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Lisitsky I.Yu.

Sechenov First Moscow State Medical University

Lychagin A.V.

Sechenov First Moscow State Medical University

Zarov A.Yu.

Sechenov First Moscow State Medical University

Korkunov A.L.

Sechenov First Moscow State Medical University

Cherepanov V.G.

Sechenov First Moscow State Medical University

Vyzankin I.A.

Sechenov First Moscow State Medical University

Surgical treatment of herniated thoracic discs using transthoracic extrapleural approach

Authors:

Lisitsky I.Yu., Lychagin A.V., Zarov A.Yu., Korkunov A.L., Cherepanov V.G., Vyzankin I.A.

More about the authors

Journal: Burdenko's Journal of Neurosurgery. 2022;86(4): 50‑59

DOI: 10.17116/neiro20228604150

Read: 4057 times

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Table of contents

SURGICAL TREATMENT OF HERNIATED THORACIC DISCS USING TRANSTHORACIC EXTRAPLEURAL APPROACH
SURGICAL TREATMENT OF HERNIATED THORACIC DISCS USING TRANSTHORACIC EXTRAPLEURAL APPROACH

To cite this article:

Lisitsky IYu, Lychagin AV, Zarov AYu, Korkunov AL, Cherepanov VG, Vyzankin IA. Surgical treatment of herniated thoracic discs using transthoracic extrapleural approach. Burdenko's Journal of Neurosurgery. 2022;86(4):50‑59. (In Russ., In Engl.)
https://doi.org/10.17116/neiro20228604150

Подписка 2025 Журнал «Вопросы нейрохирургии» имени Н.Н. Бурденко (Burdenko's Journal of Neurosurgery)
МСФ на ЯМ
Использование инфографики авторами научных работ
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Abstract:

OBJECTIVE

To analyze the results of herniated thoracic disc resection via transthoracic extrapleural approach.

MATERIAL AND METHODS

The study included 16 patients with 18 symptomatic herniated thoracic discs wo underwent transthoracic extrapleural surgery. In 11 cases, clinical pattern of disease was represented by myelopathy with radicular or axial pain syndrome. Five patients had radiculopathy alone. Median localization of hernias was observed in 8 (44.4%) cases, paramedian hernias - in 10 (55.6%) cases. There were 10 (55.6%) ossified hernias, 5 (27.7%) giant, 10 (55.5%) large and 3 (16.6%) medium hernias.

RESULTS

In most patients, VAS score of pain syndrome decreased by 2-6 points (mean 3.6). In 4 patients, this value remained the same. Among 11 patients with myelopathy, regression of conduction disorders in 1 year after surgery was achieved in 9 (82%) cases including complete recovery in 6 (55%) patients (Frankel E, Nurick - 0-I). In 2 patients, neurological status was equal to preoperative one. In all cases, the follow-up examination confirmed total removal of compressive substrate and found no signs of spine instability. Surgery time varied from 80 to 210 min (mean 161), blood loss - from 300 to 800 ml (mean 378 ml). Two patients had transient neurological deterioration. There was damage to dura mater in 4 cases. Intercostal neuralgia was observed in 3 patients.

CONCLUSION

While retaining the advantages of open thoracotomy, transthoracic extrapleural approach is less traumatic, allows complete spinal cord decompression, minimizes the risk of iatrogenic spinal cord injury and avoids certain postoperative complications.

Keywords:

herniated thoracic discs
transthoracic extrapleural approach
transthoracic retropleural approach

Authors:

Lisitsky I.Yu.

Sechenov First Moscow State Medical University

Lychagin A.V.

Sechenov First Moscow State Medical University

Zarov A.Yu.

Sechenov First Moscow State Medical University

Korkunov A.L.

Sechenov First Moscow State Medical University

Cherepanov V.G.

Sechenov First Moscow State Medical University

Vyzankin I.A.

Sechenov First Moscow State Medical University

Received:

30.12.2021

Accepted:

10.06.2022

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