Matthew J. Schuchert, MD, Kristen N

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Presentation transcript:

Anterior Thoracic Surgical Approaches in the Treatment of Spinal Infections and Neoplasms Matthew J. Schuchert, MD, Kristen N. McCormick, BS, Ghulam Abbas, MD, Arjun Pennathur, MD, Joshua P. Landreneau, BS, James R. Landreneau, BS, Andre Pitanga, MD, Jamilly Gomes, MD, Felipè Franca, MD, Matthew El-Kadi, MD, PhD, Andrew B. Peitzman, MD, Peter F. Ferson, MD, James D. Luketich, MD, Rodney J. Landreneau, MD The Annals of Thoracic Surgery Volume 97, Issue 5, Pages 1750-1757 (May 2014) DOI: 10.1016/j.athoracsur.2013.09.085 Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 (A) A benign tumor involving the posterior aspect of the T1 vertebral body. (B) Spinal metastasis involving the T8 vertebral body. (C) Osteomyelitis involving the T11 vertebra. Notice the prominent perivertebral inflammation, edema, and associated bilateral pleural effusions. The Annals of Thoracic Surgery 2014 97, 1750-1757DOI: (10.1016/j.athoracsur.2013.09.085) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Cervicothoracic spine exposure. An oblique incision is performed along the sternocleidomastoid muscle. The manubrium is split inferiorly. The sternocleidomastoid and carotid sheath are reflected laterally, and gentle medial retraction is applied to the trachea and esophagus. The Annals of Thoracic Surgery 2014 97, 1750-1757DOI: (10.1016/j.athoracsur.2013.09.085) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 The Bookwalter retraction system provides excellent exposure during thoracotomy and thoracoabdominal approaches. The Annals of Thoracic Surgery 2014 97, 1750-1757DOI: (10.1016/j.athoracsur.2013.09.085) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Comparison of preoperative and postoperative neurologic symptoms after operation on the anterior spine. The Annals of Thoracic Surgery 2014 97, 1750-1757DOI: (10.1016/j.athoracsur.2013.09.085) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 Overall survival of patients with infection (red) and neoplasm (black). The Annals of Thoracic Surgery 2014 97, 1750-1757DOI: (10.1016/j.athoracsur.2013.09.085) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions