Combined intra-extradural approach for posterolateral thoracic disk herniations: how I do it.

Calcified disc herniation Combined intra-extradural approach Posterior spine approach Thoracic disc herniation Thoracic myelopathy

Journal

Acta neurochirurgica
ISSN: 0942-0940
Titre abrégé: Acta Neurochir (Wien)
Pays: Austria
ID NLM: 0151000

Informations de publication

Date de publication:
05 Oct 2024
Historique:
received: 04 09 2024
accepted: 18 09 2024
medline: 6 10 2024
pubmed: 6 10 2024
entrez: 5 10 2024
Statut: epublish

Résumé

Thoracic disc herniation is a rare degenerative spine disease that can cause severe neurological deficits. Nowadays, controversies still stand on the most effective surgical route. Herein, we describe the combined intra-extradural approach for a posterolateral thoracic disk herniation. We divided the technique into four steps: bony, extradural, intradural and intra-extradural. We disclose perioperative shrewdness aimed at improving outcomes and reducing complications. The combined intra-extradural approach represents an effective technique for posterolateral thoracic disk herniations, reducing both the risk of spinal cord damages and post-operative CSF leaks.

Sections du résumé

BACKGROUND BACKGROUND
Thoracic disc herniation is a rare degenerative spine disease that can cause severe neurological deficits. Nowadays, controversies still stand on the most effective surgical route.
METHOD METHODS
Herein, we describe the combined intra-extradural approach for a posterolateral thoracic disk herniation. We divided the technique into four steps: bony, extradural, intradural and intra-extradural. We disclose perioperative shrewdness aimed at improving outcomes and reducing complications.
CONCLUSION CONCLUSIONS
The combined intra-extradural approach represents an effective technique for posterolateral thoracic disk herniations, reducing both the risk of spinal cord damages and post-operative CSF leaks.

Identifiants

pubmed: 39367922
doi: 10.1007/s00701-024-06278-6
pii: 10.1007/s00701-024-06278-6
doi:

Types de publication

Journal Article Case Reports

Langues

eng

Sous-ensembles de citation

IM

Pagination

396

Informations de copyright

© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.

Références

Bocchetti A, Cioffi V, de Falco R (2017) Combined intra-extradural approach for posterolateral thoracic disk herniations. Preliminary study and technical note. Eur Spine J 26(Suppl 4):505–513. https://doi.org/10.1007/s00586-017-5041-7
doi: 10.1007/s00586-017-5041-7 pubmed: 28331980
Bouthors C, Benzakour A, Court C (2019) Surgical treatment of thoracic disc herniation: an overview. Int Orthop 43(4):807–816. https://doi.org/10.1007/s00264-018-4224-0
doi: 10.1007/s00264-018-4224-0 pubmed: 30406842
Charalampidis A, Jiang F, Wilson JRF, Badhiwala JH, Brodke DS, Fehlings MG (2020) The use of intraoperative neurophysiological monitoring in spine surgery. Global Spine J 10(1 Suppl):104S-114S. https://doi.org/10.1177/2192568219859314
doi: 10.1177/2192568219859314 pubmed: 31934514 pmcid: 6947672
Court C, Mansour E, Bouthors C (2018) Thoracic disc herniation: Surgical treatment. Orthop Traumatol Surg Res 104(1S):S31–S40. https://doi.org/10.1016/j.otsr.2017.04.022
doi: 10.1016/j.otsr.2017.04.022 pubmed: 29225115
Farber SH et al (2024) Reliability of a novel classification system for thoracic disc herniations. Spine (Phila Pa 1976) 49(5):341–348. https://doi.org/10.1097/BRS.0000000000004701
doi: 10.1097/BRS.0000000000004701 pubmed: 37134139
Gao L, Wang L, Su B, Wang P, Ye J, Shen H (2013) The vascular supply to the spinal cord and its relationship to anterior spine surgical approaches. Spine J 13(8):966–973. https://doi.org/10.1016/j.spinee.2013.03.017
doi: 10.1016/j.spinee.2013.03.017 pubmed: 23608560
Martinez-del-Campo E, Soriano-Baron H, Theodore N (2016) Extraspinal anatomy and surgical approaches to the thoracic spine. In Benzel's Spine Surgery: Techniques, Complication avoidance and management: volume 1–2, fourth edition, vol. 1–2, Elsevier Ed, pp 397–405
Mizutani K, Rodesch G (2020) Anatomical disposition of the anterior spinal artery and vein: Subpial or subarachnoid? Interv Neuroradiol 26(6):706–707. https://doi.org/10.1177/1591019920928628
doi: 10.1177/1591019920928628 pubmed: 32576068 pmcid: 7724610

Auteurs

Ciro Mastantuoni (C)

Division of Neurosurgery, Santa Maria Delle Grazie Hospital, AslNa2Nord, Via Domiziana 1, Località La Schiana, 80078, Pozzuoli, Naples, Italy. mastantuoniciro@gmail.com.

Maria Rosaria Scala (MR)

Division of Neurosurgery, Santa Maria Delle Grazie Hospital, AslNa2Nord, Via Domiziana 1, Località La Schiana, 80078, Pozzuoli, Naples, Italy.

Raffaele de Falco (R)

Division of Neurosurgery, Santa Maria Delle Grazie Hospital, AslNa2Nord, Via Domiziana 1, Località La Schiana, 80078, Pozzuoli, Naples, Italy.

Antonio Bocchetti (A)

Division of Neurosurgery, Santa Maria Delle Grazie Hospital, AslNa2Nord, Via Domiziana 1, Località La Schiana, 80078, Pozzuoli, Naples, Italy.

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