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Percutaneous thoracic disc decompression with real-time CT fluoroscopy
International Congress Series 1281 (2005) 1355
Percutaneous thoracic disc decompression with real-time CT fluoroscopy Ho-Yeong KangT, Sang-Hyeop Jeon, Sang-Ho Lee, Song-Woo Shin, Ho-Yeon Lee Departments of Interventional Radiology and Neurosurgery, Wooridul Spine Hospital, South Korea
Keywords: Real-time CT guidance; Percutaneous thoracic disc decompression; Symptomatic thoracic disc herniation
1. Introduction The purpose of this study is to present real-time CT-guided percutaneous thoracic disc decompression (PTDD) with Laser Assisted Spinal Endoscopy (LASE) as a new minimally invasive procedure for symptomatic thoracic disc herniation. 2. Methods Eight consecutive patients, who have suffered from intractable thoracic axial and/or radicular pain due to soft disc herniation, underwent real-time CT-guided PTDD under local anesthesia. By showing a live image, the ipsilateral or central portion of protruded disc is decompressed via the posterolateral approach using an automated nucleotome and microforceps through a small cannula. Then, disc tissue was more potentially shrunk and annuloplasty was performed using a Ho:YAG laser under endoscopic view. All patients were discharged form hospital in less than 24 h. 3. Results The mean follow-up period was 15.8 months. According to the modified Macnab criteria, excellent was obtained in 6 patients (75.0%), good in 1 (12.5%), and fair in 1 (12.5%). Compared with preoperative values, there was a significant decrease in VAS (6.5 to 1.6; p = 0.11) and ODI (55.0 to 17.5; p = 0.11) at the 3-month follow-up, and the improvements were well maintained throughout the follow-up period. There were no postoperative complications and no case required conversion to an open surgery. 4. Discussion Real-time CT-guided PTDD with LASE is an accurate, safe, and effective minimal invasive procedure for symptomatic thoracic disc herniation in selected patients, who had no myelopathy and failed to respond to all conservative treatments. More extensive long-term studies are needed to further evaluate this procedure. T Corresponding author. Tel.: +82 2 513 8150. E-mail address: [email protected] (H.-Y. Kang). 0531-5131/ D 2005 CARS & Elsevier B.V. All rights reserved. doi:10.1016/j.ics.2005.03.068
Percutaneous thoracic disc decompression with real-time CT fluoroscopy Ho-Yeong KangT, Sang-Hyeop Jeon, Sang-Ho Lee, Song-Woo Shin, Ho-Yeon Lee Departments of Interventional Radiology and Neurosurgery, Wooridul Spine Hospital, South Korea
Keywords: Real-time CT guidance; Percutaneous thoracic disc decompression; Symptomatic thoracic disc herniation
1. Introduction The purpose of this study is to present real-time CT-guided percutaneous thoracic disc decompression (PTDD) with Laser Assisted Spinal Endoscopy (LASE) as a new minimally invasive procedure for symptomatic thoracic disc herniation. 2. Methods Eight consecutive patients, who have suffered from intractable thoracic axial and/or radicular pain due to soft disc herniation, underwent real-time CT-guided PTDD under local anesthesia. By showing a live image, the ipsilateral or central portion of protruded disc is decompressed via the posterolateral approach using an automated nucleotome and microforceps through a small cannula. Then, disc tissue was more potentially shrunk and annuloplasty was performed using a Ho:YAG laser under endoscopic view. All patients were discharged form hospital in less than 24 h. 3. Results The mean follow-up period was 15.8 months. According to the modified Macnab criteria, excellent was obtained in 6 patients (75.0%), good in 1 (12.5%), and fair in 1 (12.5%). Compared with preoperative values, there was a significant decrease in VAS (6.5 to 1.6; p = 0.11) and ODI (55.0 to 17.5; p = 0.11) at the 3-month follow-up, and the improvements were well maintained throughout the follow-up period. There were no postoperative complications and no case required conversion to an open surgery. 4. Discussion Real-time CT-guided PTDD with LASE is an accurate, safe, and effective minimal invasive procedure for symptomatic thoracic disc herniation in selected patients, who had no myelopathy and failed to respond to all conservative treatments. More extensive long-term studies are needed to further evaluate this procedure. T Corresponding author. Tel.: +82 2 513 8150. E-mail address: [email protected] (H.-Y. Kang). 0531-5131/ D 2005 CARS & Elsevier B.V. All rights reserved. doi:10.1016/j.ics.2005.03.068