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Thoracoscopic Fusion

  • Peter Grunert
  • Roger Härtl
Chapter

Abstract

Thoracoscopic spinal fusion procedures represent a minimally invasive alternative to conventional open transthoracic operations. A broad spectrum of indications including degenerative, traumatic, and tumor conditions can be managed with this technique. Several instrumentation devices have been introduced to match the challenges of an endoscopic anterior approach including special screw-plate systems as well as expandable cages.

Preoperative planning involving the most appropriate side for the approach, correct patient positioning, as well as portal placements are determining factors for the overall success of the operation.

Great care must be taken during soft tissue dissection to avoid larger vessel or lung injury.

In order to visualize the lateral wall of the vertebrae, the attached rib heads have to be resected and can later be used as an interbody construct.

Discectomies in the lower thoracic spine often require instrumentation, which can be accomplished with plate and double-rod constructs. Corpectomy sites always need to be reconstructed. Expandable cages combined with anterolateral fixation devices are most widely used for this propose.

Most common complications of thoracoscopic procedures involve the respiratory system due to single-lung ventilation and lung tissue retraction. Severe intraoperative complications often require conversion to an open approach.

Keywords

Vertebral Body Chest Tube Thoracic Spine Anterior Column Thoracic Disc Herniation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Department of Neurological SurgeryWeill CornellNew YorkUSA
  2. 2.Department of Neurological SurgeryNew York Presbyterian Hospital – Weill Cornell Medical CollegeNew YorkUSA

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