Background. Clinically significant herniated intervertebral discs in the thoracic spine are quite rare, and the tactics of surgical treatment of a group of patients with this pathology remains debatable. The thoracoscopic technique has a number of advantages in the form of a shorter hospital stay and less severe pain in the surgical area compared to standard posterior surgical access.Aim. To evaluate the results of videothoracoscopic treatment of patients with discogenic thoracic myelopathy.Material and methods. The article analyzes the results of treatment of 21 patients hospitalized at the Federal Neurosurgical Center (Novosibirsk). According to the results of the examination, the patients were divided into 2 groups: with mild (10 patients) or ossified (11 patients) hernias. Each patient underwent video‑assisted thoracoscopic microdiscectomy. The median follow‑up was 29 (4 to 72) months.Results. At the time of discharge, 18 (85.7 %) patients showed no deterioration in neurological status, 2 (9.5 %) patients showed positive dynamics in the form of a decrease in the degree of hypertonicity and the degree of lower paraparesis. A satisfactory result of treatment in the late postoperative period was achieved in 14 (66.7 %) patients.Conclusion. Video‑assisted thoracoscopic surgery is an effective and safe method of surgical treatment of patients with discogenic thoracic myelopathy.
Background. Aneurysms of the posterior inferior cerebellar artery are a rare vascular pathology among both intracranial aneurysms and aneurysms of the vertebrobasilar territory. Due to the proximity of the caudal nerves, microsurgical treatment may be accompanied by the development of bulbar disorders, so endovascular occlusion is the method of choice for aneurysms of origin of the posterior inferior cerebellar artery. However, anatomical features in the vertebrobasilar territory and individual characteristics of the aneurysm often make antegrade catheterization of the artery difficult. In such cases, alternative methods should be used, one of which is transcircular access through the posterior communicating artery.Aim. To present the result of endovascular treatment of a patient with complex aneurysm of the posterior inferior cerebellar artery, performed with through a transcirculation approach.Materials and methods. The article analyzes the results of the patient's treatment at the Federal Neurosurgical Center (Novosibirsk) of the Ministry of Health of Russia. Surgical intervention consisted of endovascular occlusion of the aneurysm of the right posterior inferior cerebellar artery with stent-assistance. A specific feature of this case was the acute angle of posterior inferior cerebellar artery discharge from the vertebral artery, which significantly hampered the direct endovascular catheterization of the aneurysm and increased the risks of intraoperative complications. A transcirculation approach through the posterior communicating artery was chosen as an access. After discharge, the patient underwent a follow-up examination 6 months later.Results. Excellent clinical and angiographic results (occlusion classification (RROC - Raymond Roy I) were noted both at the time of the patient's discharge and during follow-up based on the results of control angiograms.Conclusion. The use of transcirculation endovascular access to the proximal aneurysm of the posterior inferior cerebellar artery made it possible to obtain a good result of surgical treatment.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.