Posterior thoracic interbody fusion and posterolateral fusion for thoracic disc herniation

• Published in: Journal of Spine Research Vol. 13; no. 7; pp. 915 - 921
• Main Authors: Iga, Takahito, Kataoka, Tsugikazu, Hosogane, Naobumi, Tachibana, Atsuko, Nakamichi, Kiyohiro, Kono, Hitoshi, Moroi, Takehiko, Watanabe, Hironobu
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Society for Spine Surgery and Related Research 20.07.2022; 一般社団法人 日本脊椎脊髄病学会
• Subjects: posterior thoracic interbody fusion; posterolateral fusion; thoracic disc herniation; 後側方固定術; 後方胸椎椎体間固定術; 胸椎椎間板ヘルニア
• ISSN: 1884-7137; 2435-1563
• DOI: 10.34371/jspineres.2022-0705

Introduction: Anterior decompression and fusion are the mainstay of surgical methods for thoracic disc herniation (TDH), but recent improvements in surgical techniques and other advances have enabled the use of the posterior approach. The surgical outcomes of posterior surgery for TDH in our hospital were investigated.Patients and Methods: For TDH, patients with a large hernia, or patients with malalignment, conserved disc height, and instability at the affected level are treated with posterior thoracic interbody fusion (PTIF), and with posterolateral fusion (PLF) if the hernia is small, without instability. The study subjects were eight patients (six men, two women) who underwent posterior surgery for TDH in our hospital from January 2018 to May 2021.Results: The mean age at surgery was 64.6 years, and the hernia level was T10/11 in four, T11/12 in one, and T12/L1 in three patients. PTIF was conducted in three patients and PLF in five patients. Improved gait function and reduced pain were observed postoperatively in all the patients. Their JOA scores also significantly improved, with a mean improvement rate of 52.8%. There were no perioperative complications.Conclusions: PLF can be performed as posterior surgery for TDH if the hernia can be safely removed posteriorly, but PTIF should be selected for hernias of large sizes. Overall, the treatment outcomes in the present study were good.