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The first 25 slides, exactly as they appear. The full deck has 40 content slides.
Neurosurgery
Lateral Extracavitary Approach
Built from Feldman — Neurosurgical Operative Atlas: Neuro-Oncology
What’s inside
6 sections · 40 slides
Overview
- First, what problem are we solving?
- Think of the vertebra as a three-part structure
How the approach came to be
Three surgical principles, evolving over centuries into one operation
- The three principles behind spinal tumor surgery
- The road to the lateral extracavitary approach
- Why choose LECA over a bigger operation?
- An honest balance sheet
Choosing the right patient
Who benefits, and what to check before operating
- Who is this operation for?
- Does the tumor type change the plan?
- Getting a tissue diagnosis first
- Handling a bloody tumor
The operation at a glance
Eight steps, the levels it suits, and how the room is set up
- The eight steps, in order
- Which spinal levels does it suit?
- Setting up the operating room
- Positioning the patient
Operative technique, step by step
From the incision to a rebuilt spinal column
- Incision and initial exposure
- Exposure and initial laminectomies
- Laminectomy: uncovering the cord and disk spaces
- Removing the posterior elements
- Costotransversectomy: opening the side door
- Exposing the lateral vertebral body
- Protecting the lung and controlling bleeding
- Pedicles, nerve roots, and temporary fixation
- Corpectomy: removing the vertebral body safely
- The contralateral transpedicular approach
- Reconstruction: rebuilding the column
- Reconstruction with an expandable cage
- Final fixation and closure
Aftercare and where LECA fits
Complications, a less-invasive alternative, and the bottom line
- Postoperative management and complications
- When less surgery is the smarter choice
- The bottom line
- During the corpectomy, why are the posterior longitudinal ligament and the back cortical wall of the vertebra removed LAST?
- Take-home messages
- References
- Neurosurgical Operative Atlas: Neuro-Oncology