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Lateral rhachotomy for thoracic spinal lesions.
Spine (Phila Pa 1976)
November 1990
Department of Orthopaedic Surgery, Osaka University Medical School, Japan.
Capener's "Lateral Rhachotomy" was modified by additional excision of the pedicle, articular facets, part of the lamina, and a posterior half of the vertebral bodies on one side through a transpleural approach to the thoracic spine, and a retroperitoneal approach to the lumbar spine. The aim was to excise a space-occupying lesion, which exists in front of the thoracic or lumbar spinal cord, safely. This modification enable the authors to expose more than 50% of the spinal canal, and decompress it from its anterior, lateral, and posterior compressing mass.
View Article and Find Full Text PDFIn cases of a pre-operatively diagnosed mediastinal tumour, but with no symptoms of its penetrating the vertebral canal via the intervertebral foramen, and with the surgeon suddenly discovering during anterio-lateral or lateral transpleural thoracotomy the tumor's spur going deep into the intervertebral foramen then it is a modification of the operation involving an effective removal of the mediastinal-intravertebral newgrowth, as described in this report, is most appropriate. This operation is performed in a single-stage fashion both on the level of the thoracic cavity and on that of the vertebral canal by undertaking a through examination of the intervertebral foramen from both sides. The authors believe this modification of the operative intervention to present advantages over the classical Guleke procedure, even in cases with an exactly established diagnosis of neurinoma, when one of its major node lies in the posterior mediastinum and the second--in the vertebral canal.
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