title: Modified eggshell procedure via posterior approach for sclerosing thoracic disc herniation: a preliminary study.
abstract: BACKGROUND
  Clinically, sclerosing thoracic disc herniation is a disease with high surgical risk and various complications. Eggshell procedure is a surgical method used by surgeons to treat sclerosing thoracic disc herniation. The aim of this study was to report a modified eggshell procedure to treat sclerosing thoracic disc herniation.
  
  
  METHODS
  Medical records of 25 patients with sclerosing thoracic disc herniation were collected between 2007/01 and 2010/08, including 14 males and 11 females, with an average age of 51.7 years old. Modified eggshell procedure was performed to treat the patients with sclerosing thoracic disc herniation. All patients were followed up. Japanese Orthopaedic Association (JOA) score was used to evaluate the clinical outcomes.
  
  
  RESULTS
  All operations were performed successfully with complication rate of 12 %. There were 2 cases of dural laceration and 1 subdural hematoma. All included patients were followed up for at least 5 years, with the median of 6 years. JOA score of preoperation was 5 (IQR = 1) while it was 8 (IQR = 2) at final follow-up, with significant difference (Mann-Whitney U test, Z = -4.891, P < 0.001). The improvement rate of neurological status was 51.5 ± 23.1 %. According to the classification of improvement rate, there were 15 cases at good level, 8 cases at moderate level, and 2 cases without any improvement.
  
  
  CONCLUSIONS
  Modified eggshell procedure is a safe and effective surgical method when performed to treat sclerosing thoracic disc herniation in the clinical practice.
authors.affiliation: Department of Spinal Surgery, The Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, 050051, China.
authors.forename: Si-Dong
authors.initials: SD
authors.lastname: Yang
authors.affiliation: Department of Orthopaedic Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Chen
authors.affiliation: Department of Spinal Surgery, The Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, 050051, China.
authors.forename: Sheng-Hua
authors.initials: SH
authors.lastname: Ning
authors.affiliation: Department of Spinal Surgery, The Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, 050051, China.|Hebei Provincial Key Laboratory of Orthopaedic Biomechanics, 139 Ziqiang Road, Shijiazhuang, 050051, China.
authors.forename: Wen-Yuan
authors.initials: WY
authors.lastname: Ding
authors.affiliation: Department of Spinal Surgery, The Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, 050051, China. yangdalongspine@sina.com.|Hebei Provincial Key Laboratory of Orthopaedic Biomechanics, 139 Ziqiang Road, Shijiazhuang, 050051, China. yangdalongspine@sina.com.
authors.forename: Da-Long
authors.initials: DL
authors.lastname: Yang
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D012189:Retrospective Studies; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging* / Q000601:surgery*
keywords: Eggshell technique; Modified eggshell procedure; Technical modification; Thoracic disc herniation