Expandable cage placement via a posterolateral approach in lumbar spine reconstructions

Abstract

The authors describe a technique for inserting an expandable cage via a posterior extracavitary approach while protecting the segmental nerves. The advent of expandable cages has allowed the use of a less invasive anterior access to the spine, thereby decreasing the surgery-induced insult to the patient. In an attempt to minimize this trauma, the authors have used a posterolateral approach that has allowed them to perform neural decompression, anterior reconstruction with an expandable cage, and posterior stabilization with posterior pedicle screws. The authors describe their surgical technique of posterior circumferential decompression, which entails the use of an expandable cage that is inserted at 90 degrees, rotated in place where the corpectomy has been performed, and then expanded with special custom-made tools, thus respecting the segmental nerves of the lumbar spine. One case example is provided to illustrate the technique.