Surgical outcomes of posterior thoracic interbody fusion for thoracic disc herniations

Yamasaki, Ryoji; Okuda, Shujiro; Maekawa, Takafumi; Haku, Takamitsu; Iwasaki, Motoki; Oda, Takenori

doi:10.1007/s00586-013-2877-3

Cited by 28 publications

(29 citation statements)

References 39 publications

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“…In other words, a lesser degree of lower back pain was observed in the second group, which is probably due to neuron damages. Compared to the paresthesia of the limbs and perinea, before surgery (98%) and postoperative surgery (5.75%), it is true that we have the reduction in postoperative paresthesia, but compared with numerous articles (10%) in our study were higher because of the fact that the time for referral to the doctor and the delay of patients in surgery even after the advice of physicians, and this has led to a much higher prevalence in our study (98%) than in other studies [3,4,15].…”

Section: Discussioncontrasting

confidence: 60%

Evaluation of Prognostic Factor and Pain Intensity Following Thoracolumbar Disc Surgeries

Meshkini

Salehpour

Mirzaei

et al. 2018

Iran. J. Neurosurg.

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Background and Aim: Thoracolumbar Junction (TLJ) is a transitional zone between the rigid thoracic spine and the flexible lumbar spine. Diagnosis and treatment of herniated discs pertaining to this spinal region is difficult owing to its unique anatomy has challenges to spine and orthopedic surgeons and neurosurgeon. There is not definite approach to TLJ surgeries, with different controversies surrounding each. Therefore, the outcomes and complications associated with different approaches were examined in this study. Methods and Materials/Patients: After being approved by ethics committee of Tabriz university of medical sciences Forty-nine patients undergoing TLJ disc surgeries during 2012-2016 were studied in three Iranian hospitals, i.e. Imam Reza and Shohada hospitals in Tabriz, and Azarbaijan Hospital in Urmia. Patients were examined in terms of gender, age, BMI, surgical level, number of surgical surfaces, lower extremity pain, back pain, paresthesia of limbs and perineum, weakness of lower limbs, sphincter disorder, surgery types including laminectomy+festectomy+discectomy with or without Fusion and with or without Fixation. Results: From Forty-nine patients, 22 patients were male and 27 were female. The mean age was 46.75±6.83. Nine patients had severe lower extremity pain (VAS≥6) and 40 patients had mild pain (VAS<6), which corresponded to postoperative limb pain: 24 patients reported severe pain and 25 mild pain, which lasted over 6 months. There was no significant relationship between fusion and lower extremity pain. Conclusion: Based on the results of this study, which examined the factors affecting prognosis and severity of pain after thoracolumbar discs, spinal cord manipulation should be avoided due to limited circulation of the spinal area.

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Section: Discussioncontrasting

confidence: 60%

Evaluation of Prognostic Factor and Pain Intensity Following Thoracolumbar Disc Surgeries

Meshkini

Salehpour

Mirzaei

et al. 2018

Iran. J. Neurosurg.

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“…TTIF yielded good outcome in other series as well (n ¼ 18, n ¼ 11, n ¼ 27, n ¼ 25, n ¼ 51) with minor or major complication rate of 33%, 18%, 3.70%, 12%, and 1.96% respectively. 8,10,[15][16][17] No deterioration due to cord handling noted in these series. No anticoagulants were given by us.…”

Section: Discussionmentioning

confidence: 63%

Transforaminal Thoracic Interbody Fusion for Thoracic Disc Prolapse: Surgicoradiological Analysis of 18 Cases

Krishnan

Degulmadi

Mayi

et al. 2019

Global Spine Journal

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Study Design: Retrospective observational study. Objectives: Thoracic disc prolapse (TDP) surgeries have reported complications ranging from paraplegia to approach related complications. This study is to present a series of TDP patients surgically treated with transforaminal thoracic interbody fusion (TTIF). Emphasis on surgical technique and strategies to avoid complications are analyzed. Methods: Eighteen patients with TDP were included. Imagings were analyzed for end-plate changes and calcification. Type of disc prolapse (central/para-central) and percentage of canal occupancy were noted. Objective outcome was quantified with Visual Analogue Scale (VAS), modified Nurick’s grade, and ASIA (American Spinal Injury Association) score. All complications were noted. Results: Eighteen patients (average age 43.65 years) having total 22 levels operated, that included double level (n = 2) and missed level (n = 2) are reported. All patients had myelopathy. Calcification of disc (n = 13), central disc prolapses (n = 9), para-central (n = 11) and more than 50% canal occupancy (n = 8) were noted. VAS back pain, modified Nurick’s grade and ASIA grade improved significantly in all patients. One patient had postoperative transient deficit. The functional score achieved its maximum at 1 year follow-up and remained static at final follow-up of 65.05 months. Union was achieved in all patients. Conclusions: The most important factor for outcome in TDP is the technical aspect of avoiding cord manhandling and avoiding wrong level surgeries. TTIF is not devoid of complications but can give good results to posterior approach trained surgeons.

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“…Therefore, the technique is seldom used in management of central calcified TDH. 23 However, advances in surgical techniques made the posterior approach possible for TDH. Regev et al 22 described a posterior transforaminal microscopic technique using tubular retractors for management of TDH, which enabled sufficient access to the midline of the spinal canal without extensive resection of the facet joint or the adjacent pedicle.…”

Section: Discussionmentioning

confidence: 99%

Surgical Treatment for Central Calcified Thoracic Disk Herniation: A Novel L-Shaped Osteotome

Zhuang¹,

Lun²,

Xu³

et al. 2015

Orthopedics

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Few reports are available on the posterior transfacet approach for the treatment of central calcified thoracic disk herniation (TDH). The objective of this study was to assess outcomes and complications in a consecutive series of patients with TDH who underwent posterior transfacet decompression and diskectomy with segmental instrumentation and fusion. The data for 27 patients (16 males and 11 females) were retrospectively reviewed and analyzed, including clinical presentation, blood loss, operative time, pre- and postoperative complications, visual analog scale, Japanese Orthopedic Association (JOA) score, and Frankel grade. All patients underwent trans-facet decompression and segmental instrumentation with interbody fusion. Mean patient age at surgery was 55.2 years (range, 21-81 years). Average follow-up was 30±19 months (range, 12-50 months). All patients were successfully treated with posterior decompression and segmental instrumentation with interbody fusion. Average operative time was 124±58 minutes (range, 87-180 minutes). Mean blood loss was 439±225 mL (range, 300-1500 mL). Average pre- and postoperative JOA scores were 4.12±0.87 and 8.01±0.97 points, respectively. Overall JOA scores showed a significant postoperative improvement. Overall recovery rates were excellent in 12 patients, good in 6, fair in 5, and unchanged in 1. No patient was classified as worse. The results suggest that the posterior approach using a special L-shaped osteotome is feasible. No major complications occurred while achieving adequate decompression for central calcified TDH.

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Surgical outcomes of posterior thoracic interbody fusion for thoracic disc herniations

Abstract: PTIF has produced satisfactory outcomes for myelopathy due to TDH. Therefore, PTIF is one of the surgical treatments of choice for patients with TDH causing myelopathy.

Cited by 28 publications

References 39 publications

Evaluation of Prognostic Factor and Pain Intensity Following Thoracolumbar Disc Surgeries

Evaluation of Prognostic Factor and Pain Intensity Following Thoracolumbar Disc Surgeries

Transforaminal Thoracic Interbody Fusion for Thoracic Disc Prolapse: Surgicoradiological Analysis of 18 Cases

Surgical Treatment for Central Calcified Thoracic Disk Herniation: A Novel L-Shaped Osteotome

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