scholarly journals THORACIC DISC HERNIATION: SURGICAL DECOMPRESSION BY POSTERIOR APPROACH A LA CARTE

2016 ◽  
Vol 15 (3) ◽  
pp. 213-218 ◽  
Author(s):  
MURILO TAVARES DAHER ◽  
PEDRO FELISBINO JUNIOR ◽  
ADRIANO PASSÁGLIA ESPERIDIÃO ◽  
BRENDA CRISTINA RIBEIRO ARAÚJO ◽  
ANDRÉ LUIZ PASSOS CARDOSO ◽  
...  
Keyword(s):  
Disc Herniation ◽  
Posterior Approach ◽  
Surgical Decompression ◽  
Thoracic Disc Herniation ◽  
Transpedicular Approach ◽  
Partial Body ◽  
The Mean ◽  
Thoracic Disc ◽  
A La Carte

ABSTRACT Objectives: To present the clinical and radiographic results of patients with thoracic disc herniation treated by the posterior approach, according to location and type of hernia (à la carte). Methods: We evaluated thirteen patients (14 hernias) treated by the posterior approach. Eight (61.5%) patients were male and the mean age was 53 years (34-81). Clinical evaluation was performed by the Frankel and JOA modified scales. All the patients underwent the posterior approach, which was performed by facetectomy, transpedicular approach, transpedicular + partial body resection, costotransversectomy or costotransversectomy + reconstruction with CAGE. Results: The mean follow-up was 2 years and 6 months (11-77 months). Of the 14 operated hernias, six (43%) were lateral, 2 (14%) paramedian, and 6 (43%) central. Seven were soft (50%) and seven were calcified. The transfacet approach was carried out in 5 cases (36%), transpedicular in 1 case (7%), transpedicular + partial body resection in 4 (29%), costotransversectomy in 3 (21%), and costotransversectomy + CAGE in one case (7%). The majority of patients with lateral hernia (5/6) were subjected to transfacet decompression and in cases of central and paramedian hernias, all patients underwent decompression, which is more extensive. Conclusions: The posterior approach is safe and effective, and the best approach must be chosen based on location and type of the herniation and the surgeon's experience.

scholarly journals Endoscopic Transforaminal Thoracic Foraminotomy and Discectomy for the Treatment of Thoracic Disc Herniation

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Hong-Fei Nie ◽  
Kai-Xuan Liu
Keyword(s):  
Disc Herniation ◽  
Surgical Approaches ◽  
Invasive Technique ◽  
Complication Rates ◽  
Thoracic Disc Herniation ◽  
Blood Patch ◽  
The Mean ◽  
Thoracic Disc ◽  
Rib Head

Thoracic disc herniation is a relatively rare yet challenging-to-diagnose condition. Currently there is no universally accepted optimal surgical treatment for symptomatic thoracic disc herniation. Previously reported surgical approaches are often associated with high complication rates. Here we describe our minimally invasive technique of removing thoracic disc herniation, and report the primary results of a series of cases. Between January 2009 and March 2012, 13 patients with symptomatic thoracic disc herniation were treated with endoscopic thoracic foraminotomy and discectomy under local anesthesia. A bone shaver was used to undercut the facet and rib head for foraminotomy. Discectomy was achieved by using grasper, radiofrequency, and the Holmium-YAG laser. We analyzed the clinical outcomes of the patients using the visual analogue scale (VAS), MacNab classification, and Oswestry disability index (ODI). At the final follow up (mean: 17 months; range: 6–41 months), patient self-reported satisfactory rate was 76.9%. The mean VAS for mid back pain was improved from 9.1 to 4.2, and the mean ODI was improved from 61.0 to 43.8. One complication of postoperative spinal headache occurred during the surgery and the patient was successfully treated with epidural blood patch. No other complications were observed or reported during and after the surgery.

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.

Thoracic Disc Herniation: Operative Approaches and Results

Neurosurgery ◽  
1983 ◽  
Vol 12 (3) ◽  
pp. 303-305 ◽  
Author(s):  
Laligam N. Sekhar ◽  
Peter J. Jannetta
Keyword(s):  
Disc Herniation ◽  
Clinical Presentation ◽  
Thoracic Disc Herniation ◽  
Operative Strategy ◽  
University Of Pittsburgh ◽  
Radiological Features ◽  
Thoracic Disc ◽  
The University ◽  
Lateral Sclerosis

Abstract In a series of 12 cases of thoracic disc herniation operated upon at the University of Pittsburgh, 4 different operative approaches were used. These included laminectomy in 2 early cases, posterolateral extrapleural operation in 5 cases, transthoracic operation in 3 cases, and transpedicular operation in 2 cases. The relative merits of the various approaches are discussed in this paper. The clinical presentation, radiological features, and follow-up data are also presented. Precise preoperative radiological diagnosis was essential in planning the operative strategy. The posterolateral and transpedicular approaches were both satisfactory, but the former had some advantages over the latter. With a mean follow-up period of 5 years, 5 patients were cured, 5 were improved, and 1 was unchanged. One patient was worse due to coexistent amyotrophic lateral sclerosis.

scholarly journals Laminotomy/medial facet approach in the excision of thoracic disc herniation

2000 ◽  
Vol 9 (4) ◽  
pp. 1-3 ◽  
Author(s):  
Perry Black
Keyword(s):  
Disc Herniation ◽  
Facet Joint ◽  
Thoracic Disc Herniation ◽  
Leg Weakness ◽  
Thoracic Discectomy ◽  
Thoracic Disc

Object The author describes a technique of thoracic discectomy that has evolved from the posterolateral transfacet and the transpedicular approaches but that spares the pedicle and most of the facet joint. Methods This approach was used to remove a total of 11 discs (T6–12) in seven patients. The follow-up period ranged from 8 months to 3 years. In four patients with axial and/or girdle pain significant improvement was demonstrated. The paraparesis in one patient with myelopathy improved postoperatively; that in another patient improved but recurred 8 months postoperatively. In one patient who experienced preoperative leg weakness, the weakness was slightly increased postoperatively, but this sequela was only transient. There were no other complications, and there were no deaths. Conclusions This technique appears safe and effective. It can be adapted to the conventional laminectomy known to spine surgeons and requires no specialized instruments. Further trials appear warranted.

scholarly journals Surgical management of thoracic disc herniation: anterior vs posterior approach

2019 ◽  
Author(s):  
Ismail Oltulu ◽  
Hemra Cil ◽  
Sigurd Berven ◽  
Dean Chou ◽  
Aaron Clark ◽  
...  
Keyword(s):  
Surgical Management ◽  
Disc Herniation ◽  
Posterior Approach ◽  
Thoracic Disc Herniation ◽  
Thoracic Disc

Reversible propriospinal myoclonus due to thoracic disc herniation: Long-term follow-up

2012 ◽  
Vol 313 (1-2) ◽  
pp. 32-34 ◽  
Author(s):  
Wooyoung Jang ◽  
Joong-Seok Kim ◽  
Jin Young Ahn ◽  
Hee-Tae Kim
Keyword(s):  
Disc Herniation ◽  
Thoracic Disc Herniation ◽  
Long Term Follow Up ◽  
Thoracic Disc ◽  
Propriospinal Myoclonus

scholarly journals Posterior Approach for Lower Thoracic Disc Herniation: A Report of 3 Cases

2004 ◽  
Vol 53 (4) ◽  
pp. 861-866
Author(s):  
Kunihiko Uehara ◽  
Katsuo Arakaki ◽  
Tsugukazu Toma ◽  
Hirokazu Nohara ◽  
Fuminori Kanaya ◽  
...  
Keyword(s):  
Disc Herniation ◽  
Posterior Approach ◽  
Thoracic Disc Herniation ◽  
Thoracic Disc

scholarly journals Management of Giant Thoracic Disc Herniation by Thoracoscopic Approach: Experience of 53 Cases

2018 ◽  
Vol 16 (6) ◽  
pp. 658-666 ◽  
Author(s):  
David Brauge ◽  
Catherine Horodyckid ◽  
Marta Arrighi ◽  
Vincent Reina ◽  
Christophe Eap ◽  
...  
Keyword(s):  
Disc Herniation ◽  
Surgical Techniques ◽  
Lower Limbs ◽  
Thoracic Disc Herniation ◽  
Long Term Outcome ◽  
Thoracoscopic Approach ◽  
Lower Limb Pain ◽  
Thoracic Disc ◽  
Frankel Grade

Abstract BACKGROUND Giant thoracic disc herniation (gTDH) is a rare condition. It is defined by a herniation that occupies at least 40% of the thoracic spinal canal and is usually calcified. Several surgical techniques have been described to date but this surgery remains a technically difficult procedure. OBJECTIVE To report the long-term outcome of 53 patients with myelopathy due to gTDH who were operated on by a thoracoscopic approach. The technical details of the preoperative assessment and the surgical procedure are presented. METHOD We present a retrospective study of a database of 53 patients operated for symptomatic gTDH by a thoracoscopic approach. The following clinical parameters were assessed initially and used during follow-up: Frankel grade and JOA score adapted to the thoracic spine (mJOA), pain in the lower limbs and limitation of the walking perimeter to less than 500 meters. The quality of spinal cord decompression was assessed postoperatively by magnet resonance imaging (MRI). RESULTS The mean follow-up was 78.1 mo (SD 49.4). At the last follow-up visit, clinical examination showed a mean improvement of 0.91 Frankel grade (P < 0.001) and 2.56 mJOA score respectively (P < 0.001). Lower limb pain and walking perimeter were also improved. Postoperative MRI revealed that the resection was complete in 35 cases, subtotal in 13 cases, and incomplete in 5 cases. CONCLUSION gTDH is a condition that often evolves favorably after surgery. The thoracoscopic approach is a feasible alternative technique.

High Thoracic Disc Herniation

Neurosurgery ◽  
1986 ◽  
Vol 19 (3) ◽  
pp. 449-451 ◽  
Author(s):  
Anthony M. Alberico ◽  
Singh K. Sahni ◽  
James A. Hall ◽  
Harold F. Young
Keyword(s):  
Computed Tomography ◽  
Shoulder Pain ◽  
Disc Herniation ◽  
Complete Recovery ◽  
Surgical Decompression ◽  
Hand Strength ◽  
Thoracic Disc Herniation ◽  
Cervical Myelography ◽  
Computed Tomographic ◽  
Thoracic Disc

Abstract A case of T-1, T-2 disc herniation is reported. The patient presented with diminished hand strength, medial arm and shoulder pain, and medial arm, forearm, and hand paresthesias. After surgical decompression and removal of a disc fragment, the patient made a complete recovery. Routine cervical myelography was considered inadequate in view of this patient's symptoms. High thoracic myelography followed by computed tomographic scanning should be considered for patients with this presentation. Improved diagnosis with myelography and computed tomography is discussed.

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