Prone lateral thoracolumbar corpectomy: Case series and technique description

Introduction: Thoracolumbar corpectomies are essential for managing anterior spinal column pathologies, including tumor, trauma, infection, and deformity. While traditional open approaches may cause significant morbidity, minimally invasive lateral retroperitoneal and retropleural techniques have reduced this burden and are associated with fewer complications. However, these approaches are typically performed in the lateral decubitus position, limiting posterior access and requiring patient repositioning. The adoption of prone positioning for lateral access enables single-position anterior and posterior column procedures, enhancing surgical efficiency and reducing morbidity. This case series describes a novel, dedicated prone lateral thoracolumbar corpectomy technique and presents four illustrative cases to highlight its procedural benefits and potential advantages over repurposed systems . Cases Description: Four cases are described in the present study involving different pathologies and thoracolumbar spine regions highlighting the flexibility of the procedure. Case one describes the treatment of a T12-L1 spondylodiscitis, while case 2 showcases the use of prone corpectomy to treat a T10-T12 failed instrumentation with fracture pseudarthrosis and kyphosis. Finally, both cases 3 and 4 describe the treatment of tumors, in the lumbar (L3) and thoracolumbar (T12) regions, respectively. Conclusion: The present case series reports four cases of prone lateral thoracolumbar corpectomy using a dedicated retractor system. This approach remains safe and effective in management of diverse spinal pathologies. The technique allows for robust anterior column reconstruction, control of alignment, and efficient single-position surgery avoiding repositioning. While early results are promising, larger studies are needed to validate its long-term outcomes and compare its benefits to traditional approaches.