A Novel, Minimally Invasive Hybrid Technique to Approach Intracanal Herniated Thoracic Discs.

Abstract

Multiple options exist for thoracic disc herniation (TDH). However, when a specific technique is chosen, the goal is to avoid the manipulation of the spinal cord, which is already compressed. To describe a hybrid endoscopic technique for intracanal TDH by combining an oblique paraspinal approach (OPA) and transforaminal full-endoscopic discectomy. We describe the step-by-step operative technique and present the clinical and radiological outcomes of a case series of hybrid endoscopic thoracic discectomy. A total of 3 patients were treated. We observed the usefulness of an OPA to enlarge the intervertebral foramen through the rigid tubular retractor and the feasibility of a full-endoscopic transforaminal approach to reach intracanal TDHs. Early experience with the hybrid endoscopic technique for TDHs demonstrated acceptable clinical and radiological outcomes in the 3 patients treated; however, a larger sample size and a methodologically advantageous study to compare this procedure with conventional options are necessary to probe the full benefits of the hybrid technique.