Anterior approaches for thoracolumbar metastatic spine tumors

Most spinal metastases involve the well-vascularized vertebral bodies rather than the posterior vertebral elements. In recent years, surgeons have become familiar with anterior approaches to the spine. Although no single approach is always applicable, anterior exposures provide several advantages, including (1) direct access to the diseased vertebral body for rapid tumor removal and complete epidural decompression, (2) improved hemostasis and wound healing, and (3) the ability to reconstruct the weight-bearing anterior spinal column effectively and apply short-segment fixation devices.