Applied anatomy of extra-lateral minimally invasive approach at the level of T5 to T11 spine

Objective To provide anatomic basis for extra-lateral minimally invasive approach on T5 to T11 spinal level.Methods 12 adult cadavers were dissected to observe the course,distribution and adjacent relations of vessels and nerves around lateral T5 to T11 vertebral body.Results Vessels around T5-T11 passed through the lower part of corresponding vertebral body constantly,with the upper segmental veins,and lower segmental artery.Both sympathetic trunk of gave off the great splanchnic nerves at the level of T6-T9,and the small visceral nerves at the level of T10-T12.Azygos vein located at the right and anterior of T5 to T11 spine,and closed to the left side of the upper spine.Thoracic aorta travelled through the left and anterior of the spine,and turned to the right side gradually.The distance between the right sympathetic trunk and the azygos vein was wider compared to that between the left sympathetic trunk and the thoracic aorta.Conclusions Extra-lateral minimally invasive approach around T5-T11 thoracic spine is operable,however,vessels and nerves at the antero-lateral side of vertebral body have to be protected during the operation.