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Transforaminal Endoscopic Thoracic Discectomy: Technical Review to Prevent Complications

For all the spine surgeons, thoracic disc herniations (TDHs) entrust a real challenge in terms of patient diagnosis, proper selection, surgical technique, and potential adverse events. TDHs are relatively uncommon compared to the lumbar and cervical levels. Literature reports a variable prevalence o...

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Autores principales: Choi, Gun, Munoz-Suarez, Diego
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Spinal Neurosurgery Society 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7410381/
https://www.ncbi.nlm.nih.gov/pubmed/32746518
http://dx.doi.org/10.14245/ns.2040250.125
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author Choi, Gun
Munoz-Suarez, Diego
author_facet Choi, Gun
Munoz-Suarez, Diego
author_sort Choi, Gun
collection PubMed
description For all the spine surgeons, thoracic disc herniations (TDHs) entrust a real challenge in terms of patient diagnosis, proper selection, surgical technique, and potential adverse events. TDHs are relatively uncommon compared to the lumbar and cervical levels. Literature reports a variable prevalence of TDHs around 6% to 40%, but less than 1% of all disk herniations are symptomatic TDHs, evidencing as a relatively unusual condition. Nowadays, transforaminal endoscopic thoracic discectomy (TETD) has been implemented as an alternative to classic open procedures with results that are as good as and, in some situations, better than those in traditional discectomy. However, the surgeon must be familiar with endoscopic lumbar spine surgery before opting to perform a TETD, considering that the learning curve is much harder. We describe all the steps and safety considerations during TETD based on the anatomic differences compared to lumbar endoscopic procedures. TETD is an effective and safe method that yields more benefits, provides a direct route to the lesion with less morbidity, and is performed in a minimally invasive way. Many severe complications related to the thoracic region could be avoided having the proper knowledge, adequate technique, and safety routes and considerations.
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spelling pubmed-74103812020-08-13 Transforaminal Endoscopic Thoracic Discectomy: Technical Review to Prevent Complications Choi, Gun Munoz-Suarez, Diego Neurospine Review and Technical Note For all the spine surgeons, thoracic disc herniations (TDHs) entrust a real challenge in terms of patient diagnosis, proper selection, surgical technique, and potential adverse events. TDHs are relatively uncommon compared to the lumbar and cervical levels. Literature reports a variable prevalence of TDHs around 6% to 40%, but less than 1% of all disk herniations are symptomatic TDHs, evidencing as a relatively unusual condition. Nowadays, transforaminal endoscopic thoracic discectomy (TETD) has been implemented as an alternative to classic open procedures with results that are as good as and, in some situations, better than those in traditional discectomy. However, the surgeon must be familiar with endoscopic lumbar spine surgery before opting to perform a TETD, considering that the learning curve is much harder. We describe all the steps and safety considerations during TETD based on the anatomic differences compared to lumbar endoscopic procedures. TETD is an effective and safe method that yields more benefits, provides a direct route to the lesion with less morbidity, and is performed in a minimally invasive way. Many severe complications related to the thoracic region could be avoided having the proper knowledge, adequate technique, and safety routes and considerations. Korean Spinal Neurosurgery Society 2020-07 2020-07-31 /pmc/articles/PMC7410381/ /pubmed/32746518 http://dx.doi.org/10.14245/ns.2040250.125 Text en Copyright © 2020 by the Korean Spinal Neurosurgery Society This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review and Technical Note
Choi, Gun
Munoz-Suarez, Diego
Transforaminal Endoscopic Thoracic Discectomy: Technical Review to Prevent Complications
title Transforaminal Endoscopic Thoracic Discectomy: Technical Review to Prevent Complications
title_full Transforaminal Endoscopic Thoracic Discectomy: Technical Review to Prevent Complications
title_fullStr Transforaminal Endoscopic Thoracic Discectomy: Technical Review to Prevent Complications
title_full_unstemmed Transforaminal Endoscopic Thoracic Discectomy: Technical Review to Prevent Complications
title_short Transforaminal Endoscopic Thoracic Discectomy: Technical Review to Prevent Complications
title_sort transforaminal endoscopic thoracic discectomy: technical review to prevent complications
topic Review and Technical Note
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7410381/
https://www.ncbi.nlm.nih.gov/pubmed/32746518
http://dx.doi.org/10.14245/ns.2040250.125
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