Anamnesi del paziente

The patient complained of pain and paresthesia in the thoracic and lumbar spine, irradiante a destra e sinistra lungo gli spazi intercostali, nonché alla parete addominale laterale e anteriore destra ai livelli Th5–Th12.

Right-sided thoracic paraparesis è stato notato, così come il coinvolgimento della parete addominale laterale e anteriore. Si è sviluppata disfunzione degli organi interni — fegato, pancreas e intestino — per 8 mesi con sintomi crescenti. Lumbar pain and paresthesia of both legs down to the feet developed. The patient was under constant strong pain medication.

Diagnosi

Old compression fracture of Th8 and Th9 vertebrae with contusion ventrolateral disc extrusion on the right measuring 25 mm × 15 mm
Ventral central-lateral osteo-discogenic stenosis with spinal cord membrane (Dura mater) damage and adhesion process in the Th6/Th7 area
Bilateral Th7 root compression — bilateral radiculopathy with neurological deficit

Rapporto operatorio — Metodo MIBRAR®

Microinvasive procedure performed in June 2015 at the MIBRAR clinic (Munich) under Prof. Dr. med. Arsen Babayan.

Flexible epidural catheterization of the thoracic spinal canal using ventral approach — navigation to the stenosis zone
Mechanical destruction of the osteo-cartilaginous stenosing correlate — spinal cord and root decompression without open surgery
Dilation of the stenosis zone — spinal canal lumen restoration
CGF concentrate application (blood plasma, young platelets with growth factors, late platelets with anti-inflammatory factors) — regeneration stimulation and anti-inflammatory effect
Treatment zones: spinal canal in the Th6–Th9 area, adhesion zone, Th7 root compression area

MRI Scans 3 Months After MIBRAR®

Le RMN di controllo sono state eseguite tre mesi dopo la chirurgia. Si visualizza la condizione della colonna toracica dopo decompressione del canale spinale e risoluzione della stenosi osteo-discogenica.

$Thoracic MRI: condition after MIBRAR® — Th8-Th9 fracture, spinal canal decompression$

MRI 3 months after MIBRAR®: Colonna toracica in the Th6–Th9 area. Spinal canal free, no signs of stenosis. Adhesion process in the Dura mater area not detectable. Th7 root compression resolved.

Risultati del trattamento

After 1 week

Complete absence of all symptoms. Thoracic pain, paresthesia, organ dysfunction ceased. Pain medication completely discontinued.

After 3 months

RMN di controllo confirmed stenosis resolution and nerve structure decompression. Adhesion process in the dural membrane area not detectable.

A lungo termine

Symptoms did not recur. The patient has no limitations in daily and professional life, actively participates in sports. Open thoracic surgery was not required.

Importanza del caso

Compression fracture consequences of the thoracic spine with 25×15 mm l'estrusione discale e il danno alla membrana durale appartengono alla categoria più complessa di patologia spinale. Il trattamento standard prevede un intervento a cielo aperto di diverse ore con fissazione vertebrale con viti transpedicolari, rimozione dell'estrusione e laminectomia decompressiva.

MIBRAR® achieved complete symptom resolution within one week — including paraparesis, internal organ dysfunction, and chronic pain syndrome — without open surgery, without metal fixation, on an outpatient basis. Flexible epidural catheterization with mechanical dilation and CGF provided canal decompression and damaged tissue regeneration.

Particularly notable is the restoration of internal organ function (liver, pancreas, intestines), disrupted due to thoracic root compression — a result virtually unachievable with conservative methods.