19 Harley St, London, W1G 9QJ, UK

Minimally invasive retropleural approach for central thoracic disc herniation

BACKGROUND: The management of symptomatic thoracic disc herniation (TDH) has evolved tremendously ever since the first laminectomy was performed. The last decade has witnessed the evolution of minimally invasive approaches for TDH most of which have been posterior/posterolateral. Traditional anterior approaches involve a thoracotomy or more recently, thoracoscopic techniques. The authors describe a less invasive anterior retropleural surgical approach to address central thoracic disk herniations which is less extensive than a thoracotomy and allows better anterior access than posterior or posterolateral approaches. The retropleural approach allows the use of the operative microscope with a tubular retractor in the anterior thoracic spine. MATERIAL AND METHODS: 7 patients with central disc herniation who were managed with the minimally invasive lateral retropleural approach from 2007-2010 at our institution were included in the study. Surgical technique consisted of a lateral position followed by retro-pleural exposure through tubular retractor system without the need of intraoperative lung collapse. Clinical details including age, sex, clinical presentation, surgical details, complications and outcome at last follow-up were analyzed. RESULTS: Patients age ranged in age from 30 to 70 years (mean: 52 years). The duration of symptoms ranged from 4 days to 3 years. All patients presented with thoracic myleopathy on physical examination. The average length of stay in the hospital was 2.6 days (range: 1-4 days). Follow-up was available for all the patients. Myelopathy was assessed by the Nurick scale. On examination, 3 of 7 patients improved by one point on the Nurick scale. No patient deteriorated after surgery. There were no complications related to the approach. CONCLUSIONS: A minimally invasive retropleural approach using tubular retractor system for central thoracic disc herniation is feasible and may be a less invasive anterior alternative to a thoracotomy

Keywords : Adult,Aged,Chicago,complications,diagnostic imaging,Diskectomy,Feasibility Studies,Female,Fluoroscopy,Follow-Up Studies,Humans,instrumentation,Intervertebral Disc Displacement,Laminectomy,Length of Stay,Lung,Magnetic Resonance Imaging,Male,methods,Middle Aged,Minimally Invasive Surgical Procedures,Neurosurgery,pathology,Patients,Physical Examination,Posture,Retrospective Studies,Spine,surgery,Thoracic Vertebrae,Thoracotomy,Treatment Outcome,Universities,, Invasive,Retropleural,Approach,Central, versatis plasters

Date of Publication : 2011 Aug

Authors : Kasliwal MK;Deutsch H;

Organisation : Department of Neurosurgery, RUSH University Medical Center, Chicago, IL 60612, USA

Journal of Publication : Minim Invasive Neurosurg

Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/21922445

The London Spine Unit : Harley Street UK. Specialists in Cutting Edge Technologies for Spinal Surgery

Make an Appointment 

Trustpilot Reviews
Doctify Reviews
Top Doctor Reviews

Minimally invasive retropleural approach for central thoracic disc herniation | Pain clinic london

What our patients say ...

Consultant Spine Surgeon
Consultant Spine Surgeon
Consultant Spine Surgeon

This surgical technique consists of a percutaneous approach for the treatment of small to medium size hernias of the intervertebral disc by laser energy. The main objective is to reduce the intradiscal pressure in the nucleus pulposus

Laser Disc Surgery can be performed under local anaesthetic as a day case at our centre on the prestigious Harley Street.
What is London spine unit and How it Works

The London Spine Unit was established in 2005 and has successfully treated over 5000 patients. All conditions are treated.

treatment of all spinal disorders

The London Spine Unit specialises in Minimally Invasive Treatments allowing rapid recovery and return to normal function

Trusted by patients worldwide

The London Spine Unit provides the highest quality care to all patients and has VIP services for those seeking exceptional services

If you have any emergency Doctor’s need, simply call our 24 hour emergency

Your personal case manager will ensure that you receive the best possible care.

Call Now 

+44 844 589 2020
+44 203 973 8810