Why is a thoracotomy approach popular for diskectomies in the thoracic region?

Because of the small diameter of the thoracic spinal canal.

What is an alternative approach to a thoracotomy for a diskectomy in the thoracic region?

Removal of the medial segment of rib and transverse process to expose the intervertebral disk.

For the procedures with the rib approach, what is done with the rib?

It is often used as autograft bone material and is packed into the disk space after the disk and cartilage plates have been removed  and the vertebral bodies have been curetted.

What approach may be utilized for the placement of rods and screws?

Anterior/Posterior Thoracic

What is the positioning of the patient for the anterior/posterior thoracic approach?

Patient is first placed in lateral thoracic position for the anterior approach, and then after the anterior wound is closed, the patient is put on the wilson frame in prone position. 

T/F

A Thoracic surgeon assists during an anterior thoracic approach to expose the vertebral bodies

True

T/F

A Thoracic surgeon assists during an anterior thoracic approach to expose the vertebral bodies

True

What is done during the anterior thoracic portion?

Screws and rods or fusion material is placed or secured, and the wound is closed to move to posterior.

T/F

There is no need to re-prep and drape the patient for the posterior portion.

'

False

What may be needed to deflate the lung during this procedure?

Double-Lumen ET Tube

If the procedure is a level T1-T5 will we do a left or right side approach?

Right Side Approach

If the procedure is a level T5-T12 will we have a left or right side approach?

Left Side

What is done intra-operatively to verify the correct level?

Localization X-Ray

T/F

Chest tube placement is required after this procedure.

True

T/F

The patient has risk for complications of any thoracic procedure as well as any diskectomy, fusion, or decompression.

True

Prognosis?

No Complications: 3-4 days in the hospital. Physical Therapy started immediately with walking. 

Wound Classification?

Class II: Clean Contaminated