Costotransversectomy Video

The second Thoracic spine surgery I had was in 2001, called a Costotransversectomy, with discectomy and fusion.  At T-9/10, I had an anterolateral disc protrusion, causing severe upper back pain.  A highly respected and recommended spine surgeon in Arizona was doing a newer (at the time) anterior approach through endoscopy for cervical and thoracic spines.  I was excited at the thought of a few band-aid scars and the easier recovery from a spine surgery without the large paraspinal muscles being cut!

After reviewing my studies, he suggested that the surgeons go with a more traditional approach, and do open back surgery.  My Neurosurgeon chose Costotransversectomy, removing a piece of the rib (costectomy) the herniated disc material (corpectomy) and finishing with the hopeful added stability with a fusion of the T9/10 vertebrae.

Costovertebral articulations. Anterior view. (Photo credit: Wikipedia)

Costotransversectomy was first performed in 1894, by Dr. Menard.  In this surgery, the spine is accessed through an open back incision, the proximal rib that attaches to the thoracic vertebrae creating the Costovertebral joints, is cut so as to allow a clear view and room to work on disc, tumor, spur, etc.  The simple fact that the ribs are 'in the way' for many thoracic procedures, lends to the use of this approach, and also used for surgery on anterior or lateral herniations, osteophytes, etc.  The transverse process of the vertebrae is then cut, leaving a nice view and area to work.  This surgery can only be done in the thoracic spine.  

Costotransversectomy is a combination word, like most medical terminology.  Costo: ribs.  Transverse: the transverse process of the vertebrae.  Ectomy: the act of cutting out.  ('ectomy' is usually preceded by the name of what is to be cut out, i.e., Tonsillectomy- here it is the rib and transverse process).

I found a video of a Costo, and may I note here that I have nothing to do with the soundtrack.  Thank the rockin' surgeons at University of Southern California Neurosurgery !!

In this operation, the patient is having work done at the same level as my surgery: T9 to T11.  There is also work done on this patient above at T7.  It is the approach via Costotransversectomy that is exactly like mine,  showing the cutting and resection of the rib and transverse process to visualize the needed area, and it is always interesting for me to see what my spine has had done to it!  Also in this video the surgeons insert hardware, and I did not have any put in.  Although twelve years later I feel as if the hardware shown in this surgery may give some feeling of stability to my spine.

Note the cut paraspinal muscles and the retractors necessary.  Minimally invasive surgery now completely eliminates the need for this, lessening recovery time, and even post-surgical pain.

Enjoy!!    Those of you that can watch surgeries that is.  ;)


Gentle Hugs....