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Calcified giant thoracic disc herniations: considerations and treatment strategies

N A Quraishi1, A Khurana, M M Tsegaye

  • 1Centre for Spine Studies and Surgery, Queens Medical Centre, West Block, D Floor, Derby Road, Nottingham, NG7 2UH, UK, nasquraishi@hotmail.com.

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
|February 13, 2014
PubMed

Insights

Surgical management of calcified giant herniated thoracic discs (GHTD) using an anterior thoracotomy approach is effective. This technique safely removes calcified disc fragments, leading to neurological improvement in most patients.

Area of Science:

  • Neurosurgery
  • Spinal Surgery
  • Thoracic Surgery

Background:

  • Giant herniated thoracic discs (GHTD) present significant surgical challenges.
  • Calcified GHTD are infrequently described and necessitate modified surgical strategies.

Purpose of the Study:

  • To describe surgical approaches for managing calcified giant herniated thoracic discs.
  • To evaluate the outcomes and complications associated with these surgical interventions.

Main Methods:

  • Retrospective cohort study of 13 patients with calcified GHTD operated between 2004 and 2012.
  • Data collected included demographics, radiological findings, clinical presentation, operative procedures, and complications.
  • All patients underwent anterior thoracotomy with decompression and removal of the calcified disc fragment.

Main Results:

  • The average canal encroachment was 62%, with a mean follow-up of 37 months.
  • Postoperatively, 77% of patients improved by at least one Frankel grade, while 23% remained unchanged.
  • The complication rate was 31%, including durotomies and one case of recurrence.

Conclusions:

  • Anterior decompression via thoracotomy is a safe and effective approach for calcified GHTD.
  • Surgical intervention allows for safe removal of calcified fragments, with good neurological outcomes and no radiographic failure.
  • Despite challenges, this surgical strategy offers significant neurological improvement for patients with calcified GHTD.
Abstract

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