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胸椎间盘突出症:诊断、手术技术及并发症见解

Thoracic disc herniations: diagnosis, surgical techniques, and complication insights.

作者信息

Yurtluk Mehmet Denizhan, Apaydin Aydın Sinan, Kina Hakan, Than Khoi D

机构信息

School of Medicine, Bezmialem Vakıf University, İstanbul, Turkiye.

Department of Neurosurgery, Karabük University, Karabük, Turkiye.

出版信息

Turk J Med Sci. 2024 Dec 30;55(1):17-23. doi: 10.55730/1300-0144.5939. eCollection 2025.

Abstract

Thoracic disc herniations (TDHs) are rare conditions, comprising 0.1% to 5% of all reported herniation cases, and affecting up to 1 in 1,000,000 individuals. The mid to lower thoracic spine, particularly between the T11 and T12 vertebrae, is most frequently affected and often associated with trauma. Conditions like Scheuermann's disease can predispose patients to TDHs. This study explores the clinical manifestations, diagnostic methods, surgical techniques, and complications associated with TDHs. Diagnosis relies on magnetic resonance imaging and computed tomography myelography to identify the level and nature of the herniation. Various surgical approaches, including posterolateral, lateral, and anterior, have been implemented, each with specific indications, advantages, and pitfalls. Complications range from lung-associated to neurological deterioration to dural breaches. Clinical presentation primarily includes thoracic back pain. Patients can present with significant neurological deficits depending on the herniation's characteristics, namely giant centrally located. Surgical intervention is indicated in cases of failed conservative treatment or acute trauma with significant cord compression. This review aimed to delve into the literature to provide insights into the clinical manifestations of TDHs, diagnosis, surgical techniques, and associated complications.

摘要

胸椎间盘突出症(TDHs)较为罕见,占所有报告的椎间盘突出症病例的0.1%至5%,每100万人中发病者多达1人。胸段脊柱中下部,尤其是T11和T12椎体之间,最常受累,且常与创伤有关。像休门氏病这样的病症会使患者易患胸椎间盘突出症。本研究探讨了胸椎间盘突出症的临床表现、诊断方法、手术技术及相关并发症。诊断依靠磁共振成像和计算机断层扫描脊髓造影来确定突出的节段和性质。已实施了多种手术入路,包括后外侧、外侧和前路,每种入路都有特定的适应症、优点和缺陷。并发症包括与肺部相关的、神经功能恶化以及硬脊膜破裂。临床表现主要包括胸背部疼痛。根据突出的特征,即巨大中央型突出,患者可能会出现明显的神经功能缺损。在保守治疗失败或急性创伤伴有严重脊髓受压的情况下,需进行手术干预。本综述旨在深入研究文献,以深入了解胸椎间盘突出症的临床表现、诊断、手术技术及相关并发症。

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