Research ArticleMinimally Invasive Surgery

Five-Year Outcomes After Transforaminal Endoscopic Foraminotomy and Discectomy for Soft and Calcified Thoracic Disc Herniations

Karlo Houra, Robert Saftic and Martin Knight
International Journal of Spine Surgery June 2021, 15 (3) 494-503; DOI: https://doi.org/10.14444/8071

Article Figures & Data

Figures

  • Figure 1
    Figure 1

    Determining skin entry point and a surgical trajectory using preoperative axial T2-weighted magnetic resonance imaging. The line is drawn from posterior annulus at the medial pedicular line to lateral margin of facet joint. The distance from the midline is 5.99 cm.

  • Figure 2
    Figure 2

    (A) Lateral intraoperative fluoroscopic view depicting final position of TOM Shidi bone needle in the posterior part of annulus fibrosus. (B) Anterior-posterior intraoperative fluoroscopic view of the TOM Shidi needle showing its tip in medial pedicular line. Vertebral endplates are squared.

  • Figure 3
    Figure 3

    (A) Intraoperative fluoroscopic lateral view showing position of first manual reamer used for foraminotomy which is introduced over a guide wire. (B) Intraoperative fluoroscopic anterior-posterior view showing position of larger manual reamer with its tip at medial pedicle line at the entrance of the disk.

  • Figure 4
    Figure 4

    (A) Intraoperative fluoroscopic anterior-posterior (AP) view showing position of electric burr with curved tip used for bone drilling and making indirect decompression beneath the calcified portion of the disc. (B) Intraoperative fluoroscopic AP view showing position of grasper used for removal of soft disc.

  • Figure 5
    Figure 5

    (A) and (B) Intraoperative fluoroscopic anterior-posterior view showing caudal and cranial position of blunt tip dissecting tool used while detaching the calcified herniation from the dura.

  • Figure 6
    Figure 6

    (A) The visual analog scale (VAS) for pain and (B) the Oswestry Disability Index (ODI) measurements in sampled timepoints. Measurements on the same subject were connected with lines. Measurements were also summarized with boxplots at each timepoint. Lower and upper box limits present first quartile (Q1) and third quartile (Q3), while thick line inside the box presents median. Whiskers are connecting minimum or maximum values within inner fence calculated as 1.5 × interquartile range (calculated as Q3 – Q1) below Q1 or above Q3, respectively. Any measurements which are not within inner fence are considered outliers and presented with points. Statistically significant differences (resulted from post hoc tests) are presented above compared groups with asterisks according to following P value pattern: .05 > * > .01 > ** > .001 > ***.

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Five-Year Outcomes After Transforaminal Endoscopic Foraminotomy and Discectomy for Soft and Calcified Thoracic Disc Herniations
Karlo Houra, Robert Saftic, Martin Knight
International Journal of Spine Surgery Jun 2021, 15 (3) 494-503; DOI: 10.14444/8071
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