Moskovich R, Benson D, Zhang Z H, Kabins M
Hospital for Joint Diseases Orthopaedic Institute, New York, NY 10003.
J Bone Joint Surg Br. 1993 Nov;75(6):886-93. doi: 10.1302/0301-620X.75B6.8245077.
A modified transthoracic approach to the thoracic vertebral column is described. In this method, the parietal pleura is detached from the chest wall and retracted with the visceral pleura and its contents. A direct approach to the vertebral bodies is thus achieved without transgression of the intrapleural space. The technique can be extended to include exposure of the thoracolumbar spinal column, utilising a thoracoabdominal approach with extrapleural and extraperitoneal dissection. Management of the costophrenic detachment is thus simplified. This approach has significant advantages for orthopaedic, vascular and neurosurgical procedures.
本文描述了一种改良的经胸入路至胸椎椎体柱的方法。在该方法中，壁层胸膜从胸壁分离，并与脏层胸膜及其内容物一起牵开。从而实现了直接进入椎体而不侵犯胸膜腔内空间。该技术可扩展至包括胸腰段脊柱的显露，采用经胸腹部入路并进行胸膜外和腹膜外解剖。因此，肋膈角分离的处理得到简化。该入路在骨科、血管外科和神经外科手术中具有显著优势。
