Srpski arhiv za celokupno lekarstvo 2013 Volume 141, Issue 9-10, Pages: 671-675
https://doi.org/10.2298/SARH1310671I
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Lateral extracavitary approach to spine
Ivetić Dražen (Vojnomedicinska akademija, Klinika za neurohirurgiju, Beograd)
Spaić Milan (Vojnomedicinska akademija, Klinika za neurohirurgiju, Beograd)
Antić Branislav (Vojnomedicinska akademija, Klinika za neurohirurgiju, Beograd)
Introduction. This paper describes the lateral extracavitary approach to the
lumbar spine using the threequarter prone position. Owing to unsatisfied
results of the posterior approaches to spine in patients with the ventral
compressive lesions, many ventral approaches as well as lateral extracavitary
approach have been developed. Case Outline. A patient with tumor (chordoma)
of L3 vertebral body was operated on by means of ventral compression of cauda
equina; the tumor had paraspinal propagation. Lateral extracavitary approach
was used with a patient in threequarter prone position, and corpectomy with
the anterior stabilisation was performed followed by posterior transpedicular
stabilisation through the same approach. Complete tumor removal and excellent
neurological improvement were achieved. Conclusion. This approach provides
safe ventral decompression of the spinal cord; it also enables the anterior
and posterior instrumental stabilisation through the same incision and in the
same position during the intervention. The threequarter prone position
allows excellent view of the dural sac.
Keywords: operative approach, spinal cord decompression, threequarter prone position