Extracavitary Approach to the Thoracolumbar Spine

Because of its complex anatomy, the thoracolumbar spine remains one of the most common sites for spinal column injuries and pathologies. Current surgical management to address thoracolumbar lesions remains challenging as traditional surgical procedures—anterior, posterior, and either combined or staged anterior-posterior approaches—are frequently associated with complications and morbidity. By remaining extrapleural and/or extraperitoneal, the extracavitary approach avoids many of these potential complications by using a single incision to provide direct access to anterior, middle, and posterior column, while offering direct visualization of the common dural sac and neural elements. Recent improvements in surgical technique combined with advancements in spinal instrumentation have reduced complication rates with this approach to levels comparable to the more traditional surgical approaches.