Латерални екстракавитарни приступ кичменом стубу

Abstract

Introduction This paper describes the lateral extracavitary approach to the lumbar spine using the three-quarter prone position. Owing to unsatisfied results of the posterior approaches to spine in patients with the ventral compressive lesions, many ventral approaches as well as lateral extracavitary approach have been developed.

Case Outline A patient with tumor (chordoma) of L3 vertebral body was operated on by means of ventral compression of cauda equina; the tumor had paraspinal propagation. Lateral extracavitary approach was used with a patient in three-quarter prone position, and corpectomy with the anterior stabilisation was performed followed by posterior transpedicular stabilisation through the same approach. Complete tumor removal and excellent neurological improvement were achieved.

Conclusion This approach provides safe ventral decompression of the spinal cord; it also enables the anterior and posterior instrumental stabilisation through the same incision and in the same position during the intervention. The three-quarter prone position allows excellent view of the dural sac.

Keywords: operative approach; spinal cord decompression; three-quarter prone position