Anterior approaches to the spine – Booklet

Anterior Approaches to the Spine

Sharing the booklet on anterior approaches to the spine created for the Live Procine and Cadaveric Workshop conducted on 16th Feb 2020 as a part of Asia Pacific Spine Society’s live surgery course held in Mumbai.

The images in the document are taken from various textbooks and articles and I do not own copyright on these images. They are selected here in this booklet for their quality and clarity.

I would recommend the following books for further reading if you do like the images in this booklet.

Atlas of Spine Operations by Robert Winter

Surgical Anatomy and Techniques to the Spine by Daniel Kim

Spine Surgery: Tricks of the Trade

Atlas of Spinal Operations by Rudolf Bauer

Review Article: Metastasis

Here is a good review article from the “yellow journal” on metastasis to the spine!

Rose, P., Buchowski, J. (2011). Metastatic Disease in the Thoracic and Lumbar Spine American Academy of Orthopaedic Surgeon 19(1), 37-48.

Download PDF from the website

As a complement to this article, I found a good video lecture on this topic by Dr.  Laurence Rhinnes from MD Anderson.

Spinal metastasis – evaluation and treatment

The spine is one of the most common site for metastasis. Effective management of spinal metastasis requires a logical and systematic approach.

Dr. Laurence D. Rhines, MD is the Professor of Neurosurgery at The University of Texas MD Anderson Cancer Center, Houston, USA.

In his excellent and lucid talk given at the Seattle Science Foundation, Dr. Rhines puts forth four questions to ask ourselves when dealing with spinal metastasis.

1) Is the patient medically fit to undergo a procedure?
2) What is the clinical presentation?
3) What is the pathology (histology)?
4) Do you have a feasible surgical plan?

For more details, please watch the following lecture.

En Bloc Resection for Primary Spinal Tumors

Metastatic lesions account for majority spinal tumors. Primary spinal malignancies are rare, however, surgery in these tumours can be curative if performed with an en bloc technique. Intralesional excision of primary spinal tumor such as chordoma is associated with a 100% recurrence rate. Hence, it is important to know the histological diagnosis before embarking on surgical treatment for any spinal tumor. A surgeon will get only one chance to offer curative surgery in primary spinal malignancy and biopsy is extremely important to different such malignancies from the more common metastatic lesions.

Following is an excellent talk from the Seattle Science Foundation by Dr. Ehud Mendel, Professor of Neurosurgery at Ohio State University, Columbus, OH, on considerations for En Bloc resection for primary spinal tumors.