lateral extracavitary approach all through posterior

ABSTRACT

The Lateral extra cavitary approach [LECA] is a one stage approach allowing simultaneous ventral and dorsal exposure in the more familiar prone position without repositioning of the patients. It provides the ability to re-attack the ventral graft site after application of dorsal instrumentation. The neural elements are visualized early in the procedure allowing safe decompression. The aim of this work was to study the safety and technical difficulties of the LECA in different spinal pathology and the value of using a midline skin incision. 40 patients with different spinal pathology including trauma, tumours, infections, deformity and thoracic disc prolapse were treated via the LECA. 37 patients were operated via mid-line skin incision and only 3 patients via the hockey stick incision. All patients had decompression, anterior column reconstruction and posterior stabilization simultaneously. Mean follow up period was 21 months. Neither significant perioperative complications nor mortality were reported. The midline skin incision is more cosmetic and offers good exposure. The LECA is a safe approach better than combined anterior and posterior approaches