Dynamics of outcomes of thoracoscopic microdiscectomy

Abstract

Object of the study. Thoracoscopic microdiscectomy (TM) is used for surgical treatment of thoracic disc herniations (TDH). The purpose of this study was to analyze the factors influencing the dynamics of outcomes in the early and late postoperative period Materials and methods/ The study had a retrospective, single-center, observational cohort design. The series included all patients without exception who underwent TM from January 2018 to December 2022. Outcomes were assessed according to the Macnab scale adapted for the thoracic spine. Postoperative complications were classified according to the Clavien-Dindo Classification. Statistical univariate analysis of the data was carried out using the Fisher»s method and the Mann-Whitney U test. Multivariate analysis was performed using multiple linear regression with stepwise elimination. Results/ A total of 36 patients were operated on using the TM technique. These included 22 (61 %) women and 14 (39 %) men. The median age was 45±15 years. Early outcomes were assessed 2 months after the patients» surgery. The median duration of long-term outcomes was 22±12 months. The statistical analysis of early outcomes revealed a connection between the localization of a disc herniation in the lower thoracic spine (Th8 — Th12) with simultaneous surgery at two levels and less favorable outcomes. The analysis of long-term outcomes showed that the only prognostic factor was the patient»s condition when assessing the early outcome. Thus, complete recovery was registered at the first control in 13 out of 15 (86 %) patients and at the last control in 13 out of 16 (81 %) patients (p <0.001). Conclusions. The analysis of early and long-term outcomes made it possible to identify factors that determine the dynamics of recovery after thoracoscopic microdiscectomy. The data obtained can be used in planning postoperative management of this group of patients.