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Year : 2009  |  Volume : 57  |  Issue : 4  |  Page : 469--474

Rib head disarticulation for multilevel transpedicular thoracic corpectomies and expandable cage reconstruction

Department of Neurological Surgery, University of California San Francisco, USA

Correspondence Address:
Dean Chou
Department of Neurological Surgery, University of California, San Francisco, 505 Parnassus Ave. Box 0112, San Francisco, CA 94143-0112
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0028-3886.55602

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Traditional posterior approaches to the thoracic spine are done with either costo-transversectomy, lateral extracavitary approaches, or transpedicular approaches. The transpedicular approach is the only one that preserves the rib head. However, placing an expandable cage with this rib head intact poses special challenges because of the narrow corridor defined by the rib head and the spinal cord. Instead of removing the rib head, which requires pleural dissection and carries the risks of pleural injury, we disarticulate it and push it laterally during cage placement. This avoids pleural dissection and affords expandable cage placement through a transpedicular approach.


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Online since 20th March '04
Published by Wolters Kluwer - Medknow