An update on hemilaminectomy of the cranial thoracic spine: Review of six cases

Background: The optimal surgical approach to relieve spinal cord compression in the cranial thoracic spine is not well described, and the anatomy of the cranial thoracic vertebrae creates added surgical difficulty.Aim: This study describes the surgical approach, treatment, and outcome of three dogs and three cats that underwent a cranial thoracic hemilaminectomy for the treatment of extradural spinal cord compression. Surgical positioning was tailored to avoid extensive dissection and provide for a restricted, careful approach.Methods: Three dogs and three cats presenting for cranial thoracic spinal cord compression requiring surgical intervention were included.Results: All patients were discharged within 5 days. No patients experienced postoperative deterioration in neurologic status, and four animals had improved neurologic status at discharge.Conclusion: In cases with cranial thoracic spinal cord compression, the spinous processes can be spared, extensive muscle dissection minimized, and successful outcomes achieved with the appropriate positioning and limited approach. Keywords: Hemilaminectomy, Intervertebral Disc Disease, Myelopathy, Thoracic.

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Surgery for Metastatic Epidural Spinal Cord Compression in Thoracic Spine, Anterior or Posterior Approach?

10.21203/rs.2.334/v1 ◽

2019 ◽

Author(s):

Jen Chung Liao

Keyword(s):

Spinal Cord ◽

Blood Loss ◽

Spinal Cord Compression ◽

Thoracic Spine ◽

Posterior Approach ◽

Cord Compression ◽

Thoracic Vertebrae ◽

Neurologic Status ◽

Significant Difference ◽

Group A

Abstract Background: The most commonly encounter tumor of the spine is metastasis, and thoracic spine is the most commonly metastatic spine. Controversy exists regarding the optimal surgical approach for this kind of patient. The author conducted a study to assess the differences between anterior thoracotomy and posterior approach in patients with malignant epidural cord compression in the thoracic spine. Methods: Between January 2003 and December 2015, patients with metastatic thoracic lesion underwent surgery at our department were stratified into two groups according to different approach method to the lesion site. Group A mean anterior thoracotomy, decompression and fixation. Group P represented posterior decompression and fixation. Survival was defined as months since surgery to last tractable times. American Spinal Injury Association grade was used to assess preoperative and postoperative neurologic status. Days at intensive care unit (ICU) were compared. Every complication by surgery or during admission was documented. Results: Group A had 25 patients and Group P had 67 patients. Lung cancer was ther most commonly origin cancer in both groups. The most commonly surgical level was the 9th thoracic vertebrae in Group A and the 10th thoracic vertbrae in Group P. Both gropus had a similar preoperative neurologic (p=0.959). One patients in Group A and two in the Group P sustained neurologic deterioation immediately after surgery. Group A took more operation time (213.0 vs 199.2 minutes, p=0.380) and had more blood loss (912.5 vs 834.4 ml, p=0.571). 6 patients in Group A (24%) and 10 patients in Group P (13.9%) developed complications immediately or postoperatively. Patients in Group A need more days of care at ICU (2.36 vs 0.19 days, p<0.001). The longer survival was seen in the goup P (15.4 vs 11.2 months) but without significant differnce. Conclusion: Patients in Group P required significantly less days of care at ICU. Besides, posterior approach also took a shorter surgical time, and had a less blood loss during surgery, although without statistically significant difference. According to the results, the author would prefer posterior approach by decompression and fixation for those with thoracic metastatic tumor with epidural compression. Keywords: Thoracic spine; metastatic epidural spinal cord compression; anterior thoracotomy; posterior approach; survivorship; neurologic status; complications.

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Poster 68: Dermatomal Somatosensory Evoked Potentials to Diagnose Thoracic Spinal Cord Compression in an Achondroplastic Patient

Archives of Physical Medicine and Rehabilitation ◽

10.1016/j.apmr.2007.06.524 ◽

2007 ◽

Vol 88 (9) ◽

pp. E29

Author(s):

Thomas E. McNalley

Keyword(s):

Spinal Cord ◽

Evoked Potentials ◽

Spinal Cord Compression ◽

Somatosensory Evoked Potentials ◽

Cord Compression ◽

Thoracic Spinal Cord ◽

Thoracic Spinal

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Thoracic spinal cord compression masquerading as cauda equina syndrome

The American Journal of Emergency Medicine ◽

10.1016/j.ajem.2015.07.069 ◽

2016 ◽

Vol 34 (4) ◽

pp. 756.e3-756.e5 ◽

Cited By ~ 2

Author(s):

Katherine Stolper ◽

Erin R. Hanlin ◽

Michael D. April ◽

John L. Ritter ◽

Curtis J. Hunter ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Compression ◽

Cauda Equina Syndrome ◽

Cauda Equina ◽

Cord Compression ◽

Thoracic Spinal Cord ◽

Thoracic Spinal

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Symptomatic thoracic ossification of the ligamentum flavum in a patient with ankylosing spondylitis: Report of a case and review

Surgical Neurology International ◽

10.25259/sni_1067_2021 ◽

2021 ◽

Vol 12 ◽

pp. 596

Author(s):

Abolfazl Rahimizadeh ◽

Parviz Habibollahzadeh ◽

Walter L. Williamson ◽

Housain Soufiani ◽

Mahan Amirzadeh ◽

...

Keyword(s):

Spinal Cord ◽

Ankylosing Spondylitis ◽

Spinal Cord Compression ◽

Marked Improvement ◽

Ligamentum Flavum ◽

Cord Compression ◽

Case Description ◽

Thoracic Spinal Cord ◽

Decompressive Laminectomy ◽

Thoracic Spinal

Background: Thoracic spinal cord compression due to both ankylosing spondylitis (AS) and ossification of the ligamentum flavum (OLF) is rare. Case Description: A 33-year-old male with AS presented with a paraparesis attributed to MR documented T9-T10 OLF/stenosis. He was successfully managed with a decompressive laminectomy; this resulted in marked improvement of his deficit. Conclusion: Thoracic OLF and AS rarely contribute T9-T10 spinal cord compression that may be readily relieved with a decompressive laminectomy.

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