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Research ArticleFocus Issue Article

Management of Thoracic Disc Pathology via the Lateral Approach: Advances Using the Minimally Invasive Approach and Navigation

Saman Shabani, Praveen V. Mummaneni, Andrew Chan, Jeremy Huang, Nitin Agarwal, Vedat Deviran and Dean Chou
International Journal of Spine Surgery April 2022, 16 (S1) S44-S52; DOI: https://doi.org/10.14444/8235
Saman Shabani
1 Department of Neurological Surgery, University of California, San Francisco, CA, USA
MD
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Praveen V. Mummaneni
1 Department of Neurological Surgery, University of California, San Francisco, CA, USA
MD, MBA
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Andrew Chan
1 Department of Neurological Surgery, University of California, San Francisco, CA, USA
MD
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Jeremy Huang
1 Department of Neurological Surgery, University of California, San Francisco, CA, USA
BS
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Nitin Agarwal
1 Department of Neurological Surgery, University of California, San Francisco, CA, USA
MD
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Vedat Deviran
2 Department of Orthopedic Surgery, University of California, San Francisco, CA, USA
MD
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Dean Chou
1 Department of Neurological Surgery, University of California, San Francisco, CA, USA
MD
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Figures

  • Figure 1
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    Figure 1

    Using navigation, the correct level and the overlying rib that needs to be resected in order to obtain the ideal trajectory are identified. This localization allows for precise incision planning in setting of minimally invasive surgery.

  • Figure 2
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    Figure 2

    The reference arc is placed in the iliac crest to allow for registration navigation system.

  • Figure 3
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    Figure 3

    The correct rib is identified and dissected via electrocautery. A short segment of rib is resected to allow for easier retropleural dissection.

  • Figure 4
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    Figure 4

    After rib resection, the retropleural space is identified, and the dorsal aspect of the rib is followed to reach to the spine.

  • Figure 5
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    Figure 5

    The appropriate disc space is identified, and the level is verified with navigation.

  • Figure 6
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    Figure 6

    The minimally invasive retractors are placed to retract the pleura and allow for disc removal in the standard fashion.

  • Figure 7
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    Figure 7

    A preoperative T2-weighted magnetic resonance imaging showing a large paracentral disc protrusion at T9-10 with cord indentation.

  • Figure 8
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    Figure 8

    A postoperative T2-weighted magnetic resonance imaging (MRI) with sagittal (A) and axial views (B) showing decompression of the spinal cord after disc excision and a T1-weighted MRI (C+D) showing the T10 rib head resection and left-sided T10 pediculectomy.

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In this issue

International Journal of Spine Surgery: 16 (S1)
International Journal of Spine Surgery
Vol. 16, Issue S1
1 Apr 2022
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Management of Thoracic Disc Pathology via the Lateral Approach: Advances Using the Minimally Invasive Approach and Navigation
Saman Shabani, Praveen V. Mummaneni, Andrew Chan, Jeremy Huang, Nitin Agarwal, Vedat Deviran, Dean Chou
International Journal of Spine Surgery Apr 2022, 16 (S1) S44-S52; DOI: 10.14444/8235

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Management of Thoracic Disc Pathology via the Lateral Approach: Advances Using the Minimally Invasive Approach and Navigation
Saman Shabani, Praveen V. Mummaneni, Andrew Chan, Jeremy Huang, Nitin Agarwal, Vedat Deviran, Dean Chou
International Journal of Spine Surgery Apr 2022, 16 (S1) S44-S52; DOI: 10.14444/8235
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  • Article
    • Abstract
    • INTRODUCTION
    • HISTORY AND DEVELOPMENT
    • ADVANCES AND MODERN OUTCOMES
    • TECHNIQUE
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More in this TOC Section

  • The Future of Arthroplasty in the Spine
  • Implant Surface Technologies to Promote Spinal Fusion: A Narrative Review
  • Fundamentals of Mechanobiology and Potential Applications in Spinal Fusion
Show more Focus Issue Article

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Keywords

  • thoracic disc
  • lateral surgery
  • retropleural approach
  • minimally invasive surgery
  • lateral
  • thoracic fusion
  • lateral thoracic discectomy

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