Video-assisted thoracoscopic treatment of discogenic thoracic myelopathy

Abstract

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.