Posterior and Posterolateral Approaches to the Lumbar Spine
Overview The posterior approach is undoubtedly the most utilized approach in all of spine surgery. It remains the workhorse for exposure of the entire spine, from occiput to sacrum, during…
Transpedicular Screw Fixation: Open and Percutaneous Techniques
Overview Although earlier reports described the use of small facet screws to facilitate spinal fusion, it was Roy-Camille, in 1970, who promoted the use of the pedicle as a point…
Surgical Decompression and Stabilization for Lumbar Lesions: Osteomyelitis and Tumors
Overview Surgical management of neoplastic and infectious lesions of the lumbar spine involves extensive preoperative planning to ensure proper patient selection and operative approach. Despite the differences in patient selection…
Lumbar Microdiskectomy: Midline Open and Far-Lateral Techniques
Overview History Mixter and Barr first provided the description of a herniated disk causing sciatica in 1934. The surgical technique outlined the treatment of lumbar disk herniation at that time,…
Anterior Retroperitoneal Approach to the Lumbar Spine
Overview Anterior lumbar spinal surgery has been performed in various forms for decades. Müller described an anterior approach to the lumbar spine as early as 1906, and the anterior approach…
Surgical Approaches to Lumbar Fractures
Overview Because of the biomechanical features of the region, the most common site of injury in the lower spine is the thoracolumbar junction. The thoracic spine is stabilized by the…
Posterolateral Approaches to the Cervicothoracic Junction: Transpedicular, Costotransversectomy, Lateral Extracavitary, and Parascapular Extrapleural Approaches
Overview The cervicothoracic junction (CTJ), from C7 to T4, presents a particularly challenging region for surgical approach secondary to the unique anatomy of the upper thoracic cage, the presence of…
Surgical Approaches to Thoracic Primary and Secondary Tumors
Overview The past four decades have witnessed major advances in spine surgery, and these pioneering developments have dramatically influenced the culture and attitudes surrounding surgical management of spine tumors. At…
Surgical Decompression and Stabilization Techniques in Thoracic Trauma
Overview More than 1 million acute spinal injuries occur in the United States every year, of which approximately 50,000 result in vertebral fractures, and less than 10,000 result in spinal…
Thoracic Microdiskectomy: Lateral and Posterolateral Approaches
Overview Thoracic disk herniations are heterogeneous with respect to presenting symptoms, anatomic relationship to the spinal cord, and intrinsic tissue characteristics. Accordingly, thoracic diskectomy exists along a continuum of surgical…
