anterior approach

Thoraco Lumbar Fracture

Xray Assessment

 

A:  Alignment

B:  Bony

C:  Canal

D:  Disc

S:  Soft tissues

 

Goals of surgery

 

1.  Correct deformity

2.  Restore stability

3.  Decompress neural elements if required

 

MRI

 

Advantage

- defines level of conus

- may need anterior rather than posterior surgery if lesion above conus

Smith Robinson Approach

Via the carotid triangle

 

SCM / posterior belly digastric / superior belly omohyoid

 

Indication

 

Exposes inferior body C2 - T1

 

Position

 

1.  Supine in tongs

2.  Sit on head board with head taped and slightly extended

 

Table 30° up

Turn head away from side of incision

 

Which Side