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PMID- 28894679
OWN - NLM
STAT- PubMed-not-MEDLINE
DA  - 20170912
LR  - 20170914
IS  - 2192-5682 (Print)
IS  - 2192-5682 (Linking)
VI  - 7
IP  - 6
DP  - 2017 Sep
TI  - Management of Thoracic Disc Herniations via Posterior Unilateral Modified
      Transfacet Pedicle-Sparing Decompression With Segmental Instrumentation and
      Interbody Fusion.
PG  - 506-513
LID - 10.1177/2192568217694140 [doi]
AB  - STUDY DESIGN: Retrospective consecutive case series. OBJECTIVE: The objective of 
      this case series was to demonstrate the safety of a modified transfacet
      pedicle-sparing decompression and instrumented fusion in patients with thoracic
      disc herniations (TDHs). METHODS: Consecutive patients undergoing operative
      management of TDH from July 2007 to December 2011 using a posterior unilateral
      modified transfacet pedicle-sparing approach were identified. All patients
      underwent open or minimally invasive modified transfacet pedicle-sparing
      discectomy and segmental instrumentation with interbody fusion, performed by four
      different surgeons. Pre- and postoperative visual analog scale (VAS) pain scores,
      Nurick grade, and American Spinal Injury Association Impairment Scale (AIS) were 
      analyzed from a retrospective chart review. Estimated blood loss and
      complications were also obtained. RESULTS: Fifty-one patients were included that 
      had operations for TDH. Thirty-nine patients had single level decompression and
      12 had multilevel decompression. The total number of levels operated on was 64.
      Five patients were treated with minimally invasive surgery. A herniated disc
      level of T11-12 (n = 17) was treated most often. One major complication of
      epidural hematoma occurred. Minor complications such as malpositioned hardware,
      postoperative hematoma, wound infection, pseudoarthrosis, and pulmonary
      complications occurred in a few patients. Follow-up ranged from 1 to 46 months
      with 1 patient lost to follow-up. From preoperative to final postoperative: mean 
      VAS scores improved from 8.31 to 4.05, AIS in all patients remained stable or
      improved, and Nurick scores improved from 3 to 2.6 on average. No intraoperative 
      or permanent neurological deficit occurred. CONCLUSION: In our surgical series,
      51 consecutive patients underwent modified transfacet pedicle-sparing approach to
      TDHs and experienced improvement of functional status as well as improvement of
      objective pain scales with no neurological complications. The posterior
      unilateral modified transfacet pedicle-sparing decompression and instrumented
      fusion approach to the thoracic spine is a safe and reproducible procedure for
      the treatment of TDHs.
FAU - Carr, Daniel A
AU  - Carr DA
AD  - St John Providence Health System, Southfield, MI, USA.
FAU - Volkov, Andrey A
AU  - Volkov AA
AD  - St John Providence Health System, Southfield, MI, USA.
FAU - Rhoiney, David L
AU  - Rhoiney DL
AD  - A.T. Still University of Health Sciences, Kirksville, MO, USA.
FAU - Setty, Pradeep
AU  - Setty P
AD  - St John Providence Health System, Southfield, MI, USA.
FAU - Barrett, Ryan J
AU  - Barrett RJ
AD  - St John Providence Health System, Southfield, MI, USA.
AD  - Michigan Spine and Brain Surgeons, PLLC, Southfield, MI, USA.
FAU - Claybrooks, Roderick
AU  - Claybrooks R
AD  - St John Providence Health System, Southfield, MI, USA.
AD  - Michigan Spine and Brain Surgeons, PLLC, Southfield, MI, USA.
FAU - Bono, Peter L
AU  - Bono PL
AD  - St John Providence Health System, Southfield, MI, USA.
AD  - Michigan Spine and Brain Surgeons, PLLC, Southfield, MI, USA.
FAU - Tong, Doris
AU  - Tong D
AD  - Michigan Spine and Brain Surgeons, PLLC, Southfield, MI, USA.
FAU - Soo, Teck M
AU  - Soo TM
AD  - St John Providence Health System, Southfield, MI, USA.
AD  - Michigan Spine and Brain Surgeons, PLLC, Southfield, MI, USA.
LA  - eng
PT  - Journal Article
DEP - 20170406
PL  - England
TA  - Global Spine J
JT  - Global spine journal
JID - 101596156
PMC - PMC5582705
OTO - NOTNLM
OT  - thoracic disc herniation
OT  - thoracic discectomy
OT  - thoracic myelopathy
OT  - thoracic radiculopathy
OT  - transfacet approach
COI - Declaration of Conflicting Interests: The author(s) declared no potential
      conflicts of interest with respect to the research, authorship, and/or
      publication of this article.
EDAT- 2017/09/13 06:00
MHDA- 2017/09/13 06:01
CRDT- 2017/09/13 06:00
AID - 10.1177/2192568217694140 [doi]
AID - 10.1177_2192568217694140 [pii]
PST - ppublish
SO  - Global Spine J. 2017 Sep;7(6):506-513. doi: 10.1177/2192568217694140. Epub 2017
      Apr 6.