Transforaminal endoscopic thoracic discectomy: surgical technique.

Area of Science:

• Neurosurgery
• Minimally Invasive Spine Surgery
• Spinal Endoscopy

Background:

• Thoracic disc herniations present significant surgical challenges due to the ventral location of the herniation relative to the spinal cord.
• Traditional posterior approaches risk spinal cord retraction morbidity, while ventral approaches are obstructed by thoracic viscera.
• The lateral transcavitary approach, though standard, carries substantial morbidity.

Purpose of the Study:

• To detail a step-by-step technique for transforaminal endoscopic thoracic discectomy (TETD).
• To demonstrate the feasibility and advantages of minimally invasive endoscopic spine surgery for thoracic disc pathology.
• To address the challenges and learning curve associated with adopting TETD.

Main Methods:

• Utilizing advances in endoscopic camera technology and specialized instruments through a working channel endoscope.
• Employing a transforaminal approach combined with an angled endoscopic camera for optimal access.
• Overcoming challenges in needle targeting and endoscopic visual anatomy interpretation.

Main Results:

• Transforaminal endoscopic thoracic discectomy (TETD) provides a technically advantageous and minimally invasive method for treating ventral thoracic disc pathology.
• The technique is suitable for outpatient settings and can be performed with the patient awake.
• Advances in technology have expanded the range of accessible spinal pathologies via minimally invasive endoscopic techniques.

Conclusions:

• Transforaminal endoscopic thoracic discectomy (TETD) represents a viable, less morbid alternative to traditional surgical approaches for thoracic disc herniations.
• The technique leverages technological advancements to enable minimally invasive access to challenging ventral thoracic spinal pathology.
• Surgeons can overcome the learning curve and cost barriers to adopt this effective outpatient procedure.