title: Cadaveric evaluation of minimally invasive posterolateral thoracic corpectomy: a comparison of 3 approaches.
abstract: METHODS
  A cadaver study comparing 3 different minimally invasive approaches to the anterior thoracic spine.
  
  
  OBJECTIVE
  To assess the feasibility of minimally invasive thoracic corpectomy from a posterolateral approach and to compare surgical results from 3 approaches.
  
  
  BACKGROUND
  Traditional posterolateral approaches to the thoracic spine are effective but are associated with a high rate of operative morbidity.
  
  
  METHODS
  Thoracic corpectomies were performed using a modified tubular retractor starting at 3, 6, and 9 cm off of midline. Postoperative computed tomography scans were performed and analyzed to assess the extent of corpectomy and ventral decompression.
  
  
  RESULTS
  From 3 to 6 to 9 cm, a significant difference in extent of corpectomy (65.8%, 81.5%, and 82.6%, P=0.02) and ventral decompression (83.6%, 90.4%, 94.6%, P=0.05) was noted between 3 cm and the more lateral approaches. The 9 cm approach required more rib resection and average working distances of 8.4 to 11.3 cm, which made the procedure more difficult technically and less suited to the length of standard instruments.
  
  
  CONCLUSIONS
  Minimally invasive thoracic corpectomy is feasible and a 6 cm approach off of midline appears optimal.
authors.affiliation: Department of Neurological Surgery, Northwestern University, Chicago, IL 60611, USA. ato2@columbia.edu
authors.forename: Alfred T
authors.initials: AT
authors.lastname: Ogden
authors.forename: Kurt
authors.initials: K
authors.lastname: Eichholz
authors.forename: John
authors.initials: J
authors.lastname: O'toole
authors.forename: Justin S
authors.initials: JS
authors.lastname: Smith
authors.forename: Vishal
authors.initials: V
authors.lastname: Gala
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Voyadzis
authors.forename: Koichi
authors.initials: K
authors.lastname: Sugimoto
authors.forename: John
authors.initials: J
authors.lastname: Song
authors.forename: Richard G
authors.initials: RG
authors.lastname: Fessler
mesh_terms: D002102:Cadaver; D019299:Decompression, Surgical / Q000379:methods*; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D012272:Ribs / Q000033:anatomy & histology / Q000601:surgery; D013904:Thoracic Vertebrae / Q000033:anatomy & histology / Q000601:surgery*; D054854:Vertebroplasty / Q000379:methods*