THORACIC DISC HERNIATION: SURGICAL DECOMPRESSION BY POSTERIOR APPROACH A LA CARTE

• Autor(a) principal: DAHER,MURILO TAVARES
• Data de Publicação: 2016
• Outros Autores: FELISBINO JUNIOR,PEDRO, ESPERIDIÃO,ADRIANO PASSÁGLIA, ARAÚJO,BRENDA CRISTINA RIBEIRO, CARDOSO,ANDRÉ LUIZ PASSOS, PIMENTA JUNIOR,WILSON ELOY, DAHER,SÉRGIO
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Coluna/Columna
• Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1808-18512016000300213
• topic: Spine; Intervertebral disc displacement; Spondylosis; Evaluation of results of therapeutic interventions; Spinal cord compression

ABSTRACT Objectives: To present the clinical and radiographic results of patients with thoracic disc herniation treated by the posterior approach, according to location and type of hernia (à la carte). Methods: We evaluated thirteen patients (14 hernias) treated by the posterior approach. Eight (61.5%) patients were male and the mean age was 53 years (34-81). Clinical evaluation was performed by the Frankel and JOA modified scales. All the patients underwent the posterior approach, which was performed by facetectomy, transpedicular approach, transpedicular + partial body resection, costotransversectomy or costotransversectomy + reconstruction with CAGE. Results: The mean follow-up was 2 years and 6 months (11-77 months). Of the 14 operated hernias, six (43%) were lateral, 2 (14%) paramedian, and 6 (43%) central. Seven were soft (50%) and seven were calcified. The transfacet approach was carried out in 5 cases (36%), transpedicular in 1 case (7%), transpedicular + partial body resection in 4 (29%), costotransversectomy in 3 (21%), and costotransversectomy + CAGE in one case (7%). The majority of patients with lateral hernia (5/6) were subjected to transfacet decompression and in cases of central and paramedian hernias, all patients underwent decompression, which is more extensive. Conclusions: The posterior approach is safe and effective, and the best approach must be chosen based on location and type of the herniation and the surgeon's experience.