Thoracic intervertebral disc calcification and herniation in adults: a report of two cases

Yue, Bin; Chen, Bohua; Zou, Yun-wen; Xi, Yongming; Ren, Xianfeng; Xiang, Hongfei; Hu, Yang; Zhang, Guoqing

doi:10.1007/s00586-015-4214-5

Cited by 16 publications

(14 citation statements)

References 11 publications

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“…We reviewed the published studies of calcification of nucleus pulposus and/or calcific discitis in adults [Table 1]. [12345678910121314151617181920212223242526] The collected data in this literature review included demographic data (i.e., gender and age of the patient), level of involving spine, symptoms of patient, location or extension of calcified disc, probably precipitating event, the presence of bone marrow edema on MRI, the occurrence and follow-up time of spontaneous regression, treatment, and outcome of patient.…”

Section: Discussionmentioning

confidence: 99%

Acute calcific discitis or symptomatic calcified schmorl's node of the upper thoracic spine in an adult: A case report and literature review

2019

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We describe a patient with acute calcific discitis following symptomatic Schmorl's node (SN) of upper thoracic spine. A 28-year-old female suffered from sudden severe pain in mid-thoracic, left scapular area, radiating to her chest. Plain radiography of the thoracic spine showed calcification in T3–4 intervertebral disc space. Computed tomography (CT) scan and magnetic resonance imaging (MRI) of the spine demonstrated calcification of the T3–T4 nucleus pulposus, migrating into the inferior of T3 vertebral body with reactive bone marrow edema. By conservative treatment with multidrug therapy, the pain subsided and disappeared in 3 months. Follow-up CT scan and MRI of the thoracic spine confirmed complete resolution of calcified SN and reactive bone marrow edema.

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Section: Discussionmentioning

confidence: 99%

Acute calcific discitis or symptomatic calcified schmorl's node of the upper thoracic spine in an adult: A case report and literature review

2019

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“…Our results and also Linscott and Heyborne, [2] results were higher than those mentioned in previous studies. [4,[14][15][16] Degenerative disc disease was present in 22% (525/2,340) of the levels, whereas loss of disc height was determined in 17% (387/2,340). The findings related to the incidences and locations of the degeneration and the loss of disc height were in accordance in our study sample, both being more frequent at lower thoracic intervertebral disc levels.…”

Section: Discussionmentioning

confidence: 99%

“…The findings related to the incidences and locations of the degeneration and the loss of disc height were in accordance in our study sample, both being more frequent at lower thoracic intervertebral disc levels. Since degenerative etiology has been favored for disc herniation and bulging, [1,13,14] the levels of disc degeneration and loss of height and herniation are expected to be similar. Our findings supported this expectation.…”

Section: Discussionmentioning

confidence: 99%

“…The original report stated that they occurred with the disruption of the cartilaginous endplate of the vertebral body. [13,14] It has also been indicated that their presence is correlated with disc space loss, but not with advanced degeneration of the disc. [13] Our results favored the suggestion made by the original report, since the intervertebral levels of both findings were in correlation with each other.…”

Section: Discussionmentioning

confidence: 99%

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The incidence and most common levels of thoracic degenerative disc pathologies

Sarsilmaz

Yencilek

Özelçi

et al. 2018

Turk J Phys Med Rehab

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Objectives: In this study, we aimed to describe and characterize the incidence of thoracic degenerative disc pathologies, bulging/herniation, and the most common affected levels. Patients and methods: Between January 2008 and May 2012, a total of 195 patients (109 females, 86 males; mean age 43.5 years; range, 15 to 74 years) who were admitted with the complaint of dorsalgia and underwent magnetic resonance imaging (MRI) of the thoracic vertebral column were included in the study. Data including MRI findings, endplate and disc degeneration, disc height loss, bulging, and disc herniation were retrospectively analyzed. Results: Of 3,348 patients, 195 patients had disc bulging/herniation. When 12 levels in 195 cases were taken into consideration, disc pathologies were found in 412 (18%) levels among the total of 2,340 intervertebral disc levels. Bulging was present in 11% (244/2,340) of the levels. Disc herniation was present in 7% (168/2,340) of the levels. The most commonly affected site was T 7-8 , followed by T 8-9 and T 11-12. Conclusion: Thoracic disc pathologies are still a significant diagnostic challenge. Our study results show that the incidence of these pathologies is higher than expected.

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“…The current commonly performed thoracic procedures are open surgeries with a posterior approach or lateral approach with thoracotomy. However, the posterior approach limits any traction on the thoracic cord and requires extensive bone resection with facetectomy, as well as removal of the head of the rib in order to reach the disk space [9, 12-14]. …”

Section: Introductionmentioning

confidence: 99%

Minimally Invasive Direct Thoracic Interbody Fusion (MIS-DTIF): Technical Notes of a Single Surgeon Study

Abbasi

2016

Cureus

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BackgroundMinimally invasive direct thoracic interbody fusion (MIS-DTIF) is a new single surgeon procedure for fusion of the thoracic vertebrae below the scapula (T6/7) to the thoracolumbar junction. In this proof of concept study, we describe the surgical technique for MIS-DTIF and report our experience and the perioperative outcomes of the first four patients who underwent this procedure.Study design/settingIn this study we attempt to establish the safety and efficacy of MIS-DTIF. We have performed MIS-DTIF on six spinal levels in four patients with degenerative disk disease or disk herniation. We recorded surgery time, blood loss, fluoroscopy time, complications, and patient-reported pain.MethodsThroughout the MIS-DTIF procedure, the surgeon is aided by biplanar fluoroscopic imaging and electrophysiological monitoring. The surgeon approaches the spine with a series of gentle tissue dilations and inserts a working tube that establishes a direct connection from the outside of the skin to the disk space. Through this working tube, the surgeon performs a discectomy and inserts an interbody graft or cage. The procedure is completed with minimally invasive (MI) posterior pedicle screw fixation.ResultsFor the single level patients the mean blood loss was 90 ml, surgery time 43 minutes, fluoroscopy time 293 seconds, and hospital stay two days. For the two-level surgeries, the mean blood loss was 27 ml, surgery time 61 minutes, fluoroscopy time 321 seconds, and hospital stay three days. We did not encounter any clinically significant complications. Thirty days post-surgery, the patients reported a statistically significant reduction of 5.3 points on a 10-point sliding pain scale.ConclusionsMIS-DTIF with pedicle screw fixation is a safe and clinically effective procedure for fusions of the thoracic spine. The procedure is technically straightforward and overcomes many of the limitations of the current minimally invasive (MI) approaches to the thoracic spine. MIS-DTIF has the potential to improve patient outcomes and reduce costs relative to the current standard of care. We are currently expanding this study to a larger cohort and recording long term outcomes and costs.

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Thoracic intervertebral disc calcification and herniation in adults: a report of two cases

Abstract: We suggest that decompression surgery should be carried out as early as possible for patients with early spinal myelopathy or paraplegia caused by a calcified protruded disc.

Cited by 16 publications

References 11 publications

Acute calcific discitis or symptomatic calcified schmorl's node of the upper thoracic spine in an adult: A case report and literature review

Acute calcific discitis or symptomatic calcified schmorl's node of the upper thoracic spine in an adult: A case report and literature review

The incidence and most common levels of thoracic degenerative disc pathologies

Minimally Invasive Direct Thoracic Interbody Fusion (MIS-DTIF): Technical Notes of a Single Surgeon Study

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