Abstract:
:Background: Indications and clinical outcomes of percutaneous endoscopic thoracic discectomy(PETD) in treating thoracic disc herniation is rarely reported and still controversial. We reported an unsatisfied recovery of thoracic disc herniation with PETD, treated by a second posterior thoracic laminectomy and Ponte osteotomy.Case description: A male presented with lower extremity weakness and stagger caused by T3/4 intervertebral disc herniation. The upper thoracic curve was in excessive kyphosis with T2-5 Cobb angle of 34.3 degrees. The preoperative ODI score was 34 and Roelzs's JOA score was 14. Percutaneous transforaminal endoscopic thoracic discectomy (PETD) from a posterior lateral approach was performed. At five-month follow-up, his thoracic back pain and staggering gait did not improve. The postoperative T2-5 Cobb angle was 32.1 degrees, the ODI score was 24 and Roelzs's JOA score was 14. A second posterior thoracic decompression this time with fixation was performed, but no disc herniation was detected. A Ponte osteotomy was performed to correct the kyphosis. One month after the second surgery, muscle strength of the lower limbs was improving with the T2-5 Cobb angle decreased to 19.4 degrees, the ODI score decreased to 10 and Roelzs's JOA score increase to 16. Six month later, the ODI score decreased to 0 and Roelzs's JOA score improved to 18. In review of the literature, PETD doesn't guarantee the patient a satisfactory neurological recovery for kyphotic thoracic disc herniation. Posterior decompression with Ponte osteotomy may be beneficial to release the tension and decompression of the spinal cord tension.Conclusions: Thoracic disc herniation with kyphosis angle >20 degrees (T2-5), percutaneous endoscopic thoracic discectomy is not likely to get good neurologic results. Posterior laminectomy with ponte osteotomy might be beneficial for these patients to induce dorsal drifting of the spinal cord from anterior herniation.
journal_name
Br J Neurosurgjournal_title
British journal of neurosurgeryauthors
Xu Z,Sun B,Chen Y,Zhang Y,Wang JX,Shi CG,Zhang K,Wu HQ,Xie W,Wu XDdoi
10.1080/02688697.2020.1751069subject
Has Abstractpub_date
2020-04-11 00:00:00pages
1-6eissn
0268-8697issn
1360-046Xpub_type
杂志文章abstract::Spinal tumours in pregnancy are rare. Spinal tumours account for only 10-15% of all primary central nervous system (CNS) tumours. Most spinal tumours in pregnant women have been described as meningiomas or vascular tumours. We present the unique case of a pregnant patient presenting with a CD 99+ primary spinal centra...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2017.1302073
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abstract::Until recently, warfarin, clopidogrel and aspirin have provided the mainstay for prevention of thrombotic disease in cardiac patients. However, new classes of drugs have recently emerged that promise better clinical outcomes and lower risks. Use of such agents has increased, but increased risk and severity of intra-cr...
journal_title:British journal of neurosurgery
pub_type: 杂志文章,评审
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abstract::The anterior visual pathway (AVP) can be at risk during gamma knife surgery (GKS). There is no standardised published methodology for protecting the AVP. This paper suggests such an approach in relation to the treatment of meningiomas. There were 67 patients with a mean age of 48.8 years and a minimum follow-up of 25 ...
journal_title:British journal of neurosurgery
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doi:10.3109/02688690903536611
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abstract::Use of transcranial Doppler (TCD) to diagnose vasospasm has been criticised. We examined reproducibility of TCD middle cerebral artery (MCA) velocity measurements. Thirty-six healthy adult volunteers were recruited. Four operators, two experienced and two inexperienced, participated. MCA velocity was measured twice by...
journal_title:British journal of neurosurgery
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doi:10.1080/02688690701210539
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journal_title:British journal of neurosurgery
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abstract::Subarachnoid hemorrhage with ruptured cerebral artery dissection caused by varicella zoster (VZ) vasculopathy is rare. We report a rare case of vertebral artery (VA) dissection induced by VZ virus, successfully treated with stent-assisted coil embolization and systemic anti viral medication, on six month follow-up cer...
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abstract:INTRODUCTION:Three million African patients need a neurosurgical consultation every year, but there are not enough neurosurgeons to meet this need. Efforts have been made to increase the neurosurgical capacity through the creation of training programs in Africa. Although these programs have been successful, there is st...
journal_title:British journal of neurosurgery
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doi:10.1080/02688697.2020.1862053
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abstract::Among 344 patients with posterior fossa tumours treated from 1979 to 1986 a ventriculoperitoneal, or, less commonly, a ventriculatrial shunt was inserted in 164 cases pre-operatively. Haematoma following the insertion of a shunt was found to be an important cause of deterioration. While the occurrence of cerebrospinal...
journal_title:British journal of neurosurgery
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doi:10.3109/02688699008992760
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abstract::The previous literature on radiosurgical treatment for craniopharyngioma is sparse, because the involvement of the radiosensitive optic chiasm within the target volume (in most cases) precludes safe high single dosage. The relocatable frame, introduced at St Bartholomew's Hospital in 1989, utilizes the dosimetric adva...
journal_title:British journal of neurosurgery
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doi:10.1080/02688699943448
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journal_title:British journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3109/02688697.2015.1080215
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journal_title:British journal of neurosurgery
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journal_title:British journal of neurosurgery
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doi:10.3109/02688698809001009
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journal_title:British journal of neurosurgery
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doi:10.1080/02688697.2020.1849552
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journal_title:British journal of neurosurgery
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doi:10.3109/02688698909001022
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abstract::Seventy patients with spinal arteriovenous malformations (AVMs) referred to the author over a 25-year period (1958-82), were equally divided between congenital, intradural and acquired, dural lesions. Amongst the intradural AVMs, were 22 with subarachnoid haemorrhage (SAH), a presenting feature in 18. The clinical fin...
journal_title:British journal of neurosurgery
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abstract::Intracerebral metastasis in osteosarcoma is extremely rare. A 14-year-old girl who had previously been operated upon for osteosarcoma of the femur presented with seizures and left hemiparesis. A right parietal lesion with calcification and brain oedema was found. After resection of the mass, pathology revealed an oste...
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doi:10.3109/02688697.2011.581771
更新日期:2012-02-01 00:00:00
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journal_title:British journal of neurosurgery
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journal_title:British journal of neurosurgery
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abstract::The water content of samples of normal and oedematous brain in lobectomy specimens from 16 patients with cerebral tumours has been measured by gravimetry and by wet and dry weighing. Uncorrected gravimetry underestimated the water content of oedematous peritumoural cortex by a mean of 1.17%, and of oedematous peritumo...
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journal_title:British journal of neurosurgery
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journal_title:British journal of neurosurgery
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doi:10.3109/02688697.2011.638996
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abstract::Selecting patients who will benefit from a permanent CSF diversion procedure in benign intracranial hypertension (BIH) or communicating hydrocephalus due to normal pressure hydrocephalus (NPH) has inherent problems. The percutaneous introduction of a lumbar subcutaneous shunt (LSS) under local anaesthesia facilitates ...
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abstract::Nosrat Ollah Ameli (1913-2010) was one of the pioneers in Iranian neurosurgery. After training in England in the 1950s, Ameli returned to his country to found the Darioush Kabir Hospital, where he started the first neurosurgical ward in collaboration with Prof. E. Samiy. Here he applied his genius and innovation to de...
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abstract::Survivors of head injury are often left with varying degrees of disability and complex and varied needs, necessitating prolonged periods of rehabilitation and continuing care. Advances have been made in the acute management of these patients, but continuing management in terms of rehabilitation remains deficient with ...
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abstract::The objective of this study was to assess the technical feasibility, and the clinical and radiological results of interbody fusion with a carbon fibre cage following anterior cervical discectomy. Nineteen consecutive patients, eight male and 11 female, with an age range from 28 to 75 years (mean 45) underwent anterior...
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pub_type: 临床试验,杂志文章
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