Trans-thoracic versus retropleural approach for symptomatic thoracic disc herniations: comparative analysis of 94 consecutive cases
| Autor: | Marco Teli, Christian Soda, Cristiano Benato, Ivan Tomasi, Umberto Maria Ricci, Nicolò Marchesini, F. Faccioli, Giampietro Pinna, Luciano Annicchiarico, Marco Brollo |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Less invasive thoracotomy Thoracic Vertebrae 03 medical and health sciences Myelopathy 0302 clinical medicine myelopathy medicine Humans Thoracotomy Surgical treatment minimally invasive surgery Retrospective Studies business.industry General Medicine Middle Aged medicine.disease Surgery Treatment Outcome 030220 oncology & carcinogenesis Thoracic disc herniation Female Neurology (clinical) business Thoracic disc Intervertebral Disc Displacement 030217 neurology & neurosurgery Diskectomy |
| Popis: | The authors illustrate their results in the surgical treatment of symptomatic thoracic disc herniations (TDHs) by comparing the traditional open to the less invasive retropleural lateral approaches.Retrospective review of 94 consecutive cases treated at a single Institution between 1988 and 2014. Fifty-two patients were males, 42 females, mean age was 53.9 years. Mean follow-up was 46.9 months (12-79 months). 33 patients were diagnosed with a giant thoracic disc herniation (GTDH). Upon admission, the most common symptoms were: motor impairment (91.4%,Decompression was performed in 7 cases via a thoraco-laparo-phrenotomy and in 87 cases via an antero-lateral thoracotomy. Out of the latter cases, 49 (56%) were trans-thoracic trans-pleural approaches (TTA) and 38 (44%) were less invasive retropleural approaches (MIRA). At follow-up, there were 59.5% neurologically intact patients according to the McCormick Scale, while 64.8% and 67% had no bladder or bowel dysfunction respectively. Complications occurred in 24 patients (25.5%). Pulmonary complications were the commonest (12.7%) with pleural effusion being significantly more common in patients treated with TTA compared to MIRA (20% vs 5.2%: XMIRA is a safe and effective technique to obtain adequate TDH decompression and is associated with lower morbidity compared to TTA. |
| Databáze: | OpenAIRE |
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