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Pol. Merkur. Lek (Pol. Med. J.), 2020, XLVIII/287: 318-322 Maximize

Pol. Merkur. Lek (Pol. Med. J.), 2020, XLVIII/287: 318-322

Title: Evaluation of the results of posterior approach in thoracic disc herniation surgery

Authors: Baranowska A, Baranowski P, Baranowska J, Jarzyński T. 

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SUMMARY IN POLISH & ENGLISH. FULL ARTICLE ONLY IN ENGLISH.

Evaluation of the results of posterior approach in thoracic disc herniation surgery

Baranowska A, Baranowski P, Baranowska J, Jarzyński T.

Department of Neuroorthopedics, Mazovian Center of Rehabilitation STOCER, Konstancin Jeziorna

The incidence of symptomatic intervertebral disc hernias in the thoracic segment is estimated at 1 case per million people per year, which is about 0.25-0.75% of all symptomatic intervertebral disc hernias and 0.15-1.85% of operative intervertebral disc diseases.
The aim of the study
was to assess the results of the surgical treatment of symptomatic discopathy in the thoracic spine through the posterior approach.
Material and methods
. The results of the surgical treatment of 52 patients (35 women, 17 men) with symptomatic thoracic disc herniation in the Department of Neuroorthopedics in the years 2012-2019 were analyzed retrospectively. The neurological and functional status of patients before and after the surgery was assessed, as well as the average duration of the surgery and hospitalization, perioperative complications, intraoperative blood loss and the number of reoperations. Radiculopathy and myelopathy were the main indications for surgery.
Results
. The largest group included patients operated on in the 5th and 6th decades of life, with women being the majority (67%). Hernia of the distal thoracic spine, i.e. Th10-Th11-Th12-L1, was most often operated on. According to the Frankel scale, the largest number of patients (47 before the surgery and 48 after the surgery) were qualified for groups D and E. As regards the WISCI scale the largest group of patients was classified as level 20. The rate of complications was 7%, the rate of neurological complications was 5.2% and the rate of reoperations was 3.5%.
Conclusions
. The vast majority of discopathies in the thoracic spine occur at lower levels, i.e. Th10-Th11-Th12-L1. The analysis of the functional status after the surgery of thoracic discopathy based on 2 scales showed a greater usefulness of the WISCI scale than the Frankel scale. A larger number of patients changed the group after surgery in the WISCI scale than in the Frankel scale. Therefore, we can conclude that the WISCI scale is more accurate in assessing the functional state of patients operated on due to thoracic discopathy.

Key words: thoracic disc herniation, posterior approach surgery, complications, WISCI scale, Frankel scale

Pol Med J, 2020; XLVIII (287); 318–322