The extreme lateral approach to the thoracic disc spaces produces mini
mum disruption of the normal spinal anatomy, avoids retraction of the
spinal cord, and preserves the intercostal neurovascular bundle. It is
achieved by removal of about 5 cm of the rib which has its insertion
at the disc level, if necessary associated with partial removal of the
transverse process, followed by partial pediculotomy and a limited la
teral rachotomy (vertebral body ressection), which permits the opening
of the spinal canal exclusively ventral to the intervertebral foramen
. The initial results of 6 patients, operated in up to four discs at t
he same occasion, are promising.