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JOURNAL OF NEUROSURGICAL SCIENCES
Rivista di Neurochirurgia
Indexed/Abstracted in: e-psyche, EMBASE, PubMed/MEDLINE, Neuroscience Citation Index, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,651
Journal of Neurosurgical Sciences 1999 Marzo;43(1):37-43
Thoracic disc herniation. Unilateral transpedicular approach in 35 consecutive patients
Levi N., Gjerris F., Dons K.
Department of Neurosurgery, Rigshospitalet, University of Copenhagen, Denmark
Background. Thoracic disc herniation is uncommon and surgery for thoracic disc herniation represents less than 1-2% of operations for disc disease. However, there is no consensus on the best approach and reports are based on small series.
Methods. A consecutive series of 35 thoracic disc herniations (25 in women and 10 in men) were treated between 1991 and 1996 using the transpedicular approach and followed in a prospective study. All patients had a preoperative MRI examination. The mean age was 51 years. The T6-7 and T7-8 level were the most frequent localization. The interval between onset of symptoms and operation ranged from 6 weeks to 4 years with a mean of 18 months. Presenting symptoms on admission was radiculopathy in 12 patients and myelopathy in 23 patients. Severe urinary symptoms were found in 2 patients, moderate symptoms in 9 patients, mild symptoms in 3 patients and 21 patient had no urinary symptoms.
Results. One patient was paraplegic immediately after surgery and she made no further improvement. A good result was found in 15 patients, a fair result was found in a further 11 patients but in 8 patients the outcome was unchanged with no effect of a reoperation in two cases. No clinical or radiographic features of instability were found. The postoperative course was uneventful, except in one patient with a wound abscess leading to discitis.
Conclusions. The transpedicular approach can be an effective and safe method of surgical decompression in carefully selected patients.