Costotransversectomy- Spinal Surgery

Costotransversectomy: Definition, Uses, Benefits & Risks

From draining spinal abscess to removing tumors, costotransversectomy has numerous uses. Learn its benefits and risks.

What is Costotransversectomy?

Costotransversectomy is a surgical technique to approach limited areas of the thoracic spine. Surgeons use it to approach the spine from the side or back.

Over time, there have been many modifications in costotransversectomy. For example, extended, modified, or partial costotransversectomy. The choice of a particular technique depends on the condition for which it is being used.

During this procedure, a surgeon cuts the skin adjacent to the spine or along the spinal bone. Then, they remove a portion of the rib and a bone attached to the spine. This allows them to remove an abscess, tissues from the tumor, or release pressure on the spinal cord. 

Uses

Originally, costotransversectomy was used to drain an abscess in a patient with tuberculosis. However, its use has now expanded to several other conditions. These include:

• Removal of lesions or tumors from within the spine. Depending on the case, the tissue from the lesion or tumor may be tested under a microscope (biopsy).
• Rib pain
• Severe back pain due to compressed nerves in the spine
• Treatment of a hump
• Thoracic disc herniations
• Infection of the spine

Benefits

• Combining costotransversectomy with the anterior approach is effective in removing tumors.
• This is a preferred technique for patients who have multiple tumors in one thoracic vertebra.
• Likewise, this might be a less challenging option for people who have lesions in the upper thoracic region.

Risks

• Blood loss. Nevertheless, new drugs that prevent blood loss have significantly cut down the risk of blood loss.
• Damages to nerves close to the site of costotransversectomy
• Pain between rib cages
• Some patients may develop pneumonia or urinary tract infection after the surgery
• Pain and a lack of movement after the surgery may lead to a collapsed lung
• Instability of the rib cage

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Sources:

• Operative Techniques in Spine Surgery by John Rhee, Scott D. Boden. Wolters Kluwer Health.
• https://www.ncbi.nlm.nih.gov/pubmed/16203895
• https://www.sciencedirect.com/science/article/pii/S1048666606800455
• https://link.springer.com/chapter/10.1007/978-1-4684-0155-4_25

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