title: Surgical Treatment for Central Calcified Thoracic Disk Herniation: A Novel L-Shaped Osteotome.
abstract: Few reports are available on the posterior transfacet approach for the treatment of central calcified thoracic disk herniation (TDH). The objective of this study was to assess outcomes and complications in a consecutive series of patients with TDH who underwent posterior transfacet decompression and diskectomy with segmental instrumentation and fusion. The data for 27 patients (16 males and 11 females) were retrospectively reviewed and analyzed, including clinical presentation, blood loss, operative time, pre- and postoperative complications, visual analog scale, Japanese Orthopedic Association (JOA) score, and Frankel grade. All patients underwent trans-facet decompression and segmental instrumentation with interbody fusion. Mean patient age at surgery was 55.2 years (range, 21-81 years). Average follow-up was 30±19 months (range, 12-50 months). All patients were successfully treated with posterior decompression and segmental instrumentation with interbody fusion. Average operative time was 124±58 minutes (range, 87-180 minutes). Mean blood loss was 439±225 mL (range, 300-1500 mL). Average pre- and postoperative JOA scores were 4.12±0.87 and 8.01±0.97 points, respectively. Overall JOA scores showed a significant postoperative improvement. Overall recovery rates were excellent in 12 patients, good in 6, fair in 5, and unchanged in 1. No patient was classified as worse. The results suggest that the posterior approach using a special L-shaped osteotome is feasible. No major complications occurred while achieving adequate decompression for central calcified TDH.
authors.forename: Qing-shan
authors.initials: QS
authors.lastname: Zhuang
authors.forename: Deng-xing
authors.initials: DX
authors.lastname: Lun
authors.forename: Zhao-wan
authors.initials: ZW
authors.lastname: Xu
authors.forename: Wei-hua
authors.initials: WH
authors.lastname: Dai
authors.forename: Da-yong
authors.initials: DY
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002114:Calcinosis / Q000601:surgery*; D019299:Decompression, Surgical / Q000379:methods; D017586:Diskectomy / Q000379:methods; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010146:Pain / Q000517:prevention & control; D010147:Pain Measurement; D011182:Postoperative Care; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000379:methods; D013904:Thoracic Vertebrae / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult