title: Anterior minimally invasive extrapleural retroperitoneal approach to the thoraco-lumbar junction of the spine.
abstract: BACKGROUND
  The anterior approach to the thoraco-lumbar junction of the spine allows therapeutic interventions on post-traumatic, infectious, and neoplastic vertebral lesions from T11 to L2 combining spinal cord decompression, corporectomy, and vertebral body fusion. However, this approach also has a reputation for damaging the intervening anatomic structures (lungs, peritoneum, and diaphragm). The objective of this study was to show that both nervous structure decompression and anterior vertebral reconstruction can be achieved via an anterior minimally invasive extrapleural retroperitoneal (AMIER) approach.
  
  
  METHODS
  We describe each of the steps of the AMIER approach to the thoraco-lumbar junction of the spine.
  
  
  RESULTS
  The AMIER approach ensures excellent exposure that allows full decompression and satisfactory anterior anatomic reconstruction. The main difficulties and complications relate to the lungs, and a painstaking and rigorous technique limits the complications compared to conventional thoraco-phreno-lumbotomy.
authors.affiliation: Department of Neurosurgery, Maison-Blanche Hospital, Reims Teachning Medical Center, 45, rue Cognacq-Jay, 51092 Reims cedex, France.
authors.forename: C F
authors.initials: CF
authors.lastname: Litré
authors.forename: J
authors.initials: J
authors.lastname: Duntze
authors.forename: Y
authors.initials: Y
authors.lastname: Benhima
authors.forename: C
authors.initials: C
authors.lastname: Eap
authors.forename: S
authors.initials: S
authors.lastname: Malikov
authors.forename: G
authors.initials: G
authors.lastname: Pech-Gourg
authors.forename: B
authors.initials: B
authors.lastname: Blondel
authors.forename: P
authors.initials: P
authors.lastname: Métellus
authors.forename: S
authors.initials: S
authors.lastname: Fuentes
mesh_terms: D019299:Decompression, Surgical / Q000379:methods; D006801:Humans; D008159:Lumbar Vertebrae; D019060:Minimally Invasive Surgical Procedures; D019637:Orthopedic Procedures / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000379:methods; D012187:Retroperitoneal Space; D013122:Spinal Diseases / Q000175:diagnosis*; D016103:Spinal Fractures / Q000601:surgery; D013125:Spinal Neoplasms / Q000601:surgery; D013904:Thoracic Vertebrae