title: Transthoracic approach for lesions involving the anterior dorsal spine: A multidisciplinary approach with good outcomes.
abstract: BACKGROUND
  Anterior approach provides excellent visualization and access to the anterior thoracic spine. It may be used alone, in combination with a posterior midline approach or in a staged or sequential fashion.
  
  
  OBJECTIVE
  To analyse our institutional experience in transthoracic approaches and to determine the safety and benefit of this approach in our patient series.
  
  
  METHODS
  A total of 16 patients were operated for varying lesions of body of dorsal vertebra by the transthoracic approach. The study was for a period of 5 years from January 2011 to December 2015. Patients age ranged from 25 to 61 years with an average of 36.4 yrs. There were 7 males and 9 females. In our series 9 patients had Kochs spine, 4 patients were traumatic fracture spine and 3 had neoplastic lesion. Majority of patients had multiple symptoms with backache being present in all patients.
  
  
  RESULTS
  There was one post operative mortality which was unrelated to surgery. One patient had post operative delayed kyphosis. Remaining patients improved in their symptoms following surgery.
  
  
  CONCLUSIONS
  With careful coordination by thoracic surgeons, neurospinal surgeons and anaesthetists, the anterior spine approach for dorsal spine is safe and effective. Adequate preoperative evaluation should stratify the risk and institute measures to reduce it. Accurate surgical planning and careful surgical technique are the key to yield a good outcome and to reduce the risk of complications.
authors.affiliation: Department of Neurosurgery, TN Medical College and BYL Nair Hospital, Mumbai, Maharashtra, India.
authors.forename: Srikant
authors.initials: S
authors.lastname: Balasubramaniam
authors.affiliation: Department of Neurosurgery, TN Medical College and BYL Nair Hospital, Mumbai, Maharashtra, India.
authors.forename: Devendra K
authors.initials: DK
authors.lastname: Tyagi
authors.affiliation: Department of Neurosurgery, TN Medical College and BYL Nair Hospital, Mumbai, Maharashtra, India.
authors.forename: Sheikh H
authors.initials: SH
authors.lastname: Zafar
authors.affiliation: Department of Neurosurgery, TN Medical College and BYL Nair Hospital, Mumbai, Maharashtra, India.
authors.forename: Hemant V
authors.initials: HV
authors.lastname: Savant
keywords: Anterior approach for thoracic spine; thoracotomy for dorsal spine lesion; transthoracic approach for thoracic spine