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. 2012 Apr;21(4):637-45.
doi: 10.1007/s00586-011-2103-0. Epub 2011 Dec 10.

Thoracoscopic treatment for single level symptomatic thoracic disc herniation: a prospective followed cohort study in a group of 167 consecutive cases

Ulrich Quint  1 , Gerd Bordon, Inge Preissl, Christoph Sanner, Daniel Rosenthal
Affiliations

Thoracoscopic treatment for single level symptomatic thoracic disc herniation: a prospective followed cohort study in a group of 167 consecutive cases

Ulrich Quint et al. Eur Spine J. 2012 Apr.

Abstract

Problem: Thoracic disc disease with radicular pain and myelopathic symptoms can have serious neurological sequelae. The authors present a relevant treatment option.

Methods: Data of patients with single level symptomatic thoracic disc herniation treated with thoracoscopic microdiscectomy were prospectively collected over a period of 10 years. Data collection included the preoperative status and the follow-up status was 6, 12 and 24 months after surgery for every patient.

Results: A total of 167 single level thorascoscopic discectomies without previous surgery on the level of the procedure were included in this study. The average preoperative duration of pain symptoms was 14.3 months, myelopathic symptoms were present for an average of 16.7 months before surgery. After the procedure pain scores measured with visual analog scale (VAS) decreased by 4.4 points and the muscle strength improved by a mean of 4.6 points (American Spinal Injury Association ASIA motor score). After 2 years, 79% of the patients reported a excellent or good outcome for pain and 80% of the patients reported a excellent or good outcome for motor function. The overall complication rate was 15.6%.

Conclusions: Thoracoscopic microdiscectomy for single level symptomatic disc herniation is a highly effective and reliable technique, it can be performed safely with low complication rate.

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Figures

Fig. 1
Fig. 1
Evolution of pain symptoms measured by the visual analog score
Fig. 2
Fig. 2
Patients sensory outcome after 1 and 2 years
Fig. 3
Fig. 3
Motor outcome at 1 and 2 years. 18 patients (29%) were graded as excellent, 34 patients (55%) as good, 4 patients (6.5%) had a regular and 6 patients (9.5%) as poor outcome. Two years postoperatively 16 patients (31%) were reported as excellent, 36 (49%) as good, 5 (10%) as regular and 5 as poor outcome (10%)
Fig. 4
Fig. 4
Case example: 49-year-old female patient presented with calcified disc herniation without motor deficit and after complete resection of the herniation motor score dropped from 50 to 42 points. Image 1 shows preoperative CT scan with a calcified disc herniation of 90% canal occupation. Image 2 shows postoperative CT scan with and without contrast
See this image and copyright information in PMC

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