Our Summary

This study looks at a surgical procedure used to treat thoracic disc herniations, a condition that can cause severe pain and disability. The procedure is called thoracoscopic microdiscectomy (TMD) and it involves removing the damaged disc through a small incision in the chest. The team performed 181 of these surgeries and found that the technique is effective, reduces blood loss, and is relatively fast.

The surgery technique also helps to reduce postoperative pain because it involves preserving the rib and the costovertebral joint (where the rib meets the spine). The surgery is careful to avoid putting pressure on these areas, which can lead to pain after the procedure.

In the study, patients experienced minimal complications and most experienced a substantial decrease in both acute (short-term) and chronic (long-term) postoperative pain. The researchers believe this technique could be widely accepted by spine surgeons and be beneficial for patients suffering from thoracic disc herniations.

FAQs

  1. What is thoracoscopic microdiscectomy (TMD) and how is it performed?
  2. How does thoracoscopic microdiscectomy (TMD) help in reducing postoperative pain?
  3. What were the results of the study on the effectiveness of thoracoscopic microdiscectomy (TMD)?

Doctor’s Tip

One helpful tip a doctor might tell a patient about microdiscectomy is to follow postoperative instructions carefully to ensure proper healing and minimize the risk of complications. This may include avoiding heavy lifting, bending, or twisting for a certain period of time, as well as gradually increasing activity levels as advised by the surgeon. It is also important to attend follow-up appointments and communicate any concerns or changes in symptoms to the medical team promptly. Following these guidelines can help optimize the outcome of the surgery and promote a successful recovery.

Suitable For

Patients who are typically recommended for microdiscectomy surgery include those who have:

  1. Severe and persistent back or leg pain that has not improved with conservative treatments such as physical therapy, medications, and injections.
  2. Symptoms of nerve compression, such as weakness, numbness, or tingling in the legs.
  3. Herniated discs that are causing significant compression of the spinal nerves.
  4. Patients who have tried other treatments without success and are unable to perform daily activities due to their pain.
  5. Patients who are in good overall health and do not have any contraindications to surgery.

It is important for patients to undergo a thorough evaluation by a spine specialist to determine if they are good candidates for microdiscectomy surgery. The decision to undergo surgery should be made in collaboration with the patient’s healthcare team, taking into consideration the risks and benefits of the procedure.

Timeline

  • Before microdiscectomy:
  1. Patient experiences symptoms of a thoracic disc herniation, such as severe pain in the chest or back, numbness or tingling in the arms or legs, and weakness in the muscles.
  2. Patient undergoes diagnostic tests, such as MRI or CT scans, to confirm the diagnosis.
  3. Patient discusses treatment options with their healthcare provider, including conservative measures such as physical therapy or medications.
  4. If conservative treatments are not effective, patient and healthcare provider decide to proceed with microdiscectomy surgery.
  • After microdiscectomy:
  1. Patient undergoes thoracoscopic microdiscectomy surgery to remove the damaged disc.
  2. Patient experiences minimal complications during and after the surgery.
  3. Patient experiences a decrease in acute postoperative pain immediately after the surgery.
  4. Patient undergoes a recovery period, which may involve physical therapy and pain management to aid in the healing process.
  5. Patient experiences a substantial decrease in chronic postoperative pain in the long term.
  6. Patient may resume normal activities and experience improved quality of life.

What to Ask Your Doctor

  1. What is the success rate of thoracoscopic microdiscectomy for treating thoracic disc herniations?
  2. How long is the recovery time after undergoing thoracoscopic microdiscectomy?
  3. What are the potential risks and complications associated with this surgical procedure?
  4. How will my pain be managed after the surgery?
  5. Will I need physical therapy or rehabilitation after the procedure?
  6. Are there any restrictions or limitations on activities I should be aware of after the surgery?
  7. How long will it take for me to see improvement in my symptoms after the surgery?
  8. Are there any alternative treatments or procedures that I should consider before opting for thoracoscopic microdiscectomy?
  9. What is the long-term prognosis for patients who undergo this surgery?
  10. How many thoracoscopic microdiscectomy procedures have you performed, and what is your experience with this technique?

Reference

Authors: Cornips EMJ, Beuls EAM. Journal: Adv Tech Stand Neurosurg. 2022;45:359-378. doi: 10.1007/978-3-030-99166-1_12. PMID: 35976457