Resumo

MARIN-SANABRIA, EA; ARBO OZE DE MORVIL, CA; SILVA FIGUEREDO, JR  e  FRANCO SCHIAVO, M. First recorded case of thoracic disc herniation operated in Paraguay. Difficulties and challenges. An. Fac. Cienc. Méd. (Asunción) [online]. 2014, vol.47, n.2, pp.55-60. ISSN 1816-8949.

ABSTRACT Symptomatic herniated disks of thoracic column with surgical indication are not frequent. The difficulty for an early diagnosis lays on finding signs and symptoms orienting to request a Nuclear Magnetic Resonance of the thoracic column in order to obtain a rapid identification of the compressive phenomenon on the spinal cord. The objective of this study is to present the first herniated disk of the thoracic column treated surgically and successfully in Paraguay, discuss the natural history and determine the difficulties of the clinical diagnosis and surgical handling. The case presented is one of a 61-yeard old male patient with history of lumbar pain and progressive and rapid weakness of the left lower extremity until paraplegia. Neither the routine laboratory data of blood and cephalorachidian fluid nor the electromyographic studies showed a typical pattern. The image study determined precisely the diagnosis. The surgical treatment was an intrapleural, anterior transthoracic approach and partial discectomy of one hard fibrous hernia, without the need to add any arthrodesis system. The evolution was excellent with total recovery of mobility and sensitivity of lower extremities. Key Words: thoracic discectomy, thoracic herniated disk, paraplegia.

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