Surgical treatment of thoracic disc herniation 8 cases


83; are l3 months. 8 patients are the main symptoms of acid trapped lower back pain, lower extremity weakness progressively increased. Upper and lower motor neuron damage in 3 cases exist, simple upper motor neuron damage in 5 patients. The patients underwent x films, CT, MRI examination showed a single intervertebral disc prominent segment. Specifically highlight the three cases for the TIO/1I gap, Tll/12 gap highlights three cases, T12 ~ L1 ask gap prominent in 2 cases. 1.2 treatment of 8 patients were taken lateral anterior u, line removal of intervertebral disc, intervertebral fusion cage (Cage) implantation, extrapleural approach in 2 cases, thoracic approach in 6 cases. 8 patients, central herniation in 3 cases, left prominent in 2 cases, the right highlight the three cases. Underwent surgery on the left into the road, line 50, after endotracheal intubation, patients with right lateral, left up, right side of the chest pad, a soft pillow, so that the left intercostal space distraction. Removal of herniated disc higher than the ordinal number l ~ 2 ribs pJ, including rib vertebral joints, six patients with thoracic approach, revealing the side of the vertebral body, intervertebral space into a positioning pin, C-arm x-ray fluoroscopy confirmed the lesion disc space, vertebral segment ligated and cut off blood vessels, fully reveal the side of the vertebral body. Bone with a thin knife under the edge of the upper and lower vertebral body on the edge of the vertebral body after the l / 3 window, layer by layer to the rear cutting, scraping spoon scrape the back of the disc tissue and prominent osteophyte on the bottom, until the anterior spinal completely open, to be complete decompression of spinal cord, dural sac full filling. According to the size of the disc space width selection of different types of cage, the ribs, cut into pieces, into the fusion of compaction, screw-in disc space. Wash the wound closed thoracic drainage tube placement, followed by suturing the wound. Extrapleural approach in the pleural drainage tube can be placed outside the cavity. Routine use of anti-inflammatory drugs dehydration treatment,MBT Schuhe günstig, drainage tubes were removed after 3d, 14d after suture removal, wearable brace ambulation. 2 follow-up results mean follow-up 2 years after the evaluation standard, reference method and the Otani method Macnab J, divided into excellent, good,moncler paris, fair, poor. Advantages: asymptomatic, normal work and activities; good: occasional symptoms, can do light work; can: symptoms have improved, but still does not work; difference: heavier than the preoperative symptoms. This standard, excellent in 3 cases, good in 4 cases, l cases,uggs norge, the fine was 87%. 3 Discussion 3.1 The incidence of thoracic disc herniation lower clinical rare, its incidence reported in the literature of all disc herniation 0.5% to 4%. In recent years, with the growing awareness of the disease, and diagnostics technology continues to progress, to improve the diagnosis rate trends. As the disease once the symptoms of spinal cord compression, was mostly sexual development, higher disability, so a general idea of ​​surgery after diagnosis. 3.2 Early clinical manifestations of thoracic disc herniation complicated, Tl0 usually more prominent signs of damage on the campaign dollars, and Tl0 the following as spinal cord compression cone, both showed signs of damage on the movement element can also be expressed as signs of damage to lower motor element,moncler outlet, or both, so often cause misdiagnosis or missed diagnosis. Clinical experience with atypical symptoms acid storm back pain, leg weakness, check the thoracic spine should be held while the MRI examination. 3.3 Clinical application of surgical options currently roughly surgical approach through the pedicle or posterior lateral facet pedicle resection by means of external ChineseJoumalofC ¨ nicalPracticalMedicine. July2007Vb1.8 'side of the transverse rib resection by extrapleural approach, by the side of the chest or extrapleural anterior approach, they have their own advantages and disadvantages. The patients are used by the side of the chest or extrapleural anterior approach, we believe that side of the anterior surgery, the surgical field revealed fully, anterior decompression may be complete, as long as careful to do every step of the interference of the spinal cord is very small. Figure 1T9/10 disc (preoperative) Figure 2Cage implantation (postoperative) 3.4 complete decompression,ugg boots norge, the line of interbody fusion implants to restore the stability of the spinal column, greatly reducing the time in bed to prevent occur due to complications arising from prolonged bed rest. Patients with early ambulation, functional exercises conducive to the limbs, and eliminating the patient's anxiety. The patients wear braces an average of two weeks ambulation. [
],[