Reoperation for herniated thoracic discs.

Published on Oct 1, 1999in Journal of Neurosurgery5.115
路 DOI :10.3171/SPI.1999.91.2.0157
Curtis A. Dickman60
Estimated H-index: 60
(St. Joseph's Hospital and Medical Center),
Daniel Rosenthal6
Estimated H-index: 6
,
John J. Regan1
Estimated H-index: 1
Sources
Abstract
Object. In this review the authors address the surgical strategies required to resect residual herniated thoracic discs. Methods. Data obtained in 15 patients who had undergone prior thoracic discectomy and who harbored residual or incompletely excised symptomatic thoracic discs were reviewed retrospectively. The surgical procedures that had failed to excise the herniated discs completely included 11 posterolateral approaches, one thoracotomy, and three thoracoscopyguided surgical procedures. Of the lesions that were incompletely resected or residual, there were 13 central calcified, two soft, 12 extradural, and three intradural discs. Indications for reoperation were often multiple in each patient and included misidentification of the level of disc disease at the initial operation (five cases), abandoning the procedure because of intraoperative spinal cord injury (three cases), inadequate visualization of the pathological entity (eight cases), migration of a soft disc fragment within the spinal canal (on...
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References26
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#1Curtis A. Dickman (St. Joseph's Hospital and Medical Center)H-Index: 60
#2Karahalios DgH-Index: 1
#1Charles B. Stillerman (SC: University of Southern California)H-Index: 6
#2Tsinsue ChenH-Index: 9
Last. Martin H. WeissH-Index: 4
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A number of operative techniques have been described for the treatment of herniated thoracic discs. The transfacet pedicle-sparing approach allows for complete disc removal with limited spinal column disruption and soft-tissue dissection. Fifteen cadaveric spinal columns were used for evaluation of exposure, development of thoracic microdiscectomy instrumentation, and establishment of morphometric measurements. This approach was used to remove eight thoracic discs in six patients. Levels of hern...
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#1Paul C. McAfeeH-Index: 19
#2ReganH-Index: 1
Last. Fedder IlH-Index: 3
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Study Design. A prospective multicenter study on 100 consecutive surgical procedures. Objectives. A prospective multicenter study was performed to evaluate the early perioperative complications in 100 endoscopic spinal procedures-78 video-assisted thoracic surgical procedures and 22 laparoscopic lumbar instrumentation and fusion procedures. Summary of Background Data. Endoscopic procedures have been widely applied in general surgery for appendectomy, cholecystectomy, liver resection, Nissen fund...
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#1Tom Faciszewski (Marshfield Clinic)H-Index: 11
#2Robert B. WinterH-Index: 57
Last. Linda JohnsonH-Index: 3
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Study Design. A retrospective review of 1223 thoracic and lumbar anterior spinal fusions was performed from 1969 through 1992. Objectives. To document the incidence and specific types of perspective complications related to anterior spinal fusions. Summary of Background Data. Despite the increased use of anterior spinal surgery, there has been little documentation of the specific types and frequencies of the complications associated with its use. Methods. All Minnesota Spine Center patients age ...
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#1John J. ReganH-Index: 26
#2Michael J. MackH-Index: 64
Last. George PicettiH-Index: 5
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Study Design. This report is a preliminary description of the efficacy of video-assisted thoracoscopic surgery in thoracic spinal procedures that otherwise require open thoracotomy. Objective. This report sought to describe the efficacy of video-assisted thoracoscopic surgery in thoracic spinal procedures that otherwise require open thoracotomy. Summary of Background Data. In a landmark study that compared video-assisted thoracoscopic surgery for peripheral lung lesions with thoracotomy, video-a...
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#1Keith S. Naunheim (SLU: Saint Louis University)H-Index: 58
#2Mark G. Barnett (SLU: Saint Louis University)H-Index: 5
Last. J.Kenneth Burkus (SLU: Saint Louis University)H-Index: 1
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Abstract Spinal operation via an anterior thoracic approach is becoming increasingly common, and the thoracic surgeon is now being called upon to provide exposure for orthopedic and neurosurgical colleagues. We report experience with 126 such patients from 1982 through 1993. There were 61 male and 65 female patients (mean age, 39.0 years; range, 14 to 77 years). Indications were trauma in 45 patients (36%), spinal deformity in 42 (33%), cancer in 15 (12%), disc disease in 12 (10%), and infection...
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#1D. RosenthalH-Index: 1
#2R. RosenthalH-Index: 1
Last. A de SimoneH-Index: 1
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Study Design. The first clinical implementation of a microsurgical endoscopic technique for removal of thoracic disc herniation is described. Objective. To decompress the spinal cord with a ventral approach, combining microsurgical and endoscopic techniques, while reducing the 芦approach-related trauma.禄 Methods. A detailed description of the preoperative preparation as well as the surgical technique is given. Advantages and disadvantages of the microsurgical endoscopic technique are discussed an...
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#1Michael B. Horowitz (University of Pittsburgh)H-Index: 38
#2John MoossyH-Index: 49
Last. Katherine HunekeH-Index: 1
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Study Design. The applicability of using video assisted thoracoscopic surgery (VATS) to resect thoracic discs was investigated. A laboratory study was conducted using two human cadavers and three live pigs as surgical specimens. A total of nine thoracic levels were decomnpressed. Objectives. To study the feasibility of performing thoracic resections using VATS. Summary of Background Data. VATS has been used by thoracic surgeons since 1991 to resect pulmonary lesions. As far as we know, VAT has n...
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#1Jj ReganH-Index: 1
#1Rodney J. Landreneau (University of Pittsburgh)H-Index: 89
#2Stephen R. Hazelrigg (University of Pittsburgh)H-Index: 43
Last. Peter F. Ferson (University of Pittsburgh)H-Index: 47
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Abstract One hundred thirty-eight consecutive, nonrandomized patients, with equivalent demographic and preoperative physiologic parameters, underwent either a video-assisted thoracic surgical (VATS) approach (n = 81) or a limited lateral thoracotomy (LLT) approach (n = 57) to accomplish pulmonary resection for peripheral lung lesions (鈮3 cm in diameter). Wedge resection was done in 74 VATS patients and 19 LLT patients. Seven patients underwent VATS lobectomy and 38 patients had lobectomy perform...
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#2Paolo RoccucciH-Index: 2
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#2Jin-Sung Kim (Catholic University of Korea)H-Index: 26
BACKGROUND: Multiple options exist for thoracic disc herniation (TDH). However, when a specific technique is chosen, the goal is to avoid the manipulation of the spinal cord, which is already compressed. OBJECTIVE: To describe a hybrid endoscopic technique for intracanal TDH by combining an oblique paraspinal approach (OPA) and transforaminal full-endoscopic discectomy. METHODS: We describe the step-by-step operative technique and present the clinical and radiological outcomes of a case series o...
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#1Gun ChoiH-Index: 1
#2Diego Munoz-SuarezH-Index: 1
For all the spine surgeons, thoracic disc herniations (TDHs) entrust a real challenge in terms of patient diagnosis, proper selection, surgical technique, and potential adverse events. TDHs are relatively uncommon compared to the lumbar and cervical levels. Literature reports a variable prevalence of TDHs around 6% to 40%, but less than 1% of all disk herniations are symptomatic TDHs, evidencing as a relatively unusual condition. Nowadays, transforaminal endoscopic thoracic discectomy (TETD) has...
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#1Stephan D眉tzmann (Praxis)H-Index: 1
#2Roli Rose (Praxis)H-Index: 1
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Purpose Surgical treatment failures or strategies for the reoperation of residual thoracic disc herniations are sparsely discussed. We investigated factors that led to incomplete disc removal and recommend reoperation strategies.
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#1Aaron Wessell (UMB: University of Maryland, Baltimore)H-Index: 8
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Last. Charles A. Sansur (UMB: University of Maryland, Baltimore)H-Index: 30
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BACKGROUND: The disc location, extent of calcification, limited visualization of the ventral cord, and tenuous blood supply to the thoracic spinal cord pose unique technical challenges when surgically treating thoracic disc herniation. OBJECTIVE: To report our initial experience with a series of cases in which intraoperative ultrasound image guidance was used for thoracic discectomy through a unilateral transpedicular or costotransversectomy approach. METHODS: Five patients (n聽=聽5) underwent a t...
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#1Charlie Bouthors (University of Paris-Sud)H-Index: 3
#2Ahmed BenzakourH-Index: 7
Last. Charles Court (University of Paris-Sud)H-Index: 17
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Background Surgical treatment of thoracic disc herniation (TDH) is technically demanding due to its proximity to the spinal cord.
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#1William A. Robinson (Mayo Clinic)H-Index: 57
#2Ahmad Nassr (Mayo Clinic)H-Index: 21
Last. Arjun S. Sebastian (Mayo Clinic)H-Index: 9
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Thoracic disc herniations are a relatively rare occurrence compared to disc herniations in the cervical or lumbar spine. Surgical management of these thoracic herniations can be technically difficult with a wide array of reported complications. In this study, we aim to describe the most common complications that can occur during or after surgical management of thoracic disc herniations. Furthermore, we describe tips and tricks for avoidance and, if necessary, management of surgical complications...
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#1Ismail Oltulu (UCSF: University of California, San Francisco)H-Index: 2
#2Hemra Cil (UCSF: University of California, San Francisco)H-Index: 4
Last. Vedat Deviren (UCSF: University of California, San Francisco)H-Index: 62
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Although symptomatic thoracic disk herniation (TDH) is relatively rare, its treatment is quite difficult. Our aim is to present the outcomes and complications in patients with thoracic disk herniation treated with minimally invasive lateral transthoracic approach (LTTA). Fifty-nine consecutive patients with 69 symptomatic disk herniations that underwent minimally invasive LTTA to treat TDH between 2007 and 2016 were enrolled. Medical records were reviewed retrospectively. The numbers of TDH were...
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#1Ramanan Sivakumaran (North Bristol NHS Trust)H-Index: 1
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#2Juan S. Uribe (USF: University of South Florida)H-Index: 48
BACKGROUND: Surgeries for symptomatic thoracic disk herniations (TDH) remain challenging. OBJECTIVE: A mini-open lateral retropleural approach is described and the clinical outcomes are reported. MATERIALS AND METHODS: A total of 23 patients underwent mini-open lateral retropleural diskectomy. Patients were placed in a lateral position. A 5-cm lateral incision was made followed by resection of the rib after careful dissection of its undersurface from the endothoracic fascia. The fascia was incis...
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