[Clinical value of the posterolateral approach, supplemented with pedicle excision of the arch, to the anterior wall of the spinal canal within the thoracolumbar (Th11-L1) and lumbar spine].
The author validates clinically his own lateral approach to the lumbosacral (Th11-L1) and lumbar spine. In this approach an enlargement of the intervertebral foramen is achieved by the partial excision of adjacent pedicles or excision of one or several pedicles. The access to the anterior canal wall is gained in this manner. This surgical approach has been used in 48 patients with neurological injury (spinal cord, conus medullaris, cauda equina or the roots). An active tuberculosis was the causative factor in 12 cases, the sequelae of tuberculous infection in 10 cases, infection in one case, degenerative disc disease in 12 cases, osteochondrosis in 2 cases, nucleus pulposus prolapse into the root canal in 3 cases, developmental defect of the vertebrae in 2 cases, primary or metastatic tumors in 6 cases. These conditions resulted in plegia (3 cases), spastic paresis (3 cases), caudal paresis (5 cases), root paresis (12 cases) and root syndrome (24 cases). This approach provided possibility to recognize the pathology accurately and decompress the roots. Neurological results achieved were most advantageous since in 41 cases neurological symptoms subsided entirely, in 2 cases an improvement was noted, in 2 cases partial improvement and no improvement occurred in 3 cases only.


CONCLUSIONS
this approach offers good visualization of the anterior part of the spinal canal and allows for efficient decompression rendering good clinical results.
Malawski
S
S
Kliniki Ortopedii CMKP, Otwocku.
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000601:surgery; D011859:Radiography; D013117:Spinal Cord Compression / Q000209:etiology / Q000601:surgery*; D013122:Spinal Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery; D016896:Treatment Outcome
Wartość kliniczna dostepu tylno-bocznego, uzupełnionego pedikulotomia łuku, do przedniej ściany kanału w piersiowo-ledźwiowym (Th11-L1) i ledźwiowym odcinku kregosłupa.