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FIGURE 37.25
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Minimally invasive lateral extracelomic approach. A, Diaphragm looking from caudal to cranial demonstrating blunt dissection with the aid of a finger to develop the extracelomic space (left). The diaphragm is retracted anteriorly once the costal and lumbar attachments have been mobilized (right). B, Cadaver specimen in the right lateral decubitus position (inset) demonstrating the view through the tubular retractor when placed in the extracelomic space.( A from NuVasive, Inc. B from Dakwar E, Ahmadian A, Uribe JS: The anatomical relationship of the diaphragm to the thoracolumbar junction during minimally invasive lateral extracelomic (retropleural/retroperitoneal) approach. Laboratory investigation, J Neurosurg Spine 16:359, 2012.) SEE TECHNIQUE 37.15.

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