Thoracic Disk Disease: Diagnosis and Treatment

Vanichkachorn, Jed S.; Vaccaro, Alexander R.

doi:10.5435/00124635-200005000-00003

Cited by 79 publications

(59 citation statements)

References 24 publications

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“…Better-quality studies are required comparing conservative management with surgery in order to optimise management decision making. 56,57 For patients with suspected spinal tumours, ideal clinical care requires prompt access to magnetic resonance imaging and other diagnostic investigations. Secondary malignant tumours require surgery and radiotherapy to reduce the progression from bony lesions to symptomatic NTSCI and to limit the severity of the neurological impairment, especially within the first 48 h. 58 Chemotherapy is also sometimes indicated to improve the survival and cure prospects, especially for primary tumours, but also some secondary malignancies.…”

Section: Box 1 Zones Of Information*mentioning

confidence: 99%

Global maps of non-traumatic spinal cord injury epidemiology: towards a living data repository

2013

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Study design: Literature review. Objectives: Globally map non-traumatic spinal cord injury (NTSCI) incidence, prevalence, survival, level of injury and aetiology. Propose a research framework for NTSCI prevention and launch a repository of NTSCI data. Setting: Initiative of the International Spinal Cord Society Prevention Committee. Methods: Literature search of Medline and Embase (1959-June 2011). Relevant articles in any language regarding adults with NTSCI were included. Stratification of information about incidence and prevalence into green/yellow/orange/red data quality 'zones' and comparisons between World Health Organisation (WHO) regions and countries. Results: Three hundred and seventy-seven abstracts reviewed-45 of these from 24 countries in 12 of the 21 WHO global regions had relevant information. Only one publication had survival data. Prevalence data for NTSCI existed for only two countries, India (prevalence of 2 310/million population, Kashmir region) and Canada (prevalence of 1 120/million population). The incidence rates for WHO regions were: Asia Pacific, high income 20/million population/year; Australasia (26/million population/year); Western Europe median of 6/million population/year; North America, high income median 76/million population/year (based on poor-quality studies); and Oceania 9/million population/year. Developed countries tended to have a higher proportion of cases with degenerative conditions and tumours. Developing countries, in comparison, tended to have a higher proportion of infections, particularly tuberculosis and HIV, although a number also reported tumours as a major cause. Conclusions: Insufficient survival, prevalence and incidence data are a predominant finding of this review. The piecemeal approach to epidemiological reporting of NTSCI, particularly failing to include sound regional population denominators, has exhausted its utility. Minimum data collection standards are required.

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Section: Box 1 Zones Of Information*mentioning

confidence: 99%

Global maps of non-traumatic spinal cord injury epidemiology: towards a living data repository

2013

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“…For example, stopping the procedure in cases of significant drops in intra-operative monitoring, performing a wake-up test or even abandoning the anterior approach and performing a staged posterior decompression to allow the spinal cord to 'float dorsally' are strategies that we have employed in the past. In his review of treatment of thoracic disc, Vaccarro recommended that 'the use intra-operative neurologic monitoring greatly reduces the risk of permanent neurologic injury and allows immediate intra-operative surgical correction if necessary' [43]. In their recent large series of 60 patients from 5 institutions, Uribe and colleagues [40] used intra-operative neuromonitoring for all patients.…”

Section: Discussionmentioning

confidence: 99%

Calcified giant thoracic disc herniations: considerations and treatment strategies

et al. 2014

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Introduction Giant herniated thoracic discs (GHTD) remain a surgical challenge. When combined with calcification, these discs require altered surgical strategies and have only been infrequently described. Our objective was to describe our surgical approaches in the management of calcified GHTD. Methods This was a retrospective cohort study of all patients with calcified GHTD operated between 2004 and 2012. Data were collected from review of patients' notes and radiographs and included basic demographic and radiological data, clinical presentation and outcome, operative procedure and complications. Results During the study period, there were 13 patients with calcified GHTD, including 6 males and 7 females (mean age 55 years, range 31-83 years). The average canal encroachment was 62 % (range 40-90 %); mean follow-up 37 months (12-98). All patients were treated with anterior thoracotomy, varying degrees of vertebral resection, removal of calcified disc and with or without reconstruction. The average time for surgery was 344 min (range 212-601 min) and estimated blood loss 1,230 ml (range 350-3,000 ml). Post-operatively, 8 patients improved by 1 Frankel grade (62 %), 2 improved by 2 grades (15 %) and 3 did not change their grade (23 %). The complication rate was 4/13 (31 %; 3 patients with durotomies (2 incidental, 1 intentional) and 1 with recurrence). Discussion Calcified GHTD remain a surgical challenge. Anterior decompression through a thoracotomy approach, and varying degrees of vertebral resection with or without reconstruction allowed us to safely remove the calcified fragment. All patients remained the same (23 %) or improved by at least 1 grade (77 %) neurologically, without radiographic failure at final follow-up.

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“…The clinical presentation of a thoracic disc herniation can vary widely depending on its location and morphologic characteristics 1) . The most common initial symptom described is thoracic pain occurring midline, unilaterally, or bilaterally, or in a radicular distribution, followed later by sensory and motor disturbances 2,3,5) . Herein, we present a case of chest wall pain due to thoracic disc herniation in a professional baseball pitcher.…”

Section: Introductionmentioning

confidence: 99%

Unusual chest wall pain caused by thoracic disc herniation in a professional baseball pitcher

Kato

Yabuki

Otani

et al. 2016

FJMS

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Symptomatic thoracic disc herniation is clinically rare. There are few cases of disc herniation of the thoracic spine in top athletes described in the literature. We herein present a rare case of chest wall pain due to thoracic disc herniation in a professional baseball pitcher. A 30 -year -old, lefthanded pitcher complained of left -sided chest wall pain in the region of his lower ribs during a game. Neurological examination revealed hypoesthesia of the left side of the chest at the level of the lower thoracic spine. Magnetic resonance imaging (MRI) of the thoracic spine showed a leftsided paramedian disc herniation at the T9 -T10 level. The player was initially prescribed rest, administration of pregabalin (150 mg twice a day), and subsequent physical rehabilitation. He was able to resume full training and pitching without medication 6 months after the onset. A follow -up MRI of the thoracic spine showed a reduction in the size of the herniated disc compared to the initial findings. Though relatively rare, thoracic disc herniation should be considered in cases of chest wall pain in athletes.

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Thoracic Disk Disease: Diagnosis and Treatment

Cited by 79 publications

References 24 publications

Global maps of non-traumatic spinal cord injury epidemiology: towards a living data repository

Global maps of non-traumatic spinal cord injury epidemiology: towards a living data repository

Calcified giant thoracic disc herniations: considerations and treatment strategies

Unusual chest wall pain caused by thoracic disc herniation in a professional baseball pitcher

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