Approaches and Surgical Techniques for Costovertebral Sulcus Pathology

Tumors in the costovertebral sulcus mostly originate from the nervous vegetative system of the posterior mediastinum. The posterior mediastinum comprises the sympathetic chains, paravertebral ganglion, intercostal nerve, phrenic nerve, vagus nerve, and thoracic vertebrae with the posterior part of the ribs. Standard treatment of these tumors in the costovertebral sulcus is surgical resection. To obtain an optimal approach for curative resection, comprehension of pathologic characteristics and anatomic structures is essential. With developments in surgical instruments and skills, minimally invasive approaches and techniques for costovertebral pathology have been introduced with improved outcomes.