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Journal of Bone and Joint Surgery, 1957;39:631-644.
© 1957 by The Journal of Bone and Joint Surgery, Inc

Surgical Approaches to the Vertebral Bodies in the Cervical and Lumbar Regions

WAYNE O. SOUTHWICK M.D.1 and ROBERT A. ROBINSON M.D.1

1 Department of Surgery, Division of Orthopaedic Surgery, The Johns Hopkins Hospital and The Johns Hopkins School of Medicine, Baltimore

Four surgical approaches to the vertebral bodies have been developed which, in conjunctions with costotransversectomy, allow surgical ascess to all portions of the bodies of the vertebral column.

The pharyngcal incision is used for the first and second cervical vertebrae. The anterior tervical approach is used for lesions from the third cervical to the first thoracie vertbra.

Costotransversectomy and lateral rachotomy are used for lesions of the first thoracie to the twelfth thoracic vertebra, inclusive. The anterolateral approach is used to gain access to the first to fifth lumbar vertebra and allows excellent visualization and treatment, particularly of extensive lesions. The posterolateral approach is less formidable and is sufficient for treatment of a small lumbar lesion.

In a period of over ten years, there has not been a death from the use of these surgical approaches, and serious complications have been avoided. Use of the approaches has been highsly effective not only in obtaining early positive diagnosis of vertebral lesions but also in their definitive treatment.


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