Extract
Video-assisted thoracoscopic surgery has become an accepted alternative
approach to the thoracic spine for release of disc space contents with or
without fusion. The technique can be used for anterior spinal release,
bone-grafting of the intervertebral space, biopsy, removal of benign tumors,
or insertion of
implants1-7.
Thoracoscopy involves surgical access to the spine through several small
incisions, each 1.0 to 2.5 cm in length. Through these incisions, a
muscle-splitting technique allows placement of soft or rigid trocars (ports)
through which instruments can be inserted. While this approach is being
utilized for release and instrumentation at a few centers, the technique has
not replaced traditional thoracotomy. Traditional thoracotomy requires a long
incision with extensive dissection of muscles. It involves rib resection with
substantial spreading of the intercostal spaces, and there is tissue
desiccation. There is also limited visibility of the cephalad vertebrae. In
addition, the extensive thoracotomy incision may alter pulmonary and shoulder
girdle function. The goal of endoscopic surgery is to perform the same
operations as the classic open procedures but with less invasive methods.