Endoscopic thoracic microdiscectomy

Oskouian, Rod J.; Johnson, J. Patrick

doi:10.3171/foc.2005.18.3.12

Cited by 16 publications

(14 citation statements)

References 50 publications

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“…Similar to the result reported by Oskunian [14] the incidence of worsening was 1.8%. Compared with Stillermann's and Fessler's revision of the literature [10,21], the percentage of worsening in these thoracoscopic series is the lowest reported in recent publications.…”

Section: Discussionsupporting

confidence: 81%

“…This result contrasts with our previous published data including our early results [19,20] with an overall complication rate of 23%. The former included redo surgeries, multilevel and instrumented cases, requiring a higher level of surgical skills and experience but also bearing the risk of a higher complication rate, these data are similar to those published by Oskunian [14] 24% and Anand [2] 21%, both with a similar inhomogeneous patient population.…”

Section: Discussionsupporting

confidence: 77%

“…Anand [2] reported 6% of transitory neuralgia while Oskunian's incidence [14] reached 13% declining steeply after changing stiff for flexible trocars. Leverage between the narrow rib spaces and stiff trocars, as used in abdominal surgery, irritates the intercostal nerve leading to neuralgic pain.…”

Section: Discussionmentioning

confidence: 99%

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

Quint

Bordon²,

Preissl³

et al. 2011

Eur Spine J

119

102

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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.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionsupporting

confidence: 77%

See 1 more Smart Citation

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

Quint

Bordon²,

Preissl³

et al. 2011

Eur Spine J

119

102

View full text Add to dashboard Cite

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“…Recently, minimally invasive thoracoscopic approaches have been developed for the surgical treatment of thoracic disc herniations and traumatic fractures to overcome the problems associated with thoracotomy. 1,3,4,10,18,29,30,37 We here describe the application of a minimally invasive procedure for the surgical treatment of metastatic spinal cord compression and pathological fractures in the thoracolumbar spine, with an emphasis on recently developed reconstruction and stabilization techniques. Object.…”

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confidence: 99%

Minimally invasive thoracoscopic approach for anterior decompression and stabilization of metastatic spine disease

Kan

Schmidt

2008

FOC

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Object The choices available in the management of metastatic spine disease are complex, and the role of surgical therapy is increasing. Recent studies have indicated that patients treated with direct surgical decompression and stabilization before radiation have better functional outcomes than those treated with radiation alone. The most common anterior surgical approach for direct spinal cord decompression and stabilization in the thoracic spine is open thoracotomy; however, thoracotomy for spinal access is associated with morbidity that can be avoided with minimally invasive techniques like thoracoscopy. Methods A minimally invasive thoracoscopic approach was used for the surgical treatment of thoracic and thoracolumbar metastatic spinal cord compression. This technique allows ventral decompression via corpectomy, inter-body reconstruction with expandable cages, and stabilization with an anterolateral plating system designed specifically for minimally invasive implantation. This technique was performed in 5 patients with metastatic disease of the thoracic spine, including the thoracolumbar junction. Results All patients had improvement in preoperative symptoms and neurological deficits. No complications occurred in this small series. Conclusions The minimally invasive thoracoscopic approach can be applied to the treatment of thoracic and thoracolumbar metastatic spine disease in an effort to reduce access morbidity. Preliminary results have indicated that adequate decompression, reconstruction, and stabilization can be achieved with this technique.

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“…The incidence is estimated to be between 0.25 and 1% of all such lesions, and population studies indicate that the overall incidence of thoracic disc herniations is approximately 1 per million patient-years [1,2]. Thoracic disc herniations typically present with a variety of nonspecific symptoms, frequently leading to a wrong or delayed diagnosis [2][3][4]. A variety of surgical approaches have been described to reach these anatomically challenging lesions including open transthoracic, costotransversectomy or lateral extracavitary approach, transpedicular or transfacet approaches, as well as thoracoscopic microdiscectomy [2,3,[5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Surgical treatment of thoracic disc herniations via tailored posterior approaches

et al. 2011

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We present clinical findings, radiological characteristics and surgical modalities of various posterior approaches to thoracic disc herniations and report the clinical results in 27 consecutive patients. Within an 8-year period 27 consecutive patients (17 female, 10 male) aged 30-83 years (mean 53 years.) were surgically treated for 28 symptomatic herniated thoracic discs in our department. Six of these lesions (21%) were calcified. In all cases surgery was performed via individually tailored posterior approaches. We evaluated the pre-and postoperative clinical status and the complication rate in a retrospective study. Nearly one half of the lesions (46.4%) were located at the three lowest thoracic segments. Clinical symptoms included back pain or radicular pain (77.8%), altered sensitivity (77.8%), weakness (40.7%), impaired gait (51.9%) or bladder dysfunction (22%). Costotransversectomy was performed in 8 patients, 1 lateral extracavitary approach, 2 foraminotomies, 15 transfacet and/or transpedicular approaches and 2 interlaminar approaches were used for removing the pathologies. After a mean follow-up of 38.6 months (3-100 months), complete normalization or reduction of local pain was recorded in 87% of the patients and of radicular pain in 70% of the cases, increased motor strength could be achieved in 55%, sensitivity improved in 76.2% and improvement of myelopathy was noted in 71.4%. Two patients suffered from postoperative impairment of sensory deficits, which in one case was discrete. The overall recovery rate within the modified JOA score was 39.5%. In 1 patient, two revisions were required because of instability and a persisting osteophyte, respectively. The rate of major complications was 7.1% (2/28). Surgical treatment of thoracic disc herniations via posterior approaches tailored to the individual patient produces satisfying results referring to clinical outcome. Posterior approaches remain a viable alternative for a large proportion of patients with symptomatic thoracic disc herniations.

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Endoscopic thoracic microdiscectomy

Cited by 16 publications

References 50 publications

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

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

Minimally invasive thoracoscopic approach for anterior decompression and stabilization of metastatic spine disease

Surgical treatment of thoracic disc herniations via tailored posterior approaches

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