2116 Endoscopic Applications in the Thoracic Spine: A Single Institution, Single Surgeon Case Series

INTRODUCTION: Thoracic disc herniations (TDH) are challenging pathologies to treat. Surgical options often include morbid procedures with high complication profiles. Full endoscopic spine surgery (FESS) offers an ultra-minimally invasive option for pathologies in the lumbar spine. It minimizes collateral damage by limiting bony resection and incision size while decreasing blood loss (EBL), length of stay (LOS), post-op pain, and infection rates. FESS has been described as a feasible and safe technique in TDH. METHODS: A retrospective review was conducted for patients who underwent FESS for the resection of a TDH from 1/1/20 – 5/3/24. Patient and imaging characteristics, clinical signs/symptoms, as well as surgical considerations were all collected. Clinical data collected included EBL, surgery time, and LOS. RESULTS: 27 patients underwent 30 FESS for resection of 35 discs. 40% had myelopathy, 27% had radiculopathy, and 33% had both. There were 2 complications (7%) and 3 patients required reoperation at the same level (11%). In 94% of surgeries, the patient’s pre-op symptoms had improved or completely resolved at last follow-up (6.9 ± 9.8 months). FESS had an average surgical time of 195 ± 100 mins, an EBL of 8.5 ± 6.6 ml, and 63% had LOS <24 h. 39% of patients did not need narcotics on discharge. CONCLUSIONS: FESS for a variety of TDH can be done safely with reasonable efficacy and favorable outcomes. Comprehensive training in FESS with special considerations to the thoracic spine is necessary for successful surgical outcomes. FESS offers an alternative option to conventional procedures that may involve more extensive surgical exposures and prolonged post operative recovery.