and postoperative care for patients undergoing thoracotomy for spinal conditions.

This article has been cited by other articles:

				B. L. Pettiford, M. J. Schuchert, G. Jeyabalan, J. R. Landreneau, A. Kilic, J. P. Landreneau, O. Awais, M. S. Kent, P. F. Ferson, J. D. Luketich, et al. Technical Challenges and Utility of Anterior Exposure for Thoracic Spine Pathology. Ann. Thorac. Surg., December 1, 2008; 86(6): 1762 - 1768. [Abstract] [Full Text] [PDF]

				R. W. Ikard Methods and Complications of Anterior Exposure of the Thoracic and Lumbar Spine Arch Surg, October 1, 2006; 141(10): 1025 - 1034. [Abstract] [Full Text] [PDF]

				R. J. Nijenhuis, T. Leiner, E. M. J. Cornips, J. T. Wilmink, M. J. Jacobs, J. M. A. van Engelshoven, and W. H. Backes Spinal Cord Feeding Arteries at MR Angiography for Thoracoscopic Spinal Surgery: Feasibility Study and Implications for Surgical Approach Radiology, November 1, 2004; 233(2): 541 - 547. [Abstract] [Full Text] [PDF]

				T. M. Anderson, W. C. Horton, T. E. Whitesides, and J. I. Miller Jr Sternal Release and Advancement With Thoracotomy and Osteotomy for Idiopathic Osteopenia Ann. Thorac. Surg., August 1, 1995; 60(2): 437 - 438. [Abstract] [Full Text]