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9
Mini-Transthoracic Supradiaphragmatic Approach to the Thoracolumbar Junction.
Jae Chil Chang, Hyung Ki Park, Jae Won Doh, Jon Park
1Department of Neurosurgery, Soonchunhyang University College of Medicine, Seoul, Korea. j7chang@gmail.com
2Department of Neurosurgery, Stanford University Medical Center, Stanford, California, USA.
Abstract
Anterior reconstruction with instrumentation of the thoracolumbar junction (TLJ) offers: 1) the biomechanical advantage of immediate restoration of the load-bearing anterior column and 2) the ideal biological milieu for an optimal arthrodesis. The authors describe the mini-transthoracic supradiaphragmatic (MTTS) approach to the TLJ. Its technical feasibility is compared with that of the traditional transdiaphragmatic and thoracoscopic supradiaphragmatic approaches to this area of the spine. This technique was performed in 21 patients from 2004 to 2006. There were no surgical mortalities. The MTTS approach without the use of a thoracoscope was successfully employed in this study to treat patients with various lesions located at the TLJ. The diaphragmatic opening, even at its smallest diameter, provides excellent views of the operative field and avoids the significant morbidities associated with the traditional transdiaphragmatic approach.
Keywords: Thoracolumbar junction;Diaphragm;Mini-transthoracic approach


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