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Research ArticleFull Length Article
Open Access

Arthroscopic discectomy and interbody fusion of the thoracic spine: A report of ipsilateral 2-portal approach

Said G. Osman, Jeremy A. Schwartz and E. B. Marsolais
International Journal of Spine Surgery January 2012, 6 103-109; DOI: https://doi.org/10.1016/j.ijsp.2012.02.004
Said G. Osman
aAmerican Spine Center, Frederick, MD
MD, FRCSEd(Ortho)
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  • For correspondence: gotoaila@gmail.com
Jeremy A. Schwartz
bLee Memorial Hospital, Fort Myers, FL
MD
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E. B. Marsolais
cUniversity Hospitals of Cleveland, Cleveland, OH
MD, PhD
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Article Figures & Data

Figures

  • Fig. 1
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    Fig. 1

    Operating room set-up, note the laterally transparent drape. This allows the surgical team see foot pedals on the floor, and the fluoroscope as it is placed in the lateral position.

  • Fig. 2
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    Fig. 2

    Patient in prone position on the operating table. Note skin markings indicating spinal levels and iliac crests, prior to skin preparation and sterile draping.

  • Fig. 3
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    Fig. 3

    Intra-operative, anteroposterior fluoroscopic view of guide wires triangulating in the foraminal canal of the target motion-segment.

  • Fig. 4
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    Fig. 4

    Illustration of unilateral, bi-portal approach to a thoracic foramen. Note in this illustration the arthroscope is the rostral cannula.

  • Fig. 5
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    Fig. 5

    Unilateral bi-portal arthroscopic approach to the thoracic spine. Note the arthroscope and the instrument in the surgeon's left, and the right hand, respectively.

  • Fig. 6
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    Fig. 6

    Arthroscopic view of the grasping forceps in the disc space.

  • Fig. 7
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    Fig. 7

    After excision of a large calcified herniated disc material from within the disc space, a Penfield #4 probe is inserted between the posterior annulus and the dura, to decompress the epidural space.

  • Fig. 8
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    Fig. 8

    Arthroscopic view of the dura, after excision of a large herniated and calcified intervertebral disc.

  • Fig. 9
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    Fig. 9

    Anteroposterior fluoroscopic view of bone dowel being place in the intervertebral disc space, through one of the cannulas.

  • Fig. 10
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    Fig. 10

    Thoracic levels of degeneration/herniation which were operated on.

  • Fig. 11
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    Fig. 11

    Overall pain severity score preoperatively and postoperatively. The difference was statistically significant (P ≤ .005).

  • Fig. 12
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    Fig. 12

    Preoperative and postoperative level of satisfaction with life as a result of spine-related symptoms. The difference was statistically significant (P ≤ .005). ES, extremely satisfied; MX, mixed reaction; SD, somewhat dissatisfied; SS, somewhat satisfied; VD, very dissatisfied; VS, very satisfied.

  • Fig. 13
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    Fig. 13

    Preoperative and postoperative salaried work status, showing the number of hours patients were able to work per week as a result of spine-related symptoms. (NW-Other, not working for non–spine-related reason; NW-Retired, not working because of retirement; NW-SP, not working because of spine-related symptoms; W 40, working 40 hours per week.)

  • Fig. 14
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    Fig. 14

    4 months post-operative CT Scan of interbody fusion of the thoracic spine.

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International Journal of Spine Surgery
Vol. 6
1 Jan 2012
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Arthroscopic discectomy and interbody fusion of the thoracic spine: A report of ipsilateral 2-portal approach
Said G. Osman, Jeremy A. Schwartz, E. B. Marsolais
International Journal of Spine Surgery Jan 2012, 6 103-109; DOI: 10.1016/j.ijsp.2012.02.004

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Arthroscopic discectomy and interbody fusion of the thoracic spine: A report of ipsilateral 2-portal approach
Said G. Osman, Jeremy A. Schwartz, E. B. Marsolais
International Journal of Spine Surgery Jan 2012, 6 103-109; DOI: 10.1016/j.ijsp.2012.02.004
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Keywords

  • Posterolateral
  • endoscopic
  • Retropleural
  • discectomy
  • Bone dowels
  • fusion

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