ABSTRACT
This chapter addresses key issues relevant to performing a thoracoscopic corpectomy for the treatment of fractures, tumors, and infections. The anterior approach to the thoracic and thoracolumbar spine is a well-established procedure for spinal cord decompression, vertebral body reconstruction, and stabilization via internal fixation for the treatment of trauma, tumor, infection, spondylosis, or deformity. While thoracoscopic approaches may prove effective for resection of vertebral body tumors, intradural tumors require open posterior or posterolateral procedures because closure of the dura is extremely difficult via thoracoscopy. Thoracoscopic surgery has been successfully used to perform discectomy for herniation, anterior release for spinal deformity, fusion, drainage of intervertebral disc space abscesses, and corpectomy. Thoracoscopic corpectomies are performed under general endotracheal anesthesia. Insufflation of carbon dioxide into the thorax is not necessary because sufficient visualization and exposure of the affected spine region and adequate surgical space is afforded by the fixed environment enclosed by the thoracic cavity and collapse and retraction of the ipsilateral lung.
