EXTRACOELOMIC APPROACH TO THE SPINE

A modified transthoracic approach to the thoracic vertebral column is described. In this method, the parietal pleura is detached from the ch est wall and retracted with the visceral pleura and its contents. A di rect approach to the vertebral bodies is thus achieved without transgr ession of the intrapleural space. The technique can be extended to inc lude exposure of the thoracolumbar spinal column, utilising a thoracoa bdominal approach with extrapleural and extraperitoneal dissection. Ma nagement of the costophrenic detachment is thus simplified. This appro ach has significant advantages for orthopaedic, vascular and neurosurg ical procedures.