Endoscope-assisted resection of calcified thoracic disc herniations

European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
Sergio PaoliniGiampaolo Cantore

Abstract

Resection of calcified thoracic disc herniations carries significant risks of neurological worsening, particularly in case of concomitant central location. Transthoracic approaches are a first-choice option to avoid spinal cord manipulation but entail drawbacks such as postoperative pain and the risk of bronchopulmonary complications. The purpose of this report is to describe a novel approach to resect calcified herniations, even centrally located, from a posterior perspective. Unilateral lamino-arthrectomy is performed, uncovering few millimeters of the disc space beside the dura. Following discectomy and drilling of the vertebral endplates, an angled endoscope is introduced allowing resection of the calcified herniation through an anterior perspective. The spinal cord can now be decompressed with a no-touch technique. Each maneuver aimed at resecting the calcified mass up to the contralateral side can be done under visual control. The technique was used in two patients. The first was a 38-year-old man with a calcified mediolateral T9-T10 disc herniation and mild myelopathic symptoms. The second patient was a 73-year-old obese woman, with a T6-T7 central, calcified disc herniation and severe compression myelopathy. In both cas...Continue Reading

References

Apr 12, 2011·Journal of Neurosurgery. Spine·Paul M ArnoldKaren K Anderson
Sep 12, 2012·The Spine Journal : Official Journal of the North American Spine Society·Gilad J RegevZvi Lidar
Oct 10, 2012·World Neurosurgery·Justin S SmithRichard G Fessler
Jun 19, 2013·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Yongfei ZhaoBaowei Liu
Dec 25, 2013·Spine·Hiroyuki Yoshihara
Jan 1, 2014·The Spine Journal : Official Journal of the North American Spine Society·Mark P Arts, Ronald H M A Bartels
Jul 16, 2014·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Bon Sub GuSeung Chul Rhim

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Citations

Jan 4, 2021·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Lei YuanHuishu Yuan

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