scholarly journals Full-Endoscopic Transforaminal Ventral Decompression for Symptomatic Thoracic Disc Herniation with or without Calcification: Technical Notes and Case Series

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Shangju Gao ◽  
Jingchao Wei ◽  
Wenyi Li ◽  
Long Zhang ◽  
Can Cao ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Clinical Outcomes ◽  
Disc Herniation ◽  
Average Length ◽  
Case Series ◽  
Operation Time ◽  
Leg Pain ◽  
Thoracic Disc Herniation ◽  
Open Operation ◽  
Thoracic Disc

Background. Symptomatic thoracic disc herniation is a challenge in spinal surgery, especially for cases with calcification. Traditional open operation has a high complication rate. The authors introduced a modified full-endoscopic transforaminal ventral decompression technique in this study and evaluated its imaging and clinical outcomes. Materials and Methods. Eleven patients with symptomatic thoracic disc herniation who underwent full-endoscopic transforaminal ventral decompression in a single medical center were enrolled. The surgical technique was performed as described in detail. Dilator sliding punching, endoscope-monitored foraminoplasty, and base cutting through the “safe triangle zone” are the key points of the technique. Clinical outcomes were assessed by the modified Japanese Orthopedic Association (mJOA) score for neurological improvement and the visual analogy score (VAS) for thoracic and leg pain. The operation time, hospital stay, and complications were also analyzed. Results. Postoperative magnetic resonance imaging (MRI) revealed good decompression of the spinal cord. The mJOA improved from 7.4 (range: 5–10) to 10.2 (range: 9–11). Axial thoracic pain improved in 8 of 9 patients. Leg pain and thoracic radicular pain improved in all patients. No complications were observed. The average operation time was 136 minutes (range: 70–180 minutes). The average length of hospital stay was 5.3 days (range: 2–8 days). Conclusion. Minimally invasive full-endoscopic transforaminal ventral decompression for the treatment of symptomatic thoracic disc herniation with or without calcification is feasible and may be another option for this challenging spine disease.

scholarly journals Posterior Minimally Invasive Transpedicular Approach for Giant Calcified Thoracic Disc Herniation

2020 ◽  
pp. 219256822093327 ◽  
Author(s):  
Daniel Shedid ◽  
Zhi Wang ◽  
Ahmad Najjar ◽  
Sung-Joo Yuh ◽  
Ghassan Boubez ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Disc Herniation ◽  
Case Series ◽  
Thoracic Disc Herniation ◽  
Retrospective Case ◽  
Tubular Retractor ◽  
Posterior Surgery ◽  
Transpedicular Approach ◽  
Dural Tears ◽  
Thoracic Disc

Study Design: Retrospective case series. Objective: Posterior surgery for thoracic disc herniation was associated with increased morbidity and mortality and new minimally invasive approaches have been recommended for soft disc herniation but not for calcified central disc. The objective of this study is to describe a posterolateral microscopic transpedicular approach for central thoracic disc herniation. Methods: This is a single center retrospective review of all the cases of giant thoracic calcified disc herniation as defined by Hott et al. Presence of myelopathy, percentage of canal compromise, T2 hypersignal, ASIA score, and ambulatory status were recorded. This posterolateral technique using a tubular retractor was thoroughly described. Results: Eight patients were operated upon with a mean follow-up of 16 months. Mean canal compromise was 61%. Mean operative time was 228 minutes and mean operative bleeding was 250 mL. There were no cases of dural tear or neurologic degradation. Conclusion: This is the first report of posterior minimally invasive transpedicular approach for giant calcified disc herniation. There were neither cases of neurological deterioration nor increased rate of dural tears. This technique is thus safe and could be recommended for treatment of this rare disease.

Management of Thoracic Disc Herniation Using the Mini-Open Retropleural Approach: Technique Illustration and Clinical Outcomes of 33 Patients From a Single Academic Center

Neurosurgery ◽  
2021 ◽  
Vol 89 (Supplement_2) ◽  
pp. S154-S154
Author(s):  
Mohammad Hassan A Noureldine ◽  
Elliot Pressman ◽  
Paul R Krafft ◽  
Marek Molcanyi ◽  
Nam D Tran ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Disc Herniation ◽  
Thoracic Disc Herniation ◽  
Academic Center ◽  
Thoracic Disc ◽  
Mini Open

scholarly journals Atypical Presentation of Thoracic Disc Herniation: Case Series and Review of the Literature

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Ali Shirzadi ◽  
Doniel Drazin ◽  
Sunil Jeswani ◽  
Leah Lovely ◽  
John Liu
Keyword(s):  
Disc Herniation ◽  
Case Series ◽  
Thoracic Disc Herniation ◽  
Lower Extremity Weakness ◽  
Delay In Diagnosis ◽  
Burning Pain ◽  
Presenting Symptoms ◽  
Asymptomatic Patients ◽  
Patient Reported ◽  
Thoracic Disc

Modern imaging has revealed that thoracic disc herniation (TDH) has a prevalence of 11–37% in asymptomatic patients. Pain, sensory disturbances, myelopathy, and lower extremity weakness are the most common presenting symptoms, but other atypical extraspinal complaints, such as gastrointestinal or cardiopulmonary discomfort, may be reported. Our objective is to make providers familiar with TDH’s atypical symptoms to help avoid potential serious consequences created by a delay in diagnosis. We report the cases of two patients who each presented with atypical extraspinal symptoms secondary to a TDH. One patient presented with a chronic history of nausea, emesis, and chest tightness and MRI showed a large right paramedian disc herniation at T7-8. A second patient reported chronic constipation, buttock and leg burning pain, gait instability, and urinary frequency; an MRI of his thoracic spine demonstrated a central disc herniation at T10-11. TDH can present with vague extraspinal symptoms and unfamiliarity with these symptoms can lead to misdiagnosis with progression of the disease and unnecessary diagnostic tests and medical procedures. Therefore, TDH should be included in the differential diagnosis of patients with negative gastrointestinal, genitourinary, and cardiopulmonary system basic studies.

scholarly journals The effect of two surgical approach Lordosis correction in degenerative lumbar diseases: minimally invasive oblique lumbar interbody fusion (OLIF) versus transforminal lumbar interbody fusion (TLIF)

2020 ◽  
Author(s):  
Renjie Li ◽  
Xiaofeng Shao ◽  
Weimin Jiang
Keyword(s):  
Hospital Stay ◽  
Clinical Outcomes ◽  
Interbody Fusion ◽  
Operation Time ◽  
Bed Rest ◽  
Leg Pain ◽  
Lumbar Interbody Fusion ◽  
Significant Difference ◽  
Vas Scores ◽  
Oblique Lumbar Interbody Fusion

Abstract Background: The present study aimed to compare clinical outcomes and radiographic results of oblique lumbar interbody fusion (OLIF) with transforaminal lumbar interbody fusion (TLIF) in patients with lumbar spondylolisthesis.Methods: We retrospectively reviewed and compared 28 patients who underwent OLIF (OLIF group) and 35 who underwent TLIF (TLIF group). The operation time, intraoperative hemorrhage, bed rest duration, and length of hospital stay were compared between the 2 groups. Clinical results were evaluated with the ODI and VAS for back and leg pain. Radiological results were evaluated with disc height (DH), foraminal height (FH), fused segment lordosis (FSL) and lumbar lordosis (LL).Results: The OLIF group had less intraoperative blood loss, shorter operative time, bed rest time, and hospital stay than TLIF group (P<0.05). The OLIF group had lower VAS scores for back pain and lower VAS scores for leg pain after surgery compared with before surgery (P<0.05), The OLIF group had lower ODI after surgery compared with before surgery (P<0.05). The was no significant difference in decrease value in VAS and ODI after surgery between the two groups (P>0.05). No significant differences were found in DH, FH and LL between the 2 groups preoperatively (P>0.05). The OLIF group showed higher DH and FH than the TLIF group at all time points (P<0.05). No significant differences were found in FSH between the 2 groups at any time point.Conclusions: OLIF has similar good long-term clinical outcomes of TLIF with the additional benefits of less initial postoperative pain, early rehabilitation, shorter hospitalization, and fewer complications.

scholarly journals Microscopic extra-laminar sequestrectomy (MELS) for the treatment of hidden zone lumbar disc herniation: report of the surgical technique, patient selection, and clinical outcomes

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chunxiao Wang ◽  
Yao Zhang ◽  
Xiaojie Tang ◽  
Haifei Cao ◽  
Qinyong Song ◽  
...  
Keyword(s):  
Blood Loss ◽  
Learning Curve ◽  
Clinical Outcomes ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Operation Time ◽  
Operation Duration ◽  
The Mean

Abstract Background The area which located at the medial pedicle, posterior vertebral body and ventral hemilamina is defined as the hidden zone. Surgical management of hidden zone lumbar disc herniation (HZLDH) is technically challenging due to its difficult surgical exposure. The conventional interlaminar approach harbors the potential risk of post-surgical instability, while other approaches consist of complicated procedures with a steep learning curve and prolonged operation time. Objective To introduce microscopic extra-laminar sequestrectomy (MELS) technique for treatment of hidden zone lumbar disc herniation and present clinical outcomes. Methods Between Jan 2016 to Jan 2018, twenty one patients (13 males) with HZLDH were enrolled in this study. All patients underwent MELS (19 patients underwent sequestrectomy only, 2 patients underwent an additional inferior discectomy). The nerve root and fragment were visually exposed using MELS. The operation duration, blood loss, intra- and postoperative complications, and recurrences were recorded. The Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and the modified MacNab criteria were used to evaluate clinical outcomes. Postoperative stability was evaluated both radiologically and clinically. Results The mean follow-up period was 20.95 ± 2.09 (18–24) months. The mean operation time was 32.43 ± 7.19 min and the mean blood loss was 25.52 ± 5.37 ml. All patients showed complete neurological symptom relief after surgery. The VAS and ODI score were significantly improved at the final follow-up compared to those before operation (7.88 ± 0.70 vs 0.10 ± 0.30, 59.24 ± 10.83 vs 11.29 ± 3.59, respectively, p < 0.05). Seventeen patients (81%) obtained an “excellent” outcome and the remaining four (19%) patients obtained a “good” outcome based the MacNab criteria. One patient suffered reherniation at the same level one year after the initial surgery and underwent a transforaminal endoscopic discectomy. No major complications and postoperative instability were observed. Conclusions Our observation suggest that MELS is safe and effective in the management of HZLDH. Due to its relative simplicity, it comprises a flat surgical learning curve and shorter operation duration, and overall results in reduced disturbance to lumbar stability.

Transforaminal Endoscopic Foraminoplasty and Discectomy for the Treatment of a Thoracic Disc Herniation

2016 ◽  
Vol 90 ◽  
pp. 194-198 ◽  
Author(s):  
Ralf Wagner ◽  
Albert E. Telfeian ◽  
Menno Iprenburg ◽  
Guntram Krzok ◽  
Ziya Gokaslan ◽  
...  
Keyword(s):  
Disc Herniation ◽  
Thoracic Disc Herniation ◽  
Thoracic Disc

scholarly journals Surgical treatment of thoracic disc herniation using the anterior approach

1982 ◽  
Vol 64-B (3) ◽  
pp. 340-343 ◽  
Author(s):  
K Otani ◽  
S Nakai ◽  
Y Fujimura ◽  
S Manzoku ◽  
K Shibasaki
Keyword(s):  
Surgical Treatment ◽  
Disc Herniation ◽  
Anterior Approach ◽  
Thoracic Disc Herniation ◽  
Thoracic Disc

scholarly journals Clinical Outcomes of TESSYS and TESSYS-ISEE Approach on Treatment of Lateral Recess Stenosis: A Comparison Study

2020 ◽  
Author(s):  
Boyu Wu ◽  
Chengjie Xiong ◽  
Biwang Huang ◽  
Dongdong Zhao ◽  
Zhipeng Yao ◽  
...  
Keyword(s):  
Radiation Exposure ◽  
Pain Score ◽  
Clinical Outcomes ◽  
Operation Time ◽  
The Elderly ◽  
Leg Pain ◽  
Lateral Recess ◽  
Lumbar Decompression ◽  
Lateral Recess Stenosis ◽  
Short Period

Abstract Background: Lateral recess stenosis (LRS) is a common degenerative disease in the elderly. Since the rise of comorbidity is associated with the increasing age, the percutaneous endoscopic lumbar decompression is advocated. The objective of this study was to compare the clinical outcomes of percutaneous endoscopic lumbar decompression in LRS via TESSYS or TESSYS-ISEE approach. Methods: A total of 45 and 42 consecutive patients with limp or radiculopathy symptoms underwent percutaneous endoscopic lumbar decompression using transforaminal endoscopic spine system (TESSYS) and TESSYS-ISEE, respectively. The radiation exposure and operation time, time to return to work, and complications were compared between two groups. Their clinical outcomes were evaluated with visual analogue scale (VAS) leg pain score, VAS back pain score, Oswestry Disability Index (ODI) and Modified MacNab’s criteria. Results: The average values of radiation exposure and operative time in TESSYS group were significantly higher than those in TESSYS-ISEE group (P<0.05). The postoperative VAS and ODI scores in both groups were significantly improved compared with before the operation (P<0.05). In addition, the VAS score of the leg and ODI score in the TESSYS-ISEE group were significantly lower than those in TESSYS group at 1 week follow-up (P<0.05). The good-to-excellent rates of the TESSYS and TESSYS-ISEE group were 88.89 and 90.48%, respectively, whereas the complication occurrence rates were 6.67 and 4.76% in TESSYS and TESSYS-ISEE groups, respectively. Conclusions: TESSYS-ISEE can be applied to treat LRS safely and effectively with short radiation exposure and operation time. This approach was comparable to the TESSYS approach with improved VAS leg pain and ODI score in short period after operation. However, potential complications and risks still needs to be considered.

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