•  Rib exposure. The anterior and posterior margins of the vertebral body to be resected are marked using fluoroscopy. The overlying rib is subperiosteally exposed.

•  The inferior portion of the rib is subperiosteally released from the neurovascular bundle.

•  Approximately two centimeters of rib have been resected. The pleura of the lung is visualized.

•  A series of tubular dilators are placed into the defect, sweeping the lung and pleura anteriorly and resulting in an extrapleural exposure of the vertebral body.

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