Laminotomy/medial facet approach in the excision of thoracic disc herniation.
OBJECTIVE
The author describes a technique of thoracic discectomy that has evolved from the posterolateral transfacet and the transpedicular approaches but that spares the pedicle and most of the facet joint.


METHODS
This approach was used to remove a total of 11 discs (T6-12) in seven patients. The follow-up period ranged from 8 months to 3 years. In four patients with axial and/or girdle pain significant improvement was demonstrated. The paraparesis in one patient with myelopathy improved postoperatively; that in another patient improved but recurred 8 months postoperatively. In one patient who experienced preoperative leg weakness, the weakness was slightly increased postoperatively, but this sequela was only transient. There were no other complications, and there were no deaths.


CONCLUSIONS
This technique appears safe and effective. It can be adapted to the conventional laminectomy known to spine surgeons and requires no specialized instruments. Further trials appear warranted.
Black
P
P
Department of Neurosurgery, MCP Hahnemann University, Philadelphia, Pennsylvania 19102, USA.
D017586:Diskectomy / Q000295:instrumentation / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D007403:Intervertebral Disc / Q000033:anatomy & histology / Q000473:pathology / Q000601:surgery*; D007405:Intervertebral Disc Displacement / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D007796:Laminectomy / Q000295:instrumentation / Q000379:methods*; D018908:Muscle Weakness / Q000209:etiology / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D011843:Radiculopathy / Q000209:etiology / Q000601:surgery; D013904:Thoracic Vertebrae / Q000033:anatomy & histology / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D021801:Zygapophyseal Joint / Q000033:anatomy & histology / Q000601:surgery*