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Management of massive calcified transdural thoracic disk herniation.
J Clin Neurosci. 2003 Nov; 10(6):707-10.JC

Abstract

Thoracic disk herniation is a not uncommon pathology faced by the spinal surgeon. The management of massive intradural thoracic disk herniation with ventral cord compression is problematic both in terms of obtaining adequate decompression and ensuring no subsequent leakage of cerebrospinal fluid. A 54-year-old woman presented with a 10 year history of back pain and left leg pain. Over the past 6 months she experienced a progressive spastic paraparesis in both legs with recent urinary incontinence. A left anterolateral thoracotomy for excision of T8/9 thoracic disk protrusion was affected. A transdural decompression was performed with resection of the calcified dura and performance of a Gore-Tex duraplasty and pleuroplasty. A free muscle graft was placed in the intervening space and the chest drains were placed on non-suction. A spinal drain was maintained for 5 days. She made an excellent neurological recovery. Avoidance of cerebrospinal leakage is paramount when performing transthoracic approaches as negative intrapleural pressure can lead to persistence of leakage. This report documents a safe and reliable way to deal with massive intradural thoracic disk rupture with avoidance of subsequent spinal fluid leak.

Authors+Show Affiliations

Department of Neurosurgery, Royal North Shore Hospital and the University of Sydney, Sydney, Australia.No affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

14592628

Citation

Al-Barbarawi, Mohammed, and Lali H S. Sekhon. "Management of Massive Calcified Transdural Thoracic Disk Herniation." Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia, vol. 10, no. 6, 2003, pp. 707-10.
Al-Barbarawi M, Sekhon LH. Management of massive calcified transdural thoracic disk herniation. J Clin Neurosci. 2003;10(6):707-10.
Al-Barbarawi, M., & Sekhon, L. H. (2003). Management of massive calcified transdural thoracic disk herniation. Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia, 10(6), 707-10.
Al-Barbarawi M, Sekhon LH. Management of Massive Calcified Transdural Thoracic Disk Herniation. J Clin Neurosci. 2003;10(6):707-10. PubMed PMID: 14592628.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Management of massive calcified transdural thoracic disk herniation. AU - Al-Barbarawi,Mohammed, AU - Sekhon,Lali H S, PY - 2003/11/1/pubmed PY - 2009/12/16/medline PY - 2003/11/1/entrez SP - 707 EP - 10 JF - Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia JO - J Clin Neurosci VL - 10 IS - 6 N2 - Thoracic disk herniation is a not uncommon pathology faced by the spinal surgeon. The management of massive intradural thoracic disk herniation with ventral cord compression is problematic both in terms of obtaining adequate decompression and ensuring no subsequent leakage of cerebrospinal fluid. A 54-year-old woman presented with a 10 year history of back pain and left leg pain. Over the past 6 months she experienced a progressive spastic paraparesis in both legs with recent urinary incontinence. A left anterolateral thoracotomy for excision of T8/9 thoracic disk protrusion was affected. A transdural decompression was performed with resection of the calcified dura and performance of a Gore-Tex duraplasty and pleuroplasty. A free muscle graft was placed in the intervening space and the chest drains were placed on non-suction. A spinal drain was maintained for 5 days. She made an excellent neurological recovery. Avoidance of cerebrospinal leakage is paramount when performing transthoracic approaches as negative intrapleural pressure can lead to persistence of leakage. This report documents a safe and reliable way to deal with massive intradural thoracic disk rupture with avoidance of subsequent spinal fluid leak. SN - 1532-2653 UR - https://www.unboundmedicine.com/medline/citation/14592628/Management_of_massive_calcified_transdural_thoracic_disk_herniation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0967586803002327 DB - PRIME DP - Unbound Medicine ER -