Calcified Thoracic Disc Herniations in the Elderly: Revisiting the Laminectomy for Single Level Disease

Abstract

Study Design: Retrospective case series. Objectives: Calcified thoracic disc herniations in the elderly present with a variety of clinical conditions and the treatment is a source of significant debate. Decompression of the disc space is done through anterior, lateral, posterolateral, and posterior approaches. There is significant morbidity of thoracic disc herniation and associated decompression. Methods: The present report is a case series of 8 elderly patients with calcified discopathy who received a simple laminectomy without decompression of the disc space. Results: Postoperatively, 5 patients mobilized independently, 2 with a walker, and 1 patient was nonambulatory. Two patients improved 1 ASIA (American Spinal Injury Association Impairment Scale) score, 1 patient improved 2 ASIA scores, and 3 patients had no change in ASIA score. Conclusion: In our experience, thoracic disc herniations require a technically difficult decompression and overall the complications are significant. We present a series of 8 patients who generally improved from a simple laminectomy and consider this a viable procedure for patients too unwell to undergo direct disc decompression.