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KEY FACTS
Pre-Procedure
Outcomes
TERMINOLOGY
Definitions
- Multiple techniques
- Posterior approaches
- Laminectomy
- No longer performed for thoracic disc herniations
- Increased risk of neurologic injury (25-75%)
- Cord manipulation for approach to ventral disease may interfere with cord blood supply
- Kyphotic deformities cause tethering of cord over incompletely removed disc/osteophyte
- Transpedicular
- Less extensive procedure
- Limited access to midline
- Transforaminal
- Less extensive procedure
- Limited access to midline
- Transfacet
- Less extensive procedure
- Limited access to midline
- Laminectomy
- Posterolateral
- Costotransversectomy
- Greater ventral access
- Increased muscle and rib resection
- Lateral extracavitary
- Greater ventral access
- Increased muscle/rib dissection
- Costotransversectomy
- Anterior
- Transthoracic
- Excellent ventral access
- Extensive surgery with potential of increased morbidity
- Favored for central thoracic herniations with myelopathy and calcification
- Varieties
- Transpleural
- Extrapleural
- Transsternal
- Thorascopic
- Transthoracic
PRE-PROCEDURE
Indications
Pre-Procedure Imaging
PROCEDURE
Alternative Procedures/Therapies
OUTCOMES
Problems
Selected References
- Arnold PM et al: Surgical management of multiple thoracic disc herniations via a transfacet approach: a report of 15 cases. J Neurosurg Spine. 15(1):76-81, 2011
- Cornips EM et al: Thoracic disc herniation and acute myelopathy: clinical presentation, neuroimaging findings, surgical considerations, and outcome. J Neurosurg Spine. 14(4):520-8, 2011
- Diabira S et al: Brown-Sequard syndrome revealing intradural thoracic disc herniation. Eur Spine J. 20(1):65-70, 2011
- Khoo LT et al: Minimally invasive extracavitary approach for thoracic discectomy and interbody fusion: 1-year clinical and radiographic outcomes in 13 patients compared with a cohort of traditional anterior transthoracic approaches. J Neurosurg Spine. 14(2):250-60, 2011
- Binning MJ et al: Percutaneous placement of radiopaque markers at the pedicle of interest for preoperative localization of thoracic spine level. Spine (Phila Pa 1976). 35(19):1821-5, 2010
- Bransford R et al: Early experience treating thoracic disc herniations using a modified transfacet pedicle-sparing decompression and fusion. J Neurosurg Spine. 12(2):221-31, 2010
- Choi KY et al: Percutaneous endoscopic thoracic discectomy; transforaminal approach. Minim Invasive Neurosurg. 53(1):25-8, 2010
- Machino M et al: A new thoracic reconstruction technique "transforaminal thoracic interbody fusion": a preliminary report of clinical outcomes. Spine (Phila Pa 1976). 35(19):E1000-5, 2010
- Baranto A et al: Acute chest pain in a top soccer player due to thoracic disc herniation. Spine (Phila Pa 1976). 34(10):E359-62, 2009
- Barbanera A et al: Giant calcified thoracic herniated disc: considerations aiming a proper surgical strategy. J Neurosurg Sci. 53(1):19-25; discussion 25-6, 2009
- Burke TG et al: Treatment of thoracic disc herniation: evolution toward the minimally invasive thoracoscopic technique. Neurosurg Focus. 9(4):e9, 2000
- McCormick WE et al: Surgery for thoracic disc disease. Complication avoidance: overview and management. Neurosurg Focus. 9(4):e13, 2000
- Vollmer DG et al: Transthoracic approaches to thoracic disc herniations. Neurosurg Focus. 9(4):e8, 2000
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Pre-Procedure
Outcomes
TERMINOLOGY
Definitions
- Multiple techniques
- Posterior approaches
- Laminectomy
- No longer performed for thoracic disc herniations
- Increased risk of neurologic injury (25-75%)
- Cord manipulation for approach to ventral disease may interfere with cord blood supply
- Kyphotic deformities cause tethering of cord over incompletely removed disc/osteophyte
- Transpedicular
- Less extensive procedure
- Limited access to midline
- Transforaminal
- Less extensive procedure
- Limited access to midline
- Transfacet
- Less extensive procedure
- Limited access to midline
- Laminectomy
- Posterolateral
- Costotransversectomy
- Greater ventral access
- Increased muscle and rib resection
- Lateral extracavitary
- Greater ventral access
- Increased muscle/rib dissection
- Costotransversectomy
- Anterior
- Transthoracic
- Excellent ventral access
- Extensive surgery with potential of increased morbidity
- Favored for central thoracic herniations with myelopathy and calcification
- Varieties
- Transpleural
- Extrapleural
- Transsternal
- Thorascopic
- Transthoracic
PRE-PROCEDURE
Indications
Pre-Procedure Imaging
PROCEDURE
Alternative Procedures/Therapies
OUTCOMES
Problems
Selected References
- Arnold PM et al: Surgical management of multiple thoracic disc herniations via a transfacet approach: a report of 15 cases. J Neurosurg Spine. 15(1):76-81, 2011
- Cornips EM et al: Thoracic disc herniation and acute myelopathy: clinical presentation, neuroimaging findings, surgical considerations, and outcome. J Neurosurg Spine. 14(4):520-8, 2011
- Diabira S et al: Brown-Sequard syndrome revealing intradural thoracic disc herniation. Eur Spine J. 20(1):65-70, 2011
- Khoo LT et al: Minimally invasive extracavitary approach for thoracic discectomy and interbody fusion: 1-year clinical and radiographic outcomes in 13 patients compared with a cohort of traditional anterior transthoracic approaches. J Neurosurg Spine. 14(2):250-60, 2011
- Binning MJ et al: Percutaneous placement of radiopaque markers at the pedicle of interest for preoperative localization of thoracic spine level. Spine (Phila Pa 1976). 35(19):1821-5, 2010
- Bransford R et al: Early experience treating thoracic disc herniations using a modified transfacet pedicle-sparing decompression and fusion. J Neurosurg Spine. 12(2):221-31, 2010
- Choi KY et al: Percutaneous endoscopic thoracic discectomy; transforaminal approach. Minim Invasive Neurosurg. 53(1):25-8, 2010
- Machino M et al: A new thoracic reconstruction technique "transforaminal thoracic interbody fusion": a preliminary report of clinical outcomes. Spine (Phila Pa 1976). 35(19):E1000-5, 2010
- Baranto A et al: Acute chest pain in a top soccer player due to thoracic disc herniation. Spine (Phila Pa 1976). 34(10):E359-62, 2009
- Barbanera A et al: Giant calcified thoracic herniated disc: considerations aiming a proper surgical strategy. J Neurosurg Sci. 53(1):19-25; discussion 25-6, 2009
- Burke TG et al: Treatment of thoracic disc herniation: evolution toward the minimally invasive thoracoscopic technique. Neurosurg Focus. 9(4):e9, 2000
- McCormick WE et al: Surgery for thoracic disc disease. Complication avoidance: overview and management. Neurosurg Focus. 9(4):e13, 2000
- Vollmer DG et al: Transthoracic approaches to thoracic disc herniations. Neurosurg Focus. 9(4):e8, 2000
