Lateral Extracavitary Approach for Thoracic Spine Trauma

ABSTRACT

OBJECTIVE: The lateral extracavitary approach(LECA) to the thoracic spine is known as one of the procedure which allows direct vision of pathologic lesion, ventral decompression and dorsal fixation of the spine through the same incision. The authors present a usefulness of the LECA to the complicated unstable thoracic spine caused by trauma. METHODS: The authors performed LECA on six patients from January 1999 to June 2001. All patients were male and their age distribution was from 17 to 65 years. Perioperative neurological state, radiological image, and their changes during follow-up period were evaluated in all patients. RESULTS: After operation, neurological symptoms were improved and there were no significant post-operative complications. Among these trauma cases, three patients showed rapid recovery of their impending paraparesis. In two patients with paraplegia from severe fracture-dislocation, only one patient was minimally improved to motor grade 3. Spinal alignments were maintained in all. CONCLUSION: Lateral extracavitary approach is considered to be a alternative method for the treatment of traumatic thoracic vertebra with high grade instability. The major advantage of this approach is that circumferential decompression of the spine and rigid fixation can be obtained throurh the same incision.