Abstract
Multiple anterior and posterior approaches to the thoracic disc space have been reported. However, we are not aware of any previous reports describing a transforaminal approach for thoracic disc release and interbody cage placement. In this case report, we describe a method to perform transforaminal thoracic interbody fusion (TTIF), which is an adaptation of an established lumbar fusion technique (transforaminal lumbar interbody fusion). Key differences between the two procedures are discussed. A 24-year-old woman presented after sustaining a T11-12 Chance fracture that had been treated in a brace. She had severe, debilitating pain and a rigid segmental kyphotic deformity of 38°. The patient was treated 3 months post-injury with T10-L1 fusion with anterior release and interbody fusion with cage placement at T11-12. Anterior column release and fusion were performed via a transforaminal approach. The patient had anatomic reduction of deformity, solid arthrodesis, and relief of pain at 1-year follow-up. The TTIF approach permits access to the anterior column of the thoracic spine for the purpose of reduction of deformity and interbody fusion with reduced morbidity compared to anterior–posterior surgery.
References
Finkelstein JA, Wai EK, Jackson SS, Ahn H, Brighton-Knight M (2003) Single-level fixation of flexion distraction injuries. J. Spinal Disord. Tech. 16:236–242
Keene JS, Lash EG, Kling TF, Jr (1988) Undetected posttraumatic instability of "stable" thoracolumbar fractures. J. Orthop. Trauma 2:202–211
Kim YJ, Lenke LG, Bridwell KH, Kim KL, Steger-May K (2005) Pulmonary function in adolescent idiopathic scoliosis relative to the surgical procedure. J. Bone Joint Surg. Am. 87:1534–1541
Karmakar MK, Ho AM (2004) Postthoracotomy pain syndrome. Thorac. Surg. Clin. 14:345–352
Harms J, Rolinger H (1982) A one-stager procedure in operative treatment of spondylolistheses: dorsal traction-reposition and anterior fusion (author’s transl). Z. Orthop. Ihre. Grenzgeb. 120:343–347
Ugur HC, Attar A, Uz A, Tekdemir I, Egemen N, Genc Y (2001) Thoracic pedicle: surgical anatomic evaluation and relations. J. Spinal Disord. 14:39–45
Ebraheim NA, Jabaly G, Xu R, Yeasting RA (1997) Anatomic relations of the thoracic pedicle to the adjacent neural structures. Spine 22:1553–1556
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The authors gratefully acknowledge the guidance of H. Jürgen Roh, MD.
Each author certifies that he or she has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article.
Each author certifies that his or her institution has approved the reporting of this case and that all investigations were conducted in conformity with ethical principles of research.
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Huang, R.C., Meredith, D.S. & Taunk, R. Transforaminal Thoracic Interbody Fusion (TTIF) for Treatment of a Chronic Chance Injury. HSS Jrnl 6, 26–29 (2010). https://doi.org/10.1007/s11420-009-9138-3
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DOI: https://doi.org/10.1007/s11420-009-9138-3