Current accepted approaches include posterolateral costotransversectomy, (58) posterior transpedicular, (59) lateral extracavitary, (60) transthoracic, (61) and video-assisted thorascopic (VATS).
Re-evaluation of the posterior approach using a modified costotransversectomy. Spine (Phila Pa 1976).
Most of the dumbbell spinal hemangiomas described in the literature were resected using a posterior microsurgical approach with laminectomy or hemilaminectomy, and with or without facetectomy and costotransversectomy (Table 1).
For these reasons, several authors have hypothesized that segmental stability may be less compromised with a combined approach than with a purely posterior approach coupled with costotransversectomy (11,29).
Single-stage removal of thoracic dumbbell tumors from a posterior approach only with costotransversectomy. Yonsei Med J.
Most of these cases were treated through a transpedicular approach or costotransversectomy. Selected tumors showing anterior intrathoracic extension and proximity to vital vessels (aorta and/or vena cava) were treated with a lateral extracavitary approach or a combined posterior and transthoracic approach.
Dumbbell neurinomas of the thoracic tract were treated in 7 cases with a transpeduncular approach and in 4 cases with a costotransversectomy. A single patient with a giant schwannoma located near the aorta required a combined posterior and transthoracic approach.
He underwent decompression laminectomy and left costotransversectomy
, T10-T11, with T8 to L3 segmental instrumentation and posterior fusion with fluoroscopic navigation.
Mimbs, "Imaging-guided costotransversectomy
for thoracic disc herniation," Neurosurgical Focus, vol.