Türk Nöroşirürji Dergisi 2018 , Vol 28 , Num 2
Posterolateral Methods in the Surgical Treatment of Thoracic Disc Herniations
1Nörospinal Akademi, Beyin ve Sinir Cerrahisi Kliniği, İstanbul, Türkiye Thoracic disc herniation is a rare and often asymptomatic pathology. Because these lesions are asymptomatic, their diagnosis is usually delayed. This causes volumetric increase in and calcification of the intervertebral disc. It is known that men are affected more frequently than women and the condition is observed at the age of 30 to 50 years in the population. The lower thoracic regions are usually affected. Various approaches have been used for these pathologies which are difficult to treat for spinal surgeons. The negative consequences of various procedures, beginning with laminectomy, have forced surgeons to seek more lateral approaches. The morbidity rates are beginning to decrease thanks to the posterolateral interventions used today. Generally, which intervention is preferred depends on the experience of the surgeon, the location of the herniated disc, whether the disc herniation is calcified, and the general condition of the patient. All approaches have advantages and disadvantages. In general, approaches that provide a wider view are more invasive and the likelihood of encountering postoperative morbidity is greater. The patient"s hospital stay is usually reduced with approaches that provide a narrower view and the postoperative period can be more comfortable. Anterior approaches are generally recommended for broad-based and calcified discs. Although posterolateral approaches provide different fields of view, they are often indicated in paracentral and foraminal disc herniations. More minimal invasive posterolateral approaches have begun to be seen because of the development of the technique and the more experienced surgeons. In our manuscript, we will try to describe transpedicular, costostransversectomy, transfacet, lateral extracavitary and transforaminal approaches. Anahtar Kelimeler : Costotransversectomy, Posterolateral approach, Thoracic disc herniation, Transpedicular approach