Stone J L, Lichtor T, Banerjee S
Division of Neurosurgery, Cook County Hospital, Chicago, Illinois.
Spine (Phila Pa 1976). 1994 Jun 1;19(11):1281-4. doi: 10.1097/00007632-199405310-00016.
Patients with intradural herniation of an intervertebral disc were identified and managed surgically.
Illustrative cases of patients with intradural herniated discs at the mid-thoracic level are presented, the literature is reviewed, and the management of these patients is discussed.
Intradural herniation of an intervertebral disc is rare and most common at the lumbar level, but isolated cases have been reported at other levels. Cases reports of this entity have been published, but the surgical details have not been adequately addressed.
In this report, two patients with calcified intradural herniated discs at the mid-thoracic level are presented.
Both patients had progressive paraparesis and had calcified disc material in the mid-thoracic canal. Both were treated successfully with a posterolateral extracavitary costotransversectomy and hemilaminotomy using intraoperative ultrasound and somatosensory-evoked potential monitoring.
This entity should be suspected when a calcified disc within the spinal canal is being treated. The optimal exposure is a posterolateral extracavitary costotransversectomy with a hemilaminotomy. Alternative approaches to a typical thoracic disc would be problematic in managing these patients.
识别并通过手术治疗椎间盘硬膜内疝患者。
介绍中胸段椎间盘硬膜内疝患者的典型病例，回顾相关文献，并讨论这些患者的治疗方法。
椎间盘硬膜内疝罕见，最常见于腰椎水平，但其他水平也有孤立病例报道。关于该病症的病例报告已发表，但手术细节尚未得到充分阐述。
在本报告中，介绍了两名中胸段钙化性椎间盘硬膜内疝患者。
两名患者均有进行性下肢轻瘫，中胸段椎管内有钙化的椎间盘组织。两人均通过后外侧腔外肋骨横突切除术和半椎板切除术成功治疗，术中使用了超声和体感诱发电位监测。
当治疗椎管内钙化椎间盘时，应怀疑存在该病症。最佳暴露方式是后外侧腔外肋骨横突切除术联合半椎板切除术。对于这些患者，采用典型胸段椎间盘的替代手术方法会有问题。
