Surgical Outcomes of Posterior Approach for Thoracic Disc Herniation

Abstract

Background: Surgical strategy for thoracic disc herniation (TDH) remains contraversial. We have performed posterior thoracic interbody fusion by transfacet pedicular sparing approach and laminectomy with pedicle screw fixation. The objectives of this retrospective study are to demonstrate the surgical outcome of transfacet pedidular sparing approach for thoracic disc herniation.

Materials and Methods: In our department we have enrolled 21 patients who underwent transfacet pedicular sparing approach and laminectomy for myelopathy due to thoracic disc herniation were followed at least one year. The mean age of patient at surgery was 48.6 years and the average period of follow up was 1.4 year. The level of the operation were T11-T12 in 6 cases, T10-T11 in 5 cases, T8-T9 in 1 case, and T5-T6 in 1 case and T12-L1 in 6 cases and T11-L1 in 2 cases respectively. The pre and post clinical status was evaluated according to JOA score and ODI. Additionally, post-Op complications were assessed.

Results: Average pre and post operation JOA score were 4.1 and 8.5 points respectively. Improvement of ODI was observed in all but one patient. Bony union was observed in all cases. CSF leakage was observed in one patient post operatively with neither neurological deficit nor evidence of infection.

Conclusion: Transfacet pedicular sparing approach and laminectomy has produced satisfactory outcome for myelopathy due to thoracic disc herniation. Therefore, in transfacet pedicular sparing approach and laminectomy is one of the surgical treatment of choice for patients with thoracic disc herniation causing myelopathy.