Ventral Slot and Fenestration

A ventral slot is a ventral surgical approach to the spinal canal through the vertebral body and disk. This technique is most commonly used to relieve compressive disk lesions. Ventral fenestration consists of incising the vertebral disks to remove the nucleus pulposus in an effort to decrease the risk of future compression at that site. Ventral slot procedures are performed almost exclusively in the cervical region. Although complications are rare, they may be severe and include hypotension, cardiac arrhythmias, and respiratory distress. This chapter covers hemorrhage, iatrogenic spinal injury, postoperative disk disease, diskospondylitis, recurrence and pain. Arguably, the most common complication of ventral slot surgery consists of venous sinus hemorrhage, which rarely requires blood transfusion but is often significant enough to impair visualization and occasionally prompt the surgeon to abort the procedure.