Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Inferiorly Migrated Disc Fragment at T1 Body Treated by T1 Transcorporeal Approach

  • Choi, Byung-Kwan (Department of Neurosurgery, School of Medicine, Pusan National University) ;
  • Han, In-Ho (Department of Neurosurgery, School of Medicine, Pusan National University) ;
  • Cho, Won-Ho (Department of Neurosurgery, School of Medicine, Pusan National University) ;
  • Cha, Seung-Heon (Department of Neurosurgery, School of Medicine, Pusan National University)
  • Received : 2010.12.17
  • Accepted : 2010.12.31
  • Published : 2011.01.28
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Abstract

Upper thoracic vertebral bodies are difficult to access using standard anterior approaches. It may require sternotomy and claviculectomy, which carries significant possibility of morbidities. We report a case of inferiorly migrated cervicothoracic junction disc treated successfully by anterior upper-vertebral transcorporeal approach. This specific technique obviated the need of sternotomy, created favorable working space and saved the motion segment at cervicothoracic junction. This report is the first transcorporeal approach to a disc fragment at T1-2 space without fusion.

Keywords

References

  1. Abbott KH, Retter RH : Protrusions of thoracic intervertebral disks. Neurology 6 : 1-10, 1956
  2. Alberico AM, Sahni KS, Hall JA Jr, Young HF : High thoracic disc herniation. Neurosurgery 19 : 449-451, 1986 https://doi.org/10.1227/00006123-198609000-00020
  3. An HS, Vaccaro A, Cotler JM, Lin S : Spinal disorders at the cervicothoracic junction. Spine (Phila Pa 1976) 19 : 2557-2564, 1994 https://doi.org/10.1097/00007632-199411001-00011
  4. Birch R, Bonney G, Marshall RW : A surgical approach to the cervicothoracic spine. J Bone Joint Surg Br 72 : 904-907, 1990
  5. Caner H, Kilincoglu BF, Benli S, Altinors N, Bavbek M : Magnetic resonance image findings and surgical considerations in T1-2 disc herniation. Can J Neurol Sci 30 : 152-154, 2003 https://doi.org/10.1017/S0317167100053439
  6. Cauchoix J, Binet JP : Anterior surgical approaches to the spine. Ann R Coll Surg Engl 21 : 237-243, 1957
  7. Cha SH, Kim C, Choi BK, Kim HJ, Baek SY : C-arm assessment of cervical pedicle screw : screw coaxial fluoroscopy and oblique view. Spine (Phila Pa 1976) 32 : 1721-1727, 2007 https://doi.org/10.1097/BRS.0b013e3180b9f29b
  8. Fraser JF, Diwan AD, Peterson M, O'Brien MF, Mintz DN, Khan SN, et al. : Preoperative magnetic resonance imaging screening for a surgical decision regarding the approach for anterior spine fusion at the cervicothoracic junction. Spine (Phila Pa 1976) 27 : 675-681, 2002 https://doi.org/10.1097/00007632-200204010-00002
  9. Gelch MM : Herniated thoracic disc at T1-2 level associated with Horner's syndrome. Case report. J Neurosurg 48 : 128-130, 1978 https://doi.org/10.3171/jns.1978.48.1.0128
  10. Hamlyn PJ, Zeital T, King TT : Protrusion of the first thoracic disk. Surg Neurol 35 : 329-331, 1991 https://doi.org/10.1016/0090-3019(91)90015-2
  11. Hong WJ, Kim WK, Park CW, Lee SG, Yoo CJ, Kim YB, et al. : Comparison between transuncal approach and upper vertebral transcorporeal approach for unilateral cervical radiculopathy - a preliminary report. Minim Invasive Neurosurg 49 : 296-301, 2006 https://doi.org/10.1055/s-2006-954828
  12. Jho HD : Microsurgical anterior cervical foraminotomy for radiculopathy : a new approach to cervical disc herniation. J Neurosurg 84 : 155-160, 1996 https://doi.org/10.3171/jns.1996.84.2.0155
  13. Jho HD : Spinal cord decompression via microsurgical anterior foraminotomy for spondylotic cervical myelopathy. Minim Invasive Neurosurg 40 : 124-129, 1997 https://doi.org/10.1055/s-2008-1053432
  14. Jho HD : Decompression via microsurgical anterior foraminotomy for cervical spondylotic myelopathy. Technical note. J Neurosurg 86 : 297-302, 1997 https://doi.org/10.3171/jns.1997.86.2.0297
  15. Jho HD, Ha HG : Anterolateral approach for cervical spinal cord tumors via an anterior microforaminotomy : technical note. Minim Invasive Neurosurg 42 : 1-5, 1999 https://doi.org/10.1055/s-2008-1053359
  16. Jho HD, Kim MH, Kim WK : Anterior cervical microforaminotomy for spondylotic cervical myelopathy : part 2. Neurosurgery 51 : S54-S59, 2002
  17. Jho HD, Kim WK, Kim MH : Anterior microforaminotomy for treatment of cervical radiculopathy : part 1--disc-preserving "functional cervical disc surgery". Neurosurgery 51 : S46-S53, 2002
  18. Karikari IO, Powers CJ, Isaacs RE : Simple method for determining the need for sternotomy/manubriotomy with the anterior approach to the cervicothoracic junction. Neurosurgery 65 : E165-E166; discussion E166, 2009
  19. Knoller SM, Brethner L : Surgical treatment of the spine at the cervicothoracic junction : an illustrated review of a modified sternotomy approach with the description of tricks and pitfalls. Arch Orthop Trauma Surg 122 : 365-368, 2002 https://doi.org/10.1007/s00402-002-0392-9
  20. Kojima T, Waga S, Kubo Y, Matsubara T : Surgical treatment of ossification of the posterior longitudinal ligament in the thoracic spine. Neurosurgery 34 : 854-858; discussion 858, 1994 https://doi.org/10.1227/00006123-199405000-00010
  21. Lesoin F, Thomas CE 3rd, Autricque A, Villette L, Jomin M : A transsternal biclavicular approach to the upper anterior thoracic spine. Surg Neurol 26 : 253-256, 1986 https://doi.org/10.1016/0090-3019(86)90158-8
  22. Morgan H, Abood C : Disc herniation at T1-2. Report of four cases and literature review. J Neurosurg 88 : 148-150, 1998 https://doi.org/10.3171/jns.1998.88.1.0148
  23. Morizane A, Hanakita J, Suwa H, Ohshita N, Gotoh K, Matsuoka T : Dorsally sequestrated thoracic disc herniation--case report. Neurol Med Chir (Tokyo) 39 : 769-772, 1999 https://doi.org/10.2176/nmc.39.769
  24. Ozer AF, Kaner T, Sasani M, Oktenoglu T, Cosar M : Anterior approach to disc herniation with modified anterior microforaminotomy at C7-T2 : technical note. Spine (Phila Pa 1976) 34 : 1879-1883, 2009 https://doi.org/10.1097/BRS.0b013e3181aa7c62
  25. Pointillart V, Aurouer N, Gangnet N, Vital JM : Anterior approach to the cervicothoracic junction without sternotomy : a report of 37 cases. Spine (Phila Pa 1976) 32 : 2875-2879, 2007 https://doi.org/10.1097/BRS.0b013e31815b7632
  26. Riew KD, Cheng I, Pimenta L, Taylor B : Posterior cervical spine surgery for radiculopathy. Neurosurgery 60 : S57-S63, 2007
  27. Rossitti S, Stephensen H, Ekholm S, von Essen C : The anterior approach to high thoracic (T1-T2) disc herniation. Br J Neurosurg 7 : 189-192, 1993 https://doi.org/10.3109/02688699309103477
  28. Sharan AD, Przybylski GJ, Tartaglino L : Approaching the upper thoracic vertebrae without sternotomy or thoracotomy : a radiographic analysis with clinical application. Spine (Phila Pa 1976) 25 : 910-916, 2000 https://doi.org/10.1097/00007632-200004150-00003
  29. Standefer M, Hardy RW Jr, Marks K, Cosgrove DM : Chondromyxoid fibroma of the cervical spine--a case report with a review of the literature and a description of an operative approach to the lower anterior cervical spine. Neurosurgery 11 : 288-292, 1982 https://doi.org/10.1227/00006123-198208000-00018
  30. Sundaresan N, Shah J, Foley KM, Rosen G : An anterior surgical approach to the upper thoracic vertebrae. J Neurosurg 61 : 686-690, 1984 https://doi.org/10.3171/jns.1984.61.4.0686
  31. Svien HJ, Karavitis AL : Multiple protrusions of intervertebral disks in the upper thoracic region : report of case. Proc Staff Meet Mayo Clin 29 : 375-378, 1954

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