The spine journal : official journal of the North American Spine Society
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Surgical decompression of thoracic disc herniations is technically challenging because retraction of the thecal sac in this area must be avoided. Standard open thoracic discectomy procedures require fairly extensive soft tissue dissection and vertebral resection to provide safe decompression of the spinal cord. ⋯ The transforaminal approach enabled sufficient access to the midline of the spinal canal without extensive resection of the facet joint or the adjacent pedicle. Because most of the osseous and ligamentous structures were preserved, additional instrumentation was not required to prevent postoperative instability. Our early results suggested that minimally invasive thoracic discectomy by transforaminal microscopic technique is a valuable choice in the management of thoracic disc herniation.
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There is a paucity of literature examining the clinical yield of in-hospital postoperative radiographs for patients who have had instrumented single-level spinal fusions with intraoperative fluoroscopic guidance. Many spinal surgeons consider postoperative standing radiographs to be the appropriate standard of care, even in patients who have an uneventful postoperative course. ⋯ In patients who have a single-level instrumented fusion and a documented uneventful postoperative course, in-hospital postoperative standing AP and lateral radiographs do not appear to provide additional clinically relevant information when intraoperative fluoroscopy is properly used. Fluoroscopy also demonstrated more consistent accuracy and a potential for significant cost savings.