Full-Endoscopic Transforaminal Ventral Decompression for Symptomatic Thoracic Disc Herniation with or without Calcification: Technical Notes and Case Series

Background. Symptomatic thoracic disc herniation is a challenge in spinal surgery, especially for cases with calcification. Traditional open operation has a high complication rate. The authors introduced a modified full-endoscopic transforaminal ventral decompression technique in this study and eval...

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Main Authors: Shangju Gao, Jingchao Wei, Wenyi Li, Long Zhang, Can Cao, Jinshuai Zhai, Bo Gao
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Pain Research and Management
Online Access:http://dx.doi.org/10.1155/2021/6454760
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author Shangju Gao
Jingchao Wei
Wenyi Li
Long Zhang
Can Cao
Jinshuai Zhai
Bo Gao
author_facet Shangju Gao
Jingchao Wei
Wenyi Li
Long Zhang
Can Cao
Jinshuai Zhai
Bo Gao
author_sort Shangju Gao
collection DOAJ
description Background. Symptomatic thoracic disc herniation is a challenge in spinal surgery, especially for cases with calcification. Traditional open operation has a high complication rate. The authors introduced a modified full-endoscopic transforaminal ventral decompression technique in this study and evaluated its imaging and clinical outcomes. Materials and Methods. Eleven patients with symptomatic thoracic disc herniation who underwent full-endoscopic transforaminal ventral decompression in a single medical center were enrolled. The surgical technique was performed as described in detail. Dilator sliding punching, endoscope-monitored foraminoplasty, and base cutting through the “safe triangle zone” are the key points of the technique. Clinical outcomes were assessed by the modified Japanese Orthopedic Association (mJOA) score for neurological improvement and the visual analogy score (VAS) for thoracic and leg pain. The operation time, hospital stay, and complications were also analyzed. Results. Postoperative magnetic resonance imaging (MRI) revealed good decompression of the spinal cord. The mJOA improved from 7.4 (range: 5–10) to 10.2 (range: 9–11). Axial thoracic pain improved in 8 of 9 patients. Leg pain and thoracic radicular pain improved in all patients. No complications were observed. The average operation time was 136 minutes (range: 70–180 minutes). The average length of hospital stay was 5.3 days (range: 2–8 days). Conclusion. Minimally invasive full-endoscopic transforaminal ventral decompression for the treatment of symptomatic thoracic disc herniation with or without calcification is feasible and may be another option for this challenging spine disease.
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spelling doaj-art-e655a6ef58ef46ec936054fa734b4b472025-08-20T03:26:04ZengWileyPain Research and Management1918-15232021-01-01202110.1155/2021/6454760Full-Endoscopic Transforaminal Ventral Decompression for Symptomatic Thoracic Disc Herniation with or without Calcification: Technical Notes and Case SeriesShangju Gao0Jingchao Wei1Wenyi Li2Long Zhang3Can Cao4Jinshuai Zhai5Bo Gao6Spinal Surgery Medical Team of OrthopedicsSpinal Surgery Medical Team of OrthopedicsSpinal Surgery Medical Team of OrthopedicsSpinal Surgery Medical Team of OrthopedicsSpinal Surgery Medical Team of OrthopedicsSpinal Surgery Medical Team of OrthopedicsSpinal Surgery Medical Team of OrthopedicsBackground. Symptomatic thoracic disc herniation is a challenge in spinal surgery, especially for cases with calcification. Traditional open operation has a high complication rate. The authors introduced a modified full-endoscopic transforaminal ventral decompression technique in this study and evaluated its imaging and clinical outcomes. Materials and Methods. Eleven patients with symptomatic thoracic disc herniation who underwent full-endoscopic transforaminal ventral decompression in a single medical center were enrolled. The surgical technique was performed as described in detail. Dilator sliding punching, endoscope-monitored foraminoplasty, and base cutting through the “safe triangle zone” are the key points of the technique. Clinical outcomes were assessed by the modified Japanese Orthopedic Association (mJOA) score for neurological improvement and the visual analogy score (VAS) for thoracic and leg pain. The operation time, hospital stay, and complications were also analyzed. Results. Postoperative magnetic resonance imaging (MRI) revealed good decompression of the spinal cord. The mJOA improved from 7.4 (range: 5–10) to 10.2 (range: 9–11). Axial thoracic pain improved in 8 of 9 patients. Leg pain and thoracic radicular pain improved in all patients. No complications were observed. The average operation time was 136 minutes (range: 70–180 minutes). The average length of hospital stay was 5.3 days (range: 2–8 days). Conclusion. Minimally invasive full-endoscopic transforaminal ventral decompression for the treatment of symptomatic thoracic disc herniation with or without calcification is feasible and may be another option for this challenging spine disease.http://dx.doi.org/10.1155/2021/6454760
spellingShingle Shangju Gao
Jingchao Wei
Wenyi Li
Long Zhang
Can Cao
Jinshuai Zhai
Bo Gao
Full-Endoscopic Transforaminal Ventral Decompression for Symptomatic Thoracic Disc Herniation with or without Calcification: Technical Notes and Case Series
Pain Research and Management
title Full-Endoscopic Transforaminal Ventral Decompression for Symptomatic Thoracic Disc Herniation with or without Calcification: Technical Notes and Case Series
title_full Full-Endoscopic Transforaminal Ventral Decompression for Symptomatic Thoracic Disc Herniation with or without Calcification: Technical Notes and Case Series
title_fullStr Full-Endoscopic Transforaminal Ventral Decompression for Symptomatic Thoracic Disc Herniation with or without Calcification: Technical Notes and Case Series
title_full_unstemmed Full-Endoscopic Transforaminal Ventral Decompression for Symptomatic Thoracic Disc Herniation with or without Calcification: Technical Notes and Case Series
title_short Full-Endoscopic Transforaminal Ventral Decompression for Symptomatic Thoracic Disc Herniation with or without Calcification: Technical Notes and Case Series
title_sort full endoscopic transforaminal ventral decompression for symptomatic thoracic disc herniation with or without calcification technical notes and case series
url http://dx.doi.org/10.1155/2021/6454760
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