Transpedicular Approach to Thoracic Disc Herniaton Guided by 3D Navigation System

Area of Science:

• Neurosurgery
• Spinal Surgery
• Minimally Invasive Techniques

Background:

• Thoracic disc herniations, particularly calcified midline types, pose surgical challenges.
• Traditional transpedicular approaches have limitations due to blind spots, often necessitating riskier transthoracic approaches.
• Calcified midline disc herniations require careful consideration of surgical strategy to minimize complications.

Observation:

• Two cases of calcified midline thoracic disc herniations were treated using a transpedicular approach.
• A three-dimensional (3D) neuronavigation system was integrated to overcome the limitations of blind spots.
• The neuronavigation system allowed for verification of disc removal on the contralateral side.

Findings:

• Postoperative CT scans confirmed successful resection of the herniated disc material.
• The neuronavigation-assisted technique enabled visualization and access to the side opposite the primary herniation.
• Complete removal was achieved without intraoperative or postoperative complications.

Implications:

• Neuronavigation significantly improves the safety and efficacy of the transpedicular approach for complex thoracic disc herniations.
• This technique offers a viable alternative to more invasive procedures, potentially reducing associated risks.
• The successful application suggests broader applicability in managing challenging spinal pathologies.