1894

1894

1893-1895

Since the end of the nineteenth century, the wide dissemination of Pott's disease has ignited debates about which should be the ideal route to perform ventrolateral decompression of the dorsal rachis in case of paraplegia due to spinal cord compression in tuberculosis spondylitis. It was immediately clear that the optimal approach should be the one minimizing the surgical manipulation on both neural and extra-neural structures, while optimizing the exposure and surgical maneuverability on the target area. The first attempt was reported by Victor Auguste Menard in 1894 1) , who described, for the first time, a completely different route from traditional laminectomy, called costotransversectomy. The technique was conceived to drain tubercular paravertebral abscesses causing paraplegia without manipulating the spinal cord.

The procedure defined by Capener in 1954 2) resulted in better results for the treatment of spinal tuberculosis, due to the effect of antibiotics 3)


1)
Ménard V. Causes de la paraplégie dans le mal de Pott. Son traitement chirurgical par l’ouverture directe du foyer tuberculeux des vertebres. Rev Orthop 1894; 5: 47-64.
2)
CAPENER N. The evolution of lateral rhachotomy. J Bone Joint Surg Br. 1954 May;36-B(2):173-9. doi: 10.1302/0301-620X.36B2.173. PMID: 13163099.
3)
Benzel EC. Spine Surgery: Techniques, Complication Avoidance, and Management, 3th Ed. Saunders, Philadelphia 2012.
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