Transaxillary left-sided minimally invasive approach for upper thoracic vertebral resection and reconstruction at T2–T3 levels: a case report

Surgical procedures of the upper thoracic spine are often challenging due to the anatomical topography of the thoracic spine. The most common approaches include the anterior supramanubrial, transmanubrial, and transsternal as well as the posterior approach with costotransversectomy. Recently, an infraaxillary right-sided thoracotomy was described for upper thoracic vertebral decompression and fusion at T2–T6 levels. In the current case, we report a transaxillary left-sided mini-thoracotomy for thoracic vertebral resection and reconstruction at T2–T3 levels. The incision enabled safe and uncomplicated surgery of the upper thoracic spine providing excellent exposure of the surgical site. Compared with the common incisions applied for surgery of the upper thoracic spine, surgical trauma is minimized without the need of sternotomy, division of the back muscles or resecting a rib. Moreover, anatomical critical structures such as the common carotid trunk, the jugular vein, or trachea are not encountered, hence increasing the safety of the procedure.