经胸腔侧前方入路治疗胸椎间盘突出症

Thoracic Diskectomy With Transthoracic Approach for Treating Thoracic Disc Herniation

本文报告经胸腔侧前方入路切除椎间盘治疗胸椎间盘突出症９例。均为中央型和旁中央型，经过脊髓造影、ＣＴＭ或ＭＲＩ检查确诊。随访１～４年，平均２年１０个月。根据Ｏｔａｎｉ分级方法标准，结果为优３例，良５例，一般１例，优良率达８９％，获得较满意效果。采用ＣＴＭ或ＭＲＩ诊断胸椎间盘突出有较高价值。该手术方法直接、充分地显露硬膜囊和神经结构，切除突出的椎间盘和刮除骨赘，减压较安全有效，同时对脊柱的稳定性和脊髓的血供影响较小。作者认为经胸腔侧前方入路进行椎间盘切除减压是治疗胸椎间盘突出症的一种安全有效的方法。

cases of thoracic disc herniation treated by use of transthoracic disc excision were reported.All were central and lateral central protrusion,confirmed by myelography,CTM or MRI.The follow up period ranged from 1 to 4 years,with an average of 2 years and 10 months.According to Otani's criteria,excellent results were obtained in 3 patients,good in 5 and fair in 1.The excellent and good rate was 89%.CTM or MRI were more valuable for diagnosis of thoracic disc herniation.The transthoracic approach gives a wide direct exposure to thecal sac and neural elements,to excise herniated intervertebral disk and to curet osteophytes.Decompression is safe and effective,meanwhile,it will not affect spinal stability and blood supply of spinal cord.The authors consider that transthoracic diskectomy is a safe and an effective procedure for treatment of herniated thoracic discs.