Anterior approach to the thoracolumbar spine: technical considerations
J. D. Burrington, C. Brown, E. R. Wayne and J. Odom
Forty-five patients, of whom most were children, underwent extensive
exposure of the thoracolumbar spine to correct serious orthopedic
abnormalities. The spine was exposed through a combined thoracotomy and
retroperitoneal approach that gave excellent access with minimal morbidity.
The diaphragm was opened circumferentially after the peritoneum had been
dissected from its muscular portion. This permitted repair of the diaphragm
with no detectable loss of function. Although this approach was developed
for exposure of the spine, it can also be utilized to expose the entire
aorta, both kidneys and their blood supply, and the retroperitoneal area
for possible excision of large tumors.
