Surgical Result of Interbody Fusion in Thoracic Disc Herniation: Anterior Transthoracic Approach and Posterior Approach Performed by using Cage

ABSTRACT

OBJECTIVE: Thoracic disc herniation is an uncommon cause of thoracic cord compression. Experience with decompressive laminectomy for thoracic disc herniation proved disappointing and stimulated the development of anterior transpleural approach that does not require retraction of the spinal cord. This study is performed to evaluate the effectiveness of interbody fusion using cage in thoracic disc herniation by retrospectively analyzing data on operations performed at our institution. METHODS: There were eight patients who had undergone operation for single thoracic disc herniation between January 1997 and May 2001. There were five men and three women. All patients presented with pain and/or neurological deficits. Affeted levels were as follows, four patients at T11-T12, two patients at T10-T11, T9-T10 and T12-L1 respectively one case. An anterior transthoracic approach were performed in seven patients. Posterior approch was performed one patient. In all cases, carbon cage instrumentation was used. The mean follow up period was 32.6month(25-57 months). Cases were reviewed to evaluate the efficacy, surgical results, and complication of the operation. RESULTS: An adequate disectomy was achieved in all eight cases. Symptomatic improvement was shown in eight patients. There was no operative mortality. Postoperative follow up imaging studies, especially plain radiography demonstrated no instrumentation failure. CONCLUSION: Interbody fusion by using carbon cage is considered useful for thoracic disc herniation without significiant injury in thoracic structure and improvement of symptoms.