Controversies in Spine Surgery; Diagnosis and Treatment of Thoracic Disc Herniations; Dr. Nancy Epstein;

SUMMARY: Dr. Nancy Epstein reviews the literature on Thoracic Discs and their surgical treatment. This excellent 40 minute lecture with interactive discussion should answer the questions of how to choose the right approach to perform these operations and to avoid  complications. She discusses the symptomatic presentation with pain with/without neurological deficit, the necessity of performing CT, MR with CT myelography to define the lesion's location as lateral, paramedian, or median. She defines the operative approaches to lesions in each of these locations. DO NOT DO A POSTERIOR LAMINECTOMY as stated in multiple papers in the literature. Trans-pedicular, Costo-transversectomy or lateral extracavitary, or trans-thoracic approaches are all detailed with attention to the complications to be avoided. The need for pre-operative localization of the lesion with a marker and precise location of the lesion, and  for intra-operative monitoring, including  the proper use of the instruments to avoid injury to the spinal cord are all discussed. When to seek extra help with thoracic surgery noted.  Some other complications are discussed.   These are uncommon lesions and have a high chance of complications if not done properly with attention to detail. If you are going to do these procedures, this is a must view video to watch. (40 minute Lecture and 15 minutes of discussion). (JIA)


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Moderator / Speaker
  • James I. Ausman, MD, MA, PhD

    CEO SNI and SNI Digital; Emeritus Professor Neurosurgery

James I. and Carolyn R. Educational Foundation

  • Nancy Epstein, MD

    Chief, Neurosurgical Spine and Education, Winthrop Univesrit...

Neurosurgeon, Spine Neurosurgery, Professor of Clinical Neurosurgery, School of Medicine, State Univ...