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Comparison of Anterior Approach and Posterior Circumspinal Decompression in the Treatment of Giant Thoracic Discs
STUDY DESIGN: Retrospective cohort study. OBJECTIVES: The treatment of giant thoracic disc herniation (gTDH)remains challenging for surgeons worldwide because of its large volume and calcified or ossified nature and the limitations of the prior small-sample-size, single-center studies reporting comp...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9837516/ https://www.ncbi.nlm.nih.gov/pubmed/33511881 http://dx.doi.org/10.1177/2192568221989964 |
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author | Yuan, Lei Chen, Zhongqiang Liu, Zhongjun Liu, Xiaoguang Li, Weishi Sun, Chuiguo |
author_facet | Yuan, Lei Chen, Zhongqiang Liu, Zhongjun Liu, Xiaoguang Li, Weishi Sun, Chuiguo |
author_sort | Yuan, Lei |
collection | PubMed |
description | STUDY DESIGN: Retrospective cohort study. OBJECTIVES: The treatment of giant thoracic disc herniation (gTDH)remains challenging for surgeons worldwide because of its large volume and calcified or ossified nature and the limitations of the prior small-sample-size, single-center studies reporting comparative effectiveness. We aim to compare the anterior decompression and spinal fusion (ASF) and posterior circumspinal decompression and spinal fusion (PCDF) for patients with myelopathy due to gTDH in the largest study to date by sample size. METHODS: Preoperative and postoperative functional status, surgical details, and complication rates were compared between the 2 groups. RESULTS: A total of 186 patients were included: 63 (33.9%) ASF and 123(66.1%) PCDF. The PCDF group had significantly shorter operation duration (163.06 ± 53.49 min vs. 180.78 ± 52.06 min, P = 0.032) and a significant decrease in intraoperative blood loss(716.83 mL vs. 947.94 mL, P = 0.045), and also a shorter hospital length of stay (LOS) and postoperative LOS (6 vs. 7, P = 0.011). The perioperative complication rate (13.8% vs. 28.6%, P = 0.015) and surgery-associated complication rate(13.0% vs. 27.0%, P = 0.018) were significantly higher in the ASF group. A higher rate of complete decompression was achieved in the PCDF group. There were no observed significant differences in changes in functional status between the 2 groups. CONCLUSION: PCDF for central or paracentral gTDHs is a highly effective and reliable technique. It can be performed safely with a low complication rate. If either procedure can adequately excise a central or paracentral gTDH, a PCDF approach may be a better option. |
format | Online Article Text |
id | pubmed-9837516 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-98375162023-01-14 Comparison of Anterior Approach and Posterior Circumspinal Decompression in the Treatment of Giant Thoracic Discs Yuan, Lei Chen, Zhongqiang Liu, Zhongjun Liu, Xiaoguang Li, Weishi Sun, Chuiguo Global Spine J Original Articles STUDY DESIGN: Retrospective cohort study. OBJECTIVES: The treatment of giant thoracic disc herniation (gTDH)remains challenging for surgeons worldwide because of its large volume and calcified or ossified nature and the limitations of the prior small-sample-size, single-center studies reporting comparative effectiveness. We aim to compare the anterior decompression and spinal fusion (ASF) and posterior circumspinal decompression and spinal fusion (PCDF) for patients with myelopathy due to gTDH in the largest study to date by sample size. METHODS: Preoperative and postoperative functional status, surgical details, and complication rates were compared between the 2 groups. RESULTS: A total of 186 patients were included: 63 (33.9%) ASF and 123(66.1%) PCDF. The PCDF group had significantly shorter operation duration (163.06 ± 53.49 min vs. 180.78 ± 52.06 min, P = 0.032) and a significant decrease in intraoperative blood loss(716.83 mL vs. 947.94 mL, P = 0.045), and also a shorter hospital length of stay (LOS) and postoperative LOS (6 vs. 7, P = 0.011). The perioperative complication rate (13.8% vs. 28.6%, P = 0.015) and surgery-associated complication rate(13.0% vs. 27.0%, P = 0.018) were significantly higher in the ASF group. A higher rate of complete decompression was achieved in the PCDF group. There were no observed significant differences in changes in functional status between the 2 groups. CONCLUSION: PCDF for central or paracentral gTDHs is a highly effective and reliable technique. It can be performed safely with a low complication rate. If either procedure can adequately excise a central or paracentral gTDH, a PCDF approach may be a better option. SAGE Publications 2021-01-29 2023-01 /pmc/articles/PMC9837516/ /pubmed/33511881 http://dx.doi.org/10.1177/2192568221989964 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc-nd/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Original Articles Yuan, Lei Chen, Zhongqiang Liu, Zhongjun Liu, Xiaoguang Li, Weishi Sun, Chuiguo Comparison of Anterior Approach and Posterior Circumspinal Decompression in the Treatment of Giant Thoracic Discs |
title | Comparison of Anterior Approach and Posterior Circumspinal
Decompression in the Treatment of Giant Thoracic Discs |
title_full | Comparison of Anterior Approach and Posterior Circumspinal
Decompression in the Treatment of Giant Thoracic Discs |
title_fullStr | Comparison of Anterior Approach and Posterior Circumspinal
Decompression in the Treatment of Giant Thoracic Discs |
title_full_unstemmed | Comparison of Anterior Approach and Posterior Circumspinal
Decompression in the Treatment of Giant Thoracic Discs |
title_short | Comparison of Anterior Approach and Posterior Circumspinal
Decompression in the Treatment of Giant Thoracic Discs |
title_sort | comparison of anterior approach and posterior circumspinal
decompression in the treatment of giant thoracic discs |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9837516/ https://www.ncbi.nlm.nih.gov/pubmed/33511881 http://dx.doi.org/10.1177/2192568221989964 |
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