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The Thoracoscopic Approach in Spinal Cord Disease

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The Funnel: From the Skull Base to the Sacrum

Part of the book series: Acta Neurochirurgica Supplement ((NEUROCHIRURGICA,volume 135))

Abstract

Summary: Video-assisted thoracic surgery (VATS) has been growing in popularity over the past 2 decades as an alternative to open thoracotomy for the treatment of several spinal conditions, and in the field of minimally invasive surgery, it now acts as a keyhole to the thoracic spine.

Materials and Methods: Most VATS approaches are from the right side for pathologies involving the middle and upper thoracic spine because there is a greater working spinal surface area lateral to the azygos vein than that lateral to the aorta. Below T-9, a left-sided approach is made possible because the aorta moves away from the left posterolateral aspect of the spine to an anterior position as it passes through the diaphragm.

Results: VATS has been used extensively in spinal deformities such as scoliosis. The use of VATS in spine surgery includes the treatment of thoracic prolapsed disk diseases, vertebral osteomyelitis, fracture management, vertebral interbody fusion, tissue biopsy, anterior spinal release, and fusion without or with instrumentation (VAT-I) for spinal deformity correction. As the knowledge and the comfort of using such techniques have expanded, the indications have extended to corpectomy for tumor resections.

Discussion and Conclusions: In the field of minimally invasive surgery, VATS now acts as a keyhole to the thoracic spine and an alternative to open thoracotomy for the treatment of several spinal conditions.

Although VATS can be performed in such spine conditions, it is most beneficial in the treatment of scoliotic deformity, which requires taking a multilevel approach, from the upper to the lower thoracic spine.

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Authors and Affiliations

  1. Institute of Neurosurgery, Catholic University of Rome, Rome, Italy

    Massimiliano Visocchi

  2. Institute of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University, Rome, Italy

    Giorgio Ducoli

  3. Department of Neurosurgery, Fondazione Policlinico Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy

    Francesco Signorelli

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  1. Massimiliano Visocchi
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  2. Giorgio Ducoli
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  3. Francesco Signorelli
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Correspondence to Francesco Signorelli .

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Editors and Affiliations

  1. Institute of Neurosurgery, Catholic University of Rome, Rome, Italy

    Massimiliano Visocchi

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Visocchi, M., Ducoli, G., Signorelli, F. (2023). The Thoracoscopic Approach in Spinal Cord Disease. In: Visocchi, M. (eds) The Funnel: From the Skull Base to the Sacrum. Acta Neurochirurgica Supplement, vol 135. Springer, Cham. https://doi.org/10.1007/978-3-031-36084-8_58

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  • DOI: https://doi.org/10.1007/978-3-031-36084-8_58

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-36083-1

  • Online ISBN: 978-3-031-36084-8

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