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Clinical and radiographic features of adult calcified thoracic disc herniation: a retrospective analysis of 31 cases

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Abstract

Purpose

To analyze the clinical and radiographic characteristics of calcified thoracic disc herniation (CTDH) and explore the possible pathogeneses.

Methods

This is a retrospective clinical review of prospectively collected imaging data based at a single institute from 2004 to 2021. Clinical and radiographic parameters of CTDH patients were retrospectively collected and analyzed.

Results

All 31 patients included presented thoracic myelopathy with a 17.05-month preoperative disease duration. Three (9.7%) patients had a history of trauma, and the rest had insidious onset. The average spinal canal ventral-occupying ratio was 74.90 ± 15.16%. The most prominent radiographic feature was the calcification of the nucleus pulposus in the intervertebral disc and the calcified lesion contiguous with the disc space protruding into the spinal canal. Three main imaging forms of CTDH were found: calcium-ringed lesion (5), heterogeneous calcification lesion (19), and homogeneous calcification lesion (7). The radiographic manifestations, intraoperative findings, and postoperative pathologies of the three subtypes were different. The calcium-ringed lesion type was younger and had a shorter preoperative duration and significantly lower mJOA score. A special case was observed conservatively for five years, which suggested that a heterogeneous lesion could progress to a homogeneous lesion.

Conclusions

Adult CTDH is a special thoracic disc disease with insidious onset, a long course, and a high spinal canal-occupying ratio. Calcium deposits in the spinal canal originate from the nucleus pulposus. The intraoperative findings and postoperative pathology of subtypes are different, which might indicate different pathological mechanisms.

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Acknowledgements

This study was performed in compliance with our institution’s investigational review board (IRB00006761-M2020047) and registered in the Chinese Clinical Trial Registry (registration ID: ChiCTR2000030840. http://www.chictr.org.cn/index.aspx).

Funding

No funds were received to support this work. No benefits in any form have been or will be obtained from a commercial party related directly or indirectly to the subject of this manuscript.

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Authors and Affiliations

  1. Department of Orthopedics, Peking University Third Hospital, 49 North Garden Street, Hai Dian, Beijing, 100191, China

    Lei Yuan, Zhongqiang Chen, Zhongjun Liu, Weishi Li, Chuiguo Sun & Xiaoguang Liu

  2. Beijing Key Laboratory of Spinal Disease Research, Peking University Third Hospital, 49 North Garden Road, Beijing, 100191, China

    Lei Yuan, Zhongqiang Chen, Zhongjun Liu, Weishi Li, Chuiguo Sun & Xiaoguang Liu

  3. Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Peking University Third Hospital, 49 North Garden Road, Beijing, 100191, China

    Lei Yuan, Zhongqiang Chen, Zhongjun Liu, Weishi Li, Chuiguo Sun & Xiaoguang Liu

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  1. Lei Yuan
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Correspondence to Zhongqiang Chen.

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Yuan, L., Chen, Z., Liu, Z. et al. Clinical and radiographic features of adult calcified thoracic disc herniation: a retrospective analysis of 31 cases. Eur Spine J 32, 2387–2395 (2023). https://doi.org/10.1007/s00586-023-07784-4

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  • DOI: https://doi.org/10.1007/s00586-023-07784-4

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