الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Introduction: The thoracic spine is distinct in that it has varying anatomy between its proximal and caudal extent. It is this variability that makes thoracic surgery complex and requires thorough preoperative planning and evaluation of the patient’s bony anatomy. Despite different techniques there are general principles which have to be considered. Only with preoperative planning, the (educational) elaboration of a surgical strategy, the thorough knowledge of the patient’s individual anatomy, the respect of the anatomy, properties, and function of tissues, and the well-trained use of modern surgical high-tech equipment will there be an improvement in peri- and postoperative morbidity and clinical results for our patients. Surgical approaches to the thoracic spine can be divided into open and minimally invasive surgical procedures. In the past, laminectomy was the most widely used operations for lesions in the thoracic spine, despite the fact that, choice of the approach must be dictated by the site of primary pathology. Anterior approaches through the thorax, abdomen, or flank are best used for pathology involving the vertebral bodies, whereas pathology involving the posterior elements is best approached posteriorly through a vertical midline approach. Posterolateral structures may be approached through a midline posterior approach or a posterolateral muscle-splitting approach. Approaches should be planned so that they can be extended if necessary at the time of surgery. Aim of work: The general hypothesis of this essay is to evaluate the different approaches and techniques to the non traumatic thoracic spine lesions, To achieve excellent clinical results with acceptable rates of morbidity. Conclusions: The method of any surgical approach to any one of the thoracic spine lesions depends on the exact type of surgery proposed. Is the surgery to remove a small pathological structure or a large one? Is it to replace a pathological structure? Is there instrumentation with metal or bone replacement? Often the type of surgery is determined by the severity of the pathological process and the experience of the surgeon in dealing with the difficulty of the lesion