Читать книгу Neurosurgery Outlines - Paul E. Kaloostian - Страница 76

• Spinal stenosis

• No improvement after nonoperative therapy (physical therapy, pain management)

• Partial paraplegia

• Progressive cord compression

• Progressive kyphosis/deformity

• Existence of blunt chest trauma or potential hemorrhagic lesions

• Unstable patterns of fracture

• Sufficient disruption of supporting ligaments

• Compression places thoracic spine at risk of permanent damage

Fig. 2.7 Surgical trajectories to addressing a thoracic disk herniation (image demonstrates giant calcified herniation in central canal). Line A is a costotransversectomy approach, Line B is a lateral transthoracic/retropleural approach, and Line C is an anterior transthoracic approach. Both transthoracic approaches do not require cord retraction. (Source: Surgical management. In: Baaj A, Kakaria U, Kim H, eds. Surgery of the Thoracic Spine: Principles and Techniques. 1st ed. Thieme; 2019).