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Transcostovertebral approach for thoracic disc herniations.

D H Dinh1, J Tompkins, S B Clark

  • 1Department of Neurosurgery, University of Illinois College of Medicine, Peoria 61637, USA. ddinh@mailhost.tcs.tulane.edu

Journal of Neurosurgery
|January 9, 2001
PubMed
Summary

A novel posterolateral transcostovertebral approach effectively removes herniated thoracic discs. This minimally invasive technique offers improved patient outcomes, including reduced pain and shorter hospital stays.

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Area of Science:

  • Neurosurgery
  • Spinal Surgery
  • Minimally Invasive Procedures

Background:

  • Herniated thoracic discs can cause significant axial pain, radicular pain, myelopathy, sensory loss, and genitourinary symptoms.
  • Traditional surgical approaches may involve extensive dissection and potential complications.

Purpose of the Study:

  • To describe and evaluate a new posterolateral transcostovertebral approach for thoracic disc herniation removal.
  • To assess the efficacy and safety of this novel surgical technique.

Main Methods:

  • A posterolateral transcostovertebral approach was used to excise 28 thoracic discs in 22 patients.
  • The technique involves accessing the costovertebral junction, drilling the costovertebral joint and vertebral endplates, and exposing the lateral annulus.

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  • Ribs were preserved, avoiding the need for chest tubes.

    • Main Results:

    • The procedure demonstrated significant improvement in pain, myelopathy, sensory loss, and genitourinary symptoms.
    • Average operating time was 200.5 minutes per level, with average blood loss of 231 ml.
    • Average hospital stay was 3.8 days, with most patients discharged on postoperative Day 2 or 3. No patients experienced worsening of their condition.

    Conclusions:

    • The posterolateral transcostovertebral approach is a viable option for thoracic disc herniation at any level.
    • It offers advantages over traditional methods, including shorter operating times, reduced blood loss, less dissection, decreased postoperative pain, and shorter hospital stays.