Lei Yuan1,2,3, Zhongqiang Chen4,5,6, Weishi Li1,2,3, Chuiguo Sun1,2,3, Zhongjun Liu1,2,3, Xiaoguang Liu1,2,3, Huishu Yuan7. 1. Department of Orthopedics, Peking University Third Hospital, 49 North Garden Road, Beijing, 100191, China. 2. Beijing Key Laboratory of Spinal Disease Research, Peking University Third Hospital, 49 North Garden Road, Beijing, 100191, China. 3. Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Peking University Third Hospital, 49 North Garden Road, Beijing, 100191, China. 4. Department of Orthopedics, Peking University Third Hospital, 49 North Garden Road, Beijing, 100191, China. zqchenby@163.com. 5. Beijing Key Laboratory of Spinal Disease Research, Peking University Third Hospital, 49 North Garden Road, Beijing, 100191, China. zqchenby@163.com. 6. Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Peking University Third Hospital, 49 North Garden Road, Beijing, 100191, China. zqchenby@163.com. 7. Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Beijing, 100191, China.
Abstract
PURPOSE: To analyze the clinical and radiographic characteristics of thoracic disk disease associated with myelopathy (TDM). METHODS: This is a retrospective clinical review of prospectively collected imaging data based at a single institute. Based on preoperative CT and MRI, we classified TDM as thoracic disk herniation (TDH), THD with ossification (THDO), TDH with posterior bony avulsions of the vertebrae (TDH with PBA), TDH with posterior vertebral osteophytes (TDH with PVO), giant thoracic osteophyte and calcific discitis with herniation (CDH). Patient characteristics and radiographic data were compared between different types of TDM. RESULTS: Among the 257 patients included, 12.06% of patients presented with symptoms after traumatic events. The most frequent complaint at onset and preoperative was back pain (29.2%) and subjective lower limb weakness (75.5%), respectively. All TDH with PBA is distributed at the lower thoracic segments, while CDH predominantly in the middle and lower thoracic segments. TDH with PBA was more frequent in men than TDH and CDH. Compared with TDH, TDHO, and TDH with PVO, TDH with PBA was younger in surgery age, and TDH and CDH had lower preoperative JOA scores than TDH with PBA. CDH had a larger ventral occupying ratio than TDH, TDHO, and TDH with PBA. CONCLUSIONS: The onset of TDM was generally insidious but may be triggered acutely by apparently trivial events. With a low prevalence, TDM varied clinical symptoms. Different types of TDM had various clinical features, which might indicate different pathological mechanisms.
PURPOSE: To analyze the clinical and radiographic characteristics of thoracic disk disease associated with myelopathy (TDM). METHODS: This is a retrospective clinical review of prospectively collected imaging data based at a single institute. Based on preoperative CT and MRI, we classified TDM as thoracic disk herniation (TDH), THD with ossification (THDO), TDH with posterior bony avulsions of the vertebrae (TDH with PBA), TDH with posterior vertebral osteophytes (TDH with PVO), giant thoracic osteophyte and calcific discitis with herniation (CDH). Patient characteristics and radiographic data were compared between different types of TDM. RESULTS: Among the 257 patients included, 12.06% of patients presented with symptoms after traumatic events. The most frequent complaint at onset and preoperative was back pain (29.2%) and subjective lower limb weakness (75.5%), respectively. All TDH with PBA is distributed at the lower thoracic segments, while CDH predominantly in the middle and lower thoracic segments. TDH with PBA was more frequent in men than TDH and CDH. Compared with TDH, TDHO, and TDH with PVO, TDH with PBA was younger in surgery age, and TDH and CDH had lower preoperative JOA scores than TDH with PBA. CDH had a larger ventral occupying ratio than TDH, TDHO, and TDH with PBA. CONCLUSIONS: The onset of TDM was generally insidious but may be triggered acutely by apparently trivial events. With a low prevalence, TDM varied clinical symptoms. Different types of TDM had various clinical features, which might indicate different pathological mechanisms.
Entities:
Keywords:
Clinical features; Radiographic characteristics; THD with ossification; Thoracic disk diseases; Thoracic disk herniation
Authors: Felix E Diehn; Timothy P Maus; Jonathan M Morris; Carrie M Carr; Amy L Kotsenas; Patrick H Luetmer; Vance T Lehman; Kent R Thielen; Ahmad Nassr; John T Wald Journal: Radiographics Date: 2016-04-15 Impact factor: 5.333
Authors: Corey T Walker; M Yashar S Kalani; Mark E Oppenlander; Jakub Godzik; Nikolay L Martirosyan; Robert J Standerfer; Nicholas Theodore Journal: J Neurosurg Spine Date: 2017-12-01