Combined intra-extradural approach for posterolateral thoracic disk herniations. Preliminary study and technical...

Area of Science:

• Neurosurgery
• Spinal Surgery
• Minimally Invasive Techniques

Background:

• Thoracic disc herniation is a rare but challenging condition for spinal surgeons.
• Existing surgical strategies for thoracic disc herniation are often debated.
• Spinal cord compression due to thoracic disc herniation requires effective surgical intervention.

Purpose of the Study:

• To describe a preliminary experience with a combined extra-intra dural approach for posterolateral thoracic disc herniation.
• To evaluate the feasibility and outcomes of this novel surgical technique.
• To present an alternative surgical option for thoracic disc herniation with spinal cord compression.

Main Methods:

• A combined extra-intra dural approach was performed in two patients.
• Procedures included bilateral laminectomy, unilateral partial medial arthrectomy, and lateral extradural diskectomy.
• A median longitudinal durotomy allowed for removal of herniated disc fragments without ventral spinal dura opening.

Main Results:

• Successful resolution of spinal cord compression in both cases.
• Observed postoperative neurological improvement in all patients.
• No major complications were reported during the preliminary study.

Conclusions:

• The combined extra-intra dural approach offers a viable surgical perspective for thoracic disc herniation.
• This technique may be particularly beneficial for patients with contraindications to anterior surgical approaches.
• Further research is needed to establish definitive surgical criteria for this approach.