Excision of Posterior Half of Vertebral Bodies for the Decompression of Thoracic Myelopathy

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Anterior half of spinal canal of thoracic region can be exposed by wide resection of the rib and extrapleural anterior approach associated with the excision of posterior part of vertebral bodies. This paper reports typical thoracic myelopathy treated by this procedure for the purpose of the decompression.Case 1. 26 years old woman.Tuberculous Spondylitis of C6 to Th 4.Anterior approach to the cervical spine and costo-transversectomy to the upper thoracic spine (Th 2, 3, 4) was carried out to expose the affected vertebral bodies which compressed the spinal cord.The excision of the vertebral bodies and complete recovery of venous system.Case 2. 53 years old womanOssification of posterior longitudinal ligament and ligament Flavum in cervical, thoracic and lumbar region.Myelogram revealed complete block of contrast media in Th 6 to Th 9 level where the ossification of posterior longitudinal ligament was predominant. Excision of the rib of 15cm and extrapleural approach permitted the excision of posterior half of the bodies and the resection of ligament flavum.Case 3. 38 years old manMetastatic extradural tumor of the upper thoracic region.The extirpation of the tumor was insufficiently done by the posterior approach. On the second steps, anterior residural tumor was well exposed by anterior extrapleural approach with resection of the rib and excision of posterior half of the body.