Approaches Summary

Posted bythespinebookadminPosted inProcedures

Access to Anterior Spine 

Level Anterior Approach Posterior 
C0-C2 Transoral/ transmandibular No access 
C2-T2 Smith Robinson No access 
T2-T5 Direct Anterior with manubriectomy Transpedicular, Costotra 
T5-T11 Transthoracic through IC space  5-8 Right side up avoid heart 8-11 Left up avoid liver  
T11-L1 Thoracoabdominal (L up, 10th rib takedown, release diaphgragm)  
L2-L4 Retroperitoneal  
L5-S1 Anterio retroperritoneal  

Considerations 

  • Diaphragm 
    • Insertions 
      • T12/L1 disc 
      • Costal cartilage ribs 7-10 
      • Xiphoid process sternum 
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