Article
Results of surgical treatment of thoracic disc herniations by posterior or posterolateral approach
Ergebnisse der chirurgischen Behandlung von thorakalen Bandscheibenvorfällen über einen dorsalen oder dorsolateralen Zugang
Search Medline for
Authors
Published: | April 23, 2004 |
---|
Outline
Text
Objective
Thoracic disc herniations represent a special challenge because of their localization. Despite the introduction of transthoracic techniques posterior and posterolateral approaches keep their position in surgical treatment of herniated thoracic discs. We report our results of 30 patients with herniated thoracic discs.
Methods
Between 1993 and 2001 30 patients with thoracic disc herniations underwent surgery in our neurosurgical department. The treated group included 11 men and 19 women with a mean age of 53.7 years. We present clinical symptoms, surgical approach, complications and clinical outcome retrospectively.
Results
22 of 30 patients suffered from localized, axial or radicular pain. 24 of 30 patients presented with sensory impairment, 10 with motor impairment, 14 with gait disturbance and 6 with bladder dysfunction. In 16 cases we used the costotransversectomy or partial resection of the costotransversal joint. Other approaches used were interlaminary fenestration (8 cases), hemilaminectomy (4 cases) and foraminotomy (2 cases). Postoperatively evaluation revealed an improvement or resolution of pain in 90%, of sensory impairment in 75%, of motor impairment in 70%, of gait disturbance in 71% and of bladder function in 67%. Two patients showed postoperatively a neurological deteroriation. A postoperative bladder dysfunction recovered spontaneously. One patient showed an instability with necessity to stabilization. In this case an intraspinal revision was additionally required because of an incomplete resection of an osteophyte.
Conclusions
The posterior or posterolateral approaches to thoracic disc herniations are safe and effective and show satisfying clinical results in a respectable number of patients.