Konakondla Sanjay, Sofoluke Nelson, Barber Sean M, Rimini Sarah A, Slotkin Jonathan R
Geisinger Neuroscience Institute, Geisinger, Danville, Pennsylvania.
Department of Neurosurgery, Houston Methodist Neurological Institute, Houston, Texas; and.
Neurosurg Focus Video. 2022 Jan 1;6(1):V18. doi: 10.3171/2021.10.FOCVID2112. eCollection 2022 Jan.
Thoracic disc herniations can cause radiculopathy and myelopathy from neural compression. Surgical resection may require complex, morbid approaches. To avoid spinal cord retraction, wide exposures requiring extensive tissue, muscle, and bony disruption are needed, which may require instrumentation. Anterior approaches may require vascular surgeons, chest tube placement, and intensive care admission. Large, calcified discs or migrated fragments can pose additional challenges. Previous literature has noted the endoscopic approach to be contraindicated for calcified thoracic discs. The authors describe an ultra-minimally invasive, ambulatory endoscopic approach to resect a large calcified thoracic disc with caudal migration and avoidance of conventional approaches. The video can be found here: https://stream.cadmore.media/r10.3171/2021.10.FOCVID2112.
胸椎椎间盘突出可因神经受压导致神经根病和脊髓病。手术切除可能需要复杂、创伤性大的方法。为避免脊髓牵拉，需要广泛暴露，这需要广泛的组织、肌肉和骨骼破坏，可能还需要内固定。前路手术可能需要血管外科医生参与、放置胸管并入住重症监护病房。巨大、钙化的椎间盘或移位的碎片会带来额外挑战。既往文献指出，内镜手术方法对钙化的胸椎椎间盘为禁忌。作者描述了一种超微创、可门诊进行的内镜手术方法，用于切除一个伴有尾侧移位的巨大钙化胸椎椎间盘，避免采用传统手术方法。视频可在此处查看：https://stream.cadmore.media/r10.3171/2021.10.FOCVID2112
