Modified eggshell procedure via posterior approach for sclerosing thoracic disc herniation: a preliminary study
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RESEARCH ARTICLE
Open Access
Modified eggshell procedure via posterior approach for sclerosing thoracic disc herniation: a preliminary study Si-Dong Yang1†, Qian Chen2†, Sheng-Hua Ning1, Wen-Yuan Ding1,3 and Da-Long Yang1,3*
Abstract Background: Clinically, sclerosing thoracic disc herniation is a disease with high surgical risk and various complications. Eggshell procedure is a surgical method used by surgeons to treat sclerosing thoracic disc herniation. The aim of this study was to report a modified eggshell procedure to treat sclerosing thoracic disc herniation. Methods: Medical records of 25 patients with sclerosing thoracic disc herniation were collected between 2007/01 and 2010/08, including 14 males and 11 females, with an average age of 51.7 years old. Modified eggshell procedure was performed to treat the patients with sclerosing thoracic disc herniation. All patients were followed up. Japanese Orthopaedic Association (JOA) score was used to evaluate the clinical outcomes. Results: All operations were performed successfully with complication rate of 12 %. There were 2 cases of dural laceration and 1 subdural hematoma. All included patients were followed up for at least 5 years, with the median of 6 years. JOA score of preoperation was 5 (IQR = 1) while it was 8 (IQR = 2) at final follow-up, with significant difference (Mann-Whitney U test, Z = −4.891, P < 0.001). The improvement rate of neurological status was 51.5 ± 23. 1 %. According to the classification of improvement rate, there were 15 cases at good level, 8 cases at moderate level, and 2 cases without any improvement. Conclusions: Modified eggshell procedure is a safe and effective surgical method when performed to treat sclerosing thoracic disc herniation in the clinical practice. Keywords: Thoracic disc herniation, Eggshell technique, Modified eggshell procedure, Technical modification
Background Due to its special anatomical structure of thoracic vertebra, the incidence of thoracic disc herniation is low [1]. The herniated disc is often associated with calcification and a series of hardening performance, including ossification of posterior longitudinal ligament, the posterior marginal osteophyte formation, and so on [2]. It is known as hardening thoracic disc herniation, which is a kind of disease with high surgical risk and various complications [3, 4]. The clinical * Correspondence: [email protected] Si-Dong Yang and Qian Chen are co-first authors. † Equal contributors 1 Department of Spinal Surgery, The Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang 050051, China 3 Hebei Provincial Key Laboratory of Orthopaedic Biomechanics, 139 Ziqiang Road, Shijiazhuang 050051, China Full list of author information is available at the end of the article
manifestations of hardening thoracic disc herniation are often severe [4, 5]. The herniated and hardening part usually deepens into the ventral spinal dural with adhesions, even causing mechanical compression on thoracic spinal cord and reducing blood circulation of sp
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