scholarly journals Management of single-level thoracic disc herniation through a modified transfacet approach: A review of 86 patients

2021 ◽  
Vol 12 ◽  
pp. 338
Author(s):  
Samir Kashyap ◽  
Andrew G. Webb ◽  
Elizabeth A. Friis ◽  
Paul M. Arnold
Keyword(s):  
Disc Herniation ◽  
Significant Risk ◽  
Length Of Hospital Stay ◽  
Thoracic Disc Herniation ◽  
Estimated Blood Loss ◽  
Surgeon Experience ◽  
Thoracic Disc ◽  
Stay Hospital ◽  
Pain Improvement ◽  
Selection Of

Background: Symptomatic thoracic disc herniation (TDH) is rare and does not typically resolve with conservative management. Traditional surgical management is the transthoracic approach; however, this approach can carry significant risk. Posterolateral approaches are less invasive, but no single approach has proven to be more effective than the other results are often dependent on surgeon experience with a particular approach, as well as the location and characteristics of the disc herniation. Methods: This was retrospective review of a prospectively collected database. Eighty-six patients with TDH treated surgically through the modified transfacet approach were reviewed and evaluated for pain improvement, Nurick grade, and neurological symptoms. Patients were followed for 12 months postoperatively; estimated blood loss, length of hospital stay, hospital course, and postoperative complications were also assessed. Results: All attempts at disc resection were successful. Most patients reported improvement in pain, sensory involvement, and strength. Seventy-nine patients had complete resolution of their symptoms while four patients had unchanged symptoms. Three patients experienced mild neurologic worsening postoperatively, but this resolved back to baseline. One patient experienced myelopathy during the postoperative period that resolved with steroid administration. The procedure was well tolerated with minimal complications. Conclusion: TDH can be managed surgically through a variety of approaches. The selection of approach is dependent on surgeon experience with an approach, the patient’s health, and the location and type of disc. The transfacet approach is safe and efficacious.

Treatment of thoracic disc herniation: evolution toward the minimally invasive thoracoscopic technique

2000 ◽  
Vol 9 (4) ◽  
pp. 1-7 ◽  
Author(s):  
Timothy G. Burke ◽  
Anthony J. Caputy
Keyword(s):  
Patient Outcome ◽  
Minimally Invasive ◽  
Disc Herniation ◽  
Significant Risk ◽  
Historical Evolution ◽  
Thoracic Disc Herniation ◽  
Traditional Methods ◽  
Thoracic Disc ◽  
Thoracoscopic Technique

Thoracic disc herniation has always carried with it the potential for serious adverse neurological consequences if not treated appropriately. The authors review the historical evolution of treatment for thoracic disc herniation from the early surgical series using dorsal approaches (which were known to involve a significant risk of paraplegia) to later surgical series in which lateral and then ventral approaches to the disc were increasingly emphasized, with significant improvement in patient outcome. The evolution of minimally invasive thoracoscopic techniques is discussed, together with the results of several surgical series demonstrating significant reductions in morbidity compared with more traditional methods. The technique of thoracoscopic discectomy is presented in detail.

Thoracic microendoscopic discectomy

2004 ◽  
Vol 1 (1) ◽  
pp. 58-63 ◽  
Author(s):  
Mick J. Perez-Cruet ◽  
Bong-Soo Kim ◽  
Faheem Sandhu ◽  
Dino Samartzis ◽  
Richard G. Fessler
Keyword(s):  
Minimally Invasive ◽  
Disc Herniation ◽  
Thoracic Disc Herniation ◽  
Tubular Retractor ◽  
Content Type ◽  
Estimated Blood Loss ◽  
Disc Herniations ◽  
Microendoscopic Discectomy ◽  
Thoracic Disc ◽  
Fine Print

Object. Various approaches exist for the treatment of thoracic disc herniation. Anterior approaches facilitate ventral exposure but place the intrathoracic contents at risk. Posterolateral approaches require extensive muscle dissection that adds to the risk of postoperative morbidity. The authors have developed a novel posterolateral, minimally invasive thoracic microendoscopic discectomy (TMED) technique that provides an approach to the thoracic spine which is associated with less morbidity. Methods. Seven patients 23 to 54 years old with nine disc herniations underwent TMED. All lesions were soft lateral or midline thoracic disc herniations. Under fluoroscopic guidance with the patient positioned prone, the authors used a muscle dilation approach and the procedure was performed with endoscopic visualization through a tubular retractor. Based on a modified Prolo Scale, five patients experienced excellent results, one good, and one fair. No case required conversion to an open procedure. The mean operative time was 1.7 hours per level, and estimated blood loss was 111 ml per level. Hospital stays were short, and no complications occurred. Conclusions. The TMED is safe, effective, and provides a minimally invasive posterolateral alternative for treatment of thoracic disc herniation without the morbidity associated with traditional approaches.

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 A Case of Thoracic Arachnoid Cyst with Thoracic Disc Herniation Presenting as Angina-like Pain

2021 ◽  
Vol 35 (2) ◽  
pp. 212-214
Author(s):  
Nobuhiro Sasaki ◽  
Atsuhiko Toyoshima ◽  
Kiminori Sakurai ◽  
Ryota Motoie ◽  
Ryo Akiyama ◽  
...  
Keyword(s):  
Arachnoid Cyst ◽  
Disc Herniation ◽  
Thoracic Disc Herniation ◽  
Thoracic Disc

scholarly journals Sleep Apnea and Unilateral Upper and Lower Extremity Allodynia as a Result of a Large Thoracic Disc Herniation: A Case Report

2021 ◽  
Author(s):  
Tyler D. Alexander ◽  
Anthony Stefanelli ◽  
Sara Thalheimer ◽  
Joshua E. Heller
Keyword(s):  
Spinal Cord ◽  
Sleep Apnea ◽  
Sexual Dysfunction ◽  
Lower Extremity ◽  
Disc Herniation ◽  
Cord Compression ◽  
Thoracic Disc Herniation ◽  
Lower Extremity Weakness ◽  
Disc Herniations ◽  
Thoracic Disc

Abstract BackgroundClinically significant disc herniations in the thoracic spine are rare accounting for approximately 1% of all disc herniations. In patients with significant spinal cord compression, presenting symptoms typically include ambulatory dysfunction, lower extremity weakness, lower extremity sensory changes, as well as bowl, bladder, or sexual dysfunction. Thoracic disc herniations can also present with thoracic radiculopathy including midback pain and radiating pain wrapping around the chest or abdomen. The association between thoracic disc herniation with cord compression and sleep apnea is not well described.Case PresentationThe following is a case of a young male patient with high grade spinal cord compression at T7-8, as a result of a large thoracic disc herniation. The patient presented with complaints of upper and lower extremity unilateral allodynia and sleep apnea. Diagnosis was only made once the patient manifested more common symptoms of thoracic stenosis including left lower extremity weakness and sexual dysfunction. Following decompression and fusion the patient’s allodynia and sleep apnea quickly resolved.ConclusionsThoracic disc herniations can present atypically with sleep apnea – a symptom which may resolve with surgical treatment.

Segmental Abdominal Wall Paresis Caused by Lateral Low Thoracic Disc Herniation

Spine ◽  
2007 ◽  
Vol 32 (22) ◽  
pp. E635-E639 ◽  
Author(s):  
Ivana Stetkarova ◽  
Jiri Chrobok ◽  
Edvard Ehler ◽  
Markus Kofler
Keyword(s):  
Abdominal Wall ◽  
Disc Herniation ◽  
Thoracic Disc Herniation ◽  
Thoracic Disc

Resolution of isolated syringomyelia after removing thoracic disc herniation

2018 ◽  
Vol 34 (2) ◽  
pp. 196-199
Author(s):  
Youssef El Ouadih ◽  
Guillaume Coll ◽  
Yakouba Haro ◽  
Remi Chaix
Keyword(s):  
Disc Herniation ◽  
Thoracic Disc Herniation ◽  
Thoracic Disc

Thoracic Disc Herniation: 1 Case Report

1988 ◽  
Vol 23 (6) ◽  
pp. 1554
Author(s):  
Min Gi Kang ◽  
Jung Hwan Son ◽  
Jang Suk Choi ◽  
Young Goo Lee
Keyword(s):  
Case Report ◽  
Disc Herniation ◽  
Thoracic Disc Herniation ◽  
Thoracic Disc

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.

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