학술논문
A Novel Surgical Technique for Management of Giant Central Calcified Thoracic Disk Herniations: A Dual Corridor Method Involving Tubular Transthoracic/Retropleural Approach Followed by a Posterior Transdural Diskectomy
CONCEPTS, INNOVATIONS AND TECHNIQUES
CONCEPTS, INNOVATIONS AND TECHNIQUES
Document Type
Academic Journal
Author
Source
Operative NeuroSurgery. May 2019, Vol. 16 Issue 5, p626, 7 p.
Subject
Language
English
ISSN
2332-4252
Abstract
Thoracic disk herniation (TDH) is a unique condition that presents a distinct challenge to the neurosurgeon with regard to diagnosis, preoperative decision making, and treatment. TDHs are rare lesions, estimated [...]
BACKGROUND: Thoracic disk herniations (TDHs) represent only 0.15% to 1.8% of surgically managed disk herniations but have posed a particular challenge to spine surgeons. Numerous surgical approaches have been cited in the literature with varying degrees of success, technical complexity, and complication profiles. OBJECTIVE: To report a case of a combined lateral retropleural and dorsal transdural approach for complex thoracic discectomy. METHODS: In this report, we describe a combined lateral/retropleural and posterior transdural approach for a patient with a giant calcified TDH that was not amenable to safe removal using a single approach. RESULTS: In complex situations such as this, a dual corridor approach allows for improved visualization and maximal resection opportunity and opens up yet another option to address recalcitrant TDH. CONCLUSION: The staged dual corridor approach is safe and represents a further surgical option for extremely difficult TDH. KEY WORDS: Giant thoracic disk herniation, calcified, transthoracic, retropleural, transdural, minimally invasive, thoracic spine surgery, salvage, dual corridor, Surgical rib fixation DOI: 10.1093/ons/opy225
BACKGROUND: Thoracic disk herniations (TDHs) represent only 0.15% to 1.8% of surgically managed disk herniations but have posed a particular challenge to spine surgeons. Numerous surgical approaches have been cited in the literature with varying degrees of success, technical complexity, and complication profiles. OBJECTIVE: To report a case of a combined lateral retropleural and dorsal transdural approach for complex thoracic discectomy. METHODS: In this report, we describe a combined lateral/retropleural and posterior transdural approach for a patient with a giant calcified TDH that was not amenable to safe removal using a single approach. RESULTS: In complex situations such as this, a dual corridor approach allows for improved visualization and maximal resection opportunity and opens up yet another option to address recalcitrant TDH. CONCLUSION: The staged dual corridor approach is safe and represents a further surgical option for extremely difficult TDH. KEY WORDS: Giant thoracic disk herniation, calcified, transthoracic, retropleural, transdural, minimally invasive, thoracic spine surgery, salvage, dual corridor, Surgical rib fixation DOI: 10.1093/ons/opy225