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Peruvian Journal of Neurosurgery

Extrapleural transthoracic discectomy without fusion for resection of giant calcified dorsal disc hernia: case report

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Introduction: Calcified thoracic disc herniations are rare and their approach represents a surgical challenge when they are giant and symptomatic Surgery is indicated in cases of intractable back pain with medical management persistent intercostal neuralgia or progressive neurological deficit with the transthoracic extrapleural approach being the one of choice because it has advantages regarding the best view of the operative field We present the case of a patient with a giant calcified thoracic hernia who was successfully operated on in our hospital using an extrapleural transthoracic approach.
Clinical case: A 53-year-old male with dorsal pain in the medial region radiating to the inframammary region and progressive difficulty walking moderate proximal paraparesis T8 sensory level and urinary retention CT and MRI images showed a large calcified T6-7 disc herniation causing severe compression of the spinal cord The patient underwent a T6-7 extrapleural transthoracic discectomy plus a T6 partial corpectomy without fusion The patient tolerated the procedure well with no complications and the postoperative images one month after surgery demonstrated spinal cord decompression At follow-up irradiated back pain sensory level paraparesis and urinary retention improved.
Conclusion: Extrapleural transthoracic discectomy can be considered a safe approach in the case of giant calcified thoracic hernias since it allows resection of the calcified disc fragment and decompression of the spinal cord.
  Keywords: Intervertebral Disc Displacement, Diskectomy, Spinal Cord, Decompression (Source: MeSH NLM)