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Two-level thoracic disc herniation

S Boriani1, R Biagini, F De Iure

  • 11st Department of Orthopaedics, University of Bologna, Italy.

Spine
|November 1, 1994
PubMed
Summary
This summary is machine-generated.

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A transthoracic approach effectively treated a rare double thoracic disc herniation, relieving neurological symptoms. This surgical method achieved complete spinal cord decompression and fusion, offering a safe and effective solution.

Area of Science:

  • Neurosurgery
  • Spinal Surgery
  • Thoracic Spine Surgery

Background:

  • Double, contiguous thoracic disc herniations are rare, with limited literature on surgical approaches.
  • Only five of twenty-six reported cases utilized a transthoracic approach for two-level thoracic disc herniation.

Observation:

  • A 44-year-old male presented with progressive neurological deficits including lower extremity weakness, numbness, paresthesias, and mild sexual/urinary dysfunction.
  • Symptoms were attributed to a double, contiguous disc herniation at T7-T8 and T8-T9 in the thoracic spine.

Findings:

  • A right anterior transthoracic approach enabled complete excision of the herniated discs at T7-T8 and T8-T9.
  • The procedure involved hemicorporectomy of T8, grafting, and plating, with pre-operative spinal cord angiography and intraoperative localization.

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  • One-year follow-up revealed complete resolution of neurological symptoms and solid interbody fusion.
  • Implications:

    • The transthoracic approach, including hemicorporectomy, is a safe and effective surgical option for complex thoracic disc herniations.
    • This technique facilitates complete spinal cord decompression and prevents further herniation while minimizing iatrogenic vascular damage.
    • Successful surgical management can lead to full neurological recovery and spinal stability.