Modified eggshell procedure via posterior approach for sclerosing thoracic disc herniation: a preliminary study

Abstract

BackgroundClinically, sclerosing thoracic disc herniation is a disease with high surgical risk and various complications. Eggshell procedure is a surgical method used by surgeons to treat sclerosing thoracic disc herniation. The aim of this study was to report a modified eggshell procedure to treat sclerosing thoracic disc herniation.MethodsMedical records of 25 patients with sclerosing thoracic disc herniation were collected between 2007/01 and 2010/08, including 14 males and 11 females, with an average age of 51.7 years old. Modified eggshell procedure was performed to treat the patients with sclerosing thoracic disc herniation. All patients were followed up. Japanese Orthopaedic Association (JOA) score was used to evaluate the clinical outcomes.ResultsAll operations were performed successfully with complication rate of 12 %. There were 2 cases of dural laceration and 1 subdural hematoma. All included patients were followed up for at least 5 years, with the median of 6 years. JOA score of preoperation was 5 (IQR = 1) while it was 8 (IQR = 2) at final follow-up, with significant difference (Mann-Whitney U test, Z = −4.891, P < 0.001). The improvement rate of neurological status was 51.5 ± 23.1 %. According to the classification of improvement rate, there were 15 cases at good level, 8 cases at moderate level, and 2 cases without any improvement.ConclusionsModified eggshell procedure is a safe and effective surgical method when performed to treat sclerosing thoracic disc herniation in the clinical practice.

Full-endoscopic uniportal decompression in disc herniations and stenosis of the thoracic spine using the interlaminar, extraforaminal, or transthoracic retropleural approach

“…Therefore, depending on the location and consistency of the pathology, various anterior approaches and nonanterior approaches are used, which cover the entire area around the spinal cord. 2,4,7,10,27,30,51,55,62 The nonanterior approaches may involve difficult or inadequate visualization or handling of the area anterior to the spinal cord, with an increased risk of injury and approachrelated destabilization of the posterior structures. 5,6 Anterior approaches allow sufficient and direct access to the anterior spinal canal but may lead to problems due to opening the thoracic and pleural cavities 15,39,63 and may be more difficult due to anatomical or pathological conditions.…”

Three-Dimensional Printing for Percutaneous Endoscopic Thoracic Discectomy in Thoracic Disc Herniations: Case Report and Anatomy Review

“…The trans-thoracic extra pleural, costotransversectomy and dorsal approaches all are associated with significant drawbacks from an exposure and technical perspective [9,10]. None of these approaches can be universally employed, and each is associated with approach-specific obstacles (Figure 9).…”

Surgery of Thoracic Disc Herniation: A Systematic Review of English-Language Literature

“…Авторы публикаций, посвященных заднему доступу, видят его преиму-щество не только в меньшей частоте осложнений, но и в лучшей возможности контролировать эпидуральное пространство, его венозные сосуды и состояние твердой мозговой оболочки [7,19,22]. Разнообразие задних доступов расширяет возможности их применения и позволяет удалять не только мягкотканные латерально расположенные, но и медиальные оссифицированные грыжи диска [7,8,20,21,22,25]. Coppes et al [21], удалив 13 грыж из заднего трансдурального доступа, получили благоприятные результаты во всех наблюдениях.…”