Is There a Place for the Posterior Approach in Cases of Acute Myelopathy on Thoracic Disc Hernia ?
TypeArticles dans des revues avec comité de lecture
BACKGROUND: Acute myelopathy in cases of thoracic disc herniation (TDH) is an exceptional condition for which the treatment is not codified. Here we present the results of a standardized procedure in 10 patients who underwent surgery for acute myelopathy on TDH between December 2009 and December 2016. - METHODS: Our approach began with a cautious laminectomy without resection of the hernia on the day of admission. On subsequent days, a complementary thoracoscopic procedure was performed according to the patient’s neurologic recovery and the nature of the hernia (calcified or fibrous). Outcome was assessed by the Frankel score at the last consultation. - RESULTS: All patients had acute myelopathy, with Frankel score of C or worse and a TDH detected on magnetic resonance imaging occupying an average of 62.5 18.4% of the canal. This lesion was calcified in 6 cases and soft in 4 cases. The laminectomy allowed stabilization in 1 case and a neurologic improvement in 9 cases. Complementary surgery via a thoracoscopic approach was performed in the 6 cases of calcified hernia. After an average follow-up of 44.55 26.44 months, 6 patients showed complete neurologic recovery and 4 had moderate sequelae (Frankel D). - CONCLUSIONS: Laminectomy appears to allow stabilization of the neurologic situation in rare cases of acute myelopathy on TDH. The need for complementary resection of the hernia by an anterior approach should always be discussed secondarily.
Showing items related by title, author, creator and subject.
BRAUGE, David; HORODYCKID, Catherine; ARRIGHI, Marta; REINA, Vincent; EAP, Christophe; MIREAU, Etienne; BAUSSART, Bertrand; ALDEA, Sorin; GAILLARD, Stephan (Congress of Neurological Surgeons, 2019)BACKGROUND: Giant thoracic disc herniation (gTDH) is a rare condition. It is defined by a herniation that occupies at least 40% of the thoracic spinal canal and is usually calcified. Several surgical techniques have been ...
What are the possibilities of spontaneous resorption of a thoracic disc herniation occupying more than 20% of the spinal canal in the asymptomatic subject? Comparative study BRAUGE, David; MADKOURI, Rachid; CLEMENT, Robert; REINA, Vincent; BRAUGE, Thomas; GAILLARD, Stephan (Elsevier, 2017)Thoracic disc herniation is a rare pathology for which surgical treatment is difficult. The discovery of asymptomatic or only slightly symptomatic lesions can be problematic, especially in cases of marked canal stenosis. ...
BRANDICOURT, Pierre; SOL, José Cuesta Del; ALDEA, Sorin; BONNEVILLE, Fabrice; CINTAS, Pascal; BRAUGE, David (ELSEVIER, 2018)Introduction. Hirayama disease is a rare cervical myelopathy predominantly affecting young adults andmainly found in Asia. It results in a pure motor distal lesion of the upper limbs with slow progression.Dynamic magnetic ...
TOUIHRI, Saad; CATTIN, Linda; NGUYEN, Duc-Tuong; MORSLI, Mustapha; LOUARN, Guy; BOUTEVILLE, Anne; FROGER, Vincent; BERNÈDE, Jean-Christian (ELSEVIER, 2012)In2O3 thin films (100 nm thick) have been deposited by reactive evaporation of indium, in an oxygen partial atmosphere. Conductive (σ = 3.5×103 S/cm) and transparent films are obtained using the following experimental ...
VINCENT, Pascal; DESCOMBIN, Alexis; DAGHER, Samer; SEOUDI, Tarek; LAZARUS, Arnaud; THOMAS, Olivier; AYARI, Anthony; PURCELL, Stephen T.; PERISANU, Sorin (AIP Publishing, 2019)In this work, we study the nonlinear coupling between the transverse modes of nanoresonators such as nanotubes or nanowires in a singly clamped configuration. We previously showed that at high driving, this coupling could ...