Choices and Decisions in Decompressive Surgery for Thoracolumbar Intervertebral Disk Herniation.

Once decompressive surgery has been elected, the approach that maximizes the likelihood of gaining access to the herniated material for complete removal should be chosen. In most cases, a procedure that optimizes access to the ventrolateral aspect of the spinal cord will be advantageous but it is important to tailor the details of the surgical procedure to suit individual patients. Decompressive surgery for chronic (type II) herniations will frequently demand a ventral approach with partial corpectomy.