Anterior/Anterolateral Thoracic Access and Stabilization from Posterior Approach, Transpedicular, Costotransversectomy, Lateral Extracavitary Approaches via Minimally Invasive Approaches, Minimal Access and Tubular Access

Abstract

Metastatic and primary tumors of the thoracic spine can be clinically identified by either neurological symptoms or pain caused by biomechanical instability. Traditionally, effective tumor resection/treatment has been addressed with anterior approaches. However, with hardware improvement and the implementation of microsurgical techniques, minimally invasive spine surgery (MISS) approaches through posterior and posterolateral corridors have become more popular. These MISS techniques have demonstrated several advantages, such as improved time to return to productive activities and decreased surgical time and estimated blood loss, which may be beneficial for oncologic patients by decreasing their surgery-associated morbidity. The most common posterior MISS options to address thoracic spinal tumors include posterior, transpedicular, lateral extracavitary, and lateral approaches.

In the following chapter, we include in a well-organized fashion a brief description of the preoperative evaluation, incision planning, patient positioning, surgical details, and postoperative recommendations for successful posterior MISS thoracic tumor surgery.