Thoracoscopic treatment for single level symptomatic thoracic disc herniation: a prospective followed cohort study in a group of 167 consecutive cases

Abstract

Problem Thoracic disc disease with radicular pain and myelopathic symptoms can have serious neurological sequelae. The authors present a relevant treatment option. Methods Data of patients with single level symptomatic thoracic disc herniation treated with thoracoscopic microdiscectomy were prospectively collected over a period of 10 years. Data collection included the preoperative status and the follow-up status was 6, 12 and 24 months after surgery for every patient. Results A total of 167 single level thorascoscopic discectomies without previous surgery on the level of the procedure were included in this study. The average preoperative duration of pain symptoms was 14.3 months, myelopathic symptoms were present for an average of 16.7 months before surgery. After the procedure pain scores measured with visual analog scale (VAS) decreased by 4.4 points and the muscle strength improved by a mean of 4.6 points (American Spinal Injury Association ASIA motor score). After 2 years, 79% of the patients reported a excellent or good outcome for pain and 80% of the patients reported a excellent or good outcome for motor function. The overall complication rate was 15.6%. ConclusionsThoracoscopic microdiscectomy for single level symptomatic disc herniation is a highly effective and reliable technique, it can be performed safely with low complication rate.

Circumspinal decompression and fusion through a posterior midline incision to treat central calcified thoracolumbar disc herniation: a minimal 2-year follow-up study with reconstruction CT

“…An 18.2 % (4/22) rate of perioperative complications was found in this series, which was slightly higher than the rate of 15.6 % found in Quint and Rosenthal’s series of 167 consecutive patients with thoracic disc herniation who underwent thoracoscopic surgery [11]. However, their cases include both soft and hard thoracic disc herniations [11].…”

Intracranial hypotension with a sixth cranial nerve palsy subsequent to massive thoracic CSF hygroma: a rare complication of thoracic disc excision

“…However, Borm et al argue in a recent article that a tailored posterior approach based on the anatomic location and nature of the disc along with the general health of the patient can yield satisfactory results [6]. In a prospective cohort study of 167 cases, Quint et al conclude that thoracoscopic discectomy provides satisfactory results and can be used in calcified discs as well [9]. Cho et al recently described a minimally invasive oblique paraspinal approach using 3-D navigation and tubular retractors with the aid of a robotic holder [10].…”

“…A review of the literature reveals 44 described cases of massive pleura-dural fistula. It can be observed that 77 % of these cases were caused by trauma of varying aetiologies and only two (4.5 %) of the cases were described as subsequent to post-operative thoracic disc resection [2,9,[14][15][16][17]. Recently, two cases of spontaneous thoracic CSF leakage in the presence of thoracic disc hernias were described [18].…”

An unusual cause for chronic right-sided abdominal pain: answer

“…However tailored posterior approaches have been reported to produce similar results to anterior or thoracoscopic techniques [9]. Minimally invasive techniques using endoscopy or tubular retractors are becoming more common and are thought to be associated with a reduction in postoperative complications [3,8,10]. Use of the ultrasonic bone curette in calcified disc prolapse has been previously reported [11,12].…”