Surgical technique – anterior access route
In this operation the patient is positioned on the back or side. The intervertebral discs and the front parts of the spine are then accessed through a lateral incision from the chest or abdomen. Access is always from the side to which the spinal curvature is directed.
Then the intervertebral discs of the vertebral bodies to be operated on are removed in order to first achieve mobilization of the vertebral bodies. Bone material is then inserted between the vertebrae to achieve stiffening. Here, too, a screw-rod system is then inserted into the vertebral bodies to establish the correct position of the vertebral bodies in relation to each other.
This access route also requires the insertion of a thoracic drainage to drain the wound fluid from the thorax for a few days. A modern implant system for the anterior access route is the Halm- Zielke instrument set. An indication for this is, for example, a single-curve curvature of the thoracic spine or lumbar spine.
After the vertebral bodies to be operated on have been mobilized as described above, a flat bracket plate is inserted on the sides of the vertebral bodies and fixed in place with screws. Rods are then attached to this plate, allowing correction of the spinal section. This form of screw-rod system allows a three-dimensional correction of the spinal curvature. In addition, due to the high stability of this system, a subsequent corset treatment is not necessary.
Results
As a rule, a cosmetically and functionally better result is achieved with the anterior access route. However, an access route from the back can usually avoid the need for post-treatment in a corset. Without an additional back hump correction the cosmetic results are often rather unfavorable.
