title: Rib head disarticulation for multilevel transpedicular thoracic corpectomies and expandable cage reconstruction.
abstract: 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.
authors.affiliation: Department of Neurological Surgery, University of California San Francisco, San Francisco, CA 94143-0112, USA. choud@neurosurg.ucsf.edu
authors.forename: Dean
authors.initials: D
authors.lastname: Chou
authors.forename: Matthew
authors.initials: M
authors.lastname: Eltgroth
authors.forename: Isaac
authors.initials: I
authors.lastname: Yang
authors.forename: Daniel
authors.initials: D
authors.lastname: Lu
authors.forename: Geoff
authors.initials: G
authors.lastname: Manley
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D019637:Orthopedic Procedures / Q000295:instrumentation* / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000295:instrumentation* / Q000379:methods*; D012272:Ribs / Q000000981:diagnostic imaging / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed