ABSTRACT
The advantages of endoscopic surgery include reduced operative pain, excellent cosmetic effect, lower perioperative morbidity, and an earlier return to work. Innovative techniques, from the use of the operating microscope to image guidance, have changed our approach to problems within the operating room. Endoscopic techniques can be used for anterior decompression, reconstruction, and instrumentation of the entire thoracic spine and thoracolumbar junction (TLJ). However, they cannot be performed in patients with restricted cardiopulmonary function, acute post-traumatic lung failure, severe pleural adhesions, and severe medical instability. The screw-guiding sleeve for the anterior stabilization screw has to be attached to the polyaxial clamp. To do so, insert the insertion sleeve with handle and the hex key for the centralizer to the hexagonal end of the guiding instrument. Thoracoscopic transdiaphragmatic approach provides excellent access to the entire TLJ, thus permitting a safe and effective spinal decompression, reconstruction, and instrumentation.
