title: Spondylectomy of T-2 according to the Tomita technique via an extended Fessler approach: a cadaveric study.
abstract: OBJECTIVE
  The authors' aim was to conduct a surgical anatomy and feasibility study on the use of an extended posterolateral approach to the cervicothoracic junction (Fessler approach) in cadavers to facilitate en bloc removal of the second thoracic vertebra using the Tomita technique. To apply this technique, it is mandatory to approach both sides of the vertebra. But such a maneuver is very difficult in the region of the cervicothoracic junction because the scapula and its muscles represent an anatomical barrier to the paravertebral compartment and lateral aspects of the vertebrae.
  
  
  METHODS
  To study the extended posterolateral Fessler approach to the cervicothoracic junction and the possible application of the Tomita technique on the second thoracic vertebra, 3 fresh-frozen cadavers were used in the Laboratory of Human Anatomy at the University of Nantes.
  
  
  RESULTS
  The proposed approach allows exposure of both the posterior arch and the body of the second thoracic vertebra without any significant resection or traction of the superficial and deep posterior thoracic muscles, enabling application of the Tomita technique and facilitating intraoperative spinal fixation.
  
  
  CONCLUSIONS
  The proposed surgical technique is technically feasible. Nevertheless, it should be an option reserved for selected patients for whom the surgical complexity can be justified by the characteristics of their malignancy and expected curative outcome.
authors: Department of Medico-Surgical Sciences and Biotechnologies, University of Rome La Sapienza, Polo Pontino, Latina, Italy. m.miscusi@libero.it
authors: Massimo
authors: M
authors: Miscusi
authors: Maurizio
authors: M
authors: Domenicucci
authors: Filippo Maria
authors: FM
authors: Polli
authors: Stefano
authors: S
authors: Forcato
authors: Fabio
authors: F
authors: De Giorgio
authors: Antonino
authors: A
authors: Raco
mesh_terms: D005240:Feasibility Studies; D006801:Humans; D008297:Male; D019637:Orthopedic Procedures / Q000379:methods*; D013123:Spinal Fusion / Q000379:methods*; D013904:Thoracic Vertebrae / Q000601:surgery*