Posterior transdural discectomy: a new approach for the removal of a central thoracic disc herniation

BACKGROUND: The optimal surgical approach for thoracic disc herniation remains a matter of debate, especially for central disc herniation. In this paper, we present a new technique to remove central thoracic disc herniation, the posterior transdural approach, and report a series of 13 cases operated on in this way at our institute. METHODS: Between September 2004 and October 2010, 13 patients with symptomatic central thoracic disc herniation were operated on, utilising this posterior transdural approach. All patients underwent magnetic resonance imaging (MRI) of the thoracic spine before surgery. All patients were followed at our outpatient department for at least 3 months. In addition, all patients were interviewed in April 2009 and February 2011 to evaluate the final results. A seven-point Likert scale was applied and the Frankel score was determined preoperatively and postoperatively. Additionally, a postoperative MRI was obtained for all but two patients. RESULTS: The most frequently involved levels were T10-11 and T12-L1. Median operative time was 210 min (range 140-360). Three patients experienced reversible complications. No patient required spinal fixation. The median duration of hospitalisation was 6 days (range 4-20 days). With a median follow-up of 18 months, symptoms improved in 12 patients (92%), including the three patients with complications. One patient was unchanged (8%), while none of the patients experienced worsening of symptoms. CONCLUSIONS: The posterior transdural approach is well tolerated by the patient and has a relatively high success rate. It is a relatively simple and safe procedure, suitable for the operative treatment of almost all types of thoracic disc herniation, but especially the centrally located disc herniation

A National Collaboratory to Advance the Science of High Temperature Plasma Physics for Magnetic Fusion

This report summarizes the work of the National Fusion Collaboratory (NFC) Project to develop a persistent infrastructure to enable scientific collaboration for magnetic fusion research. The original objective of the NFC project was to develop and deploy a national FES Grid (FusionGrid) that would be a system for secure sharing of computation, visualization, and data resources over the Internet. The goal of FusionGrid was to allow scientists at remote sites to participate as fully in experiments and computational activities as if they were working on site thereby creating a unified virtual organization of the geographically dispersed U.S. fusion community. The vision for FusionGrid was that experimental and simulation data, computer codes, analysis routines, visualization tools, and remote collaboration tools are to be thought of as network services. In this model, an application service provider (ASP provides and maintains software resources as well as the necessary hardware resources. The project would create a robust, user-friendly collaborative software environment and make it available to the US FES community. This Grid's resources would be protected by a shared security infrastructure including strong authentication to identify users and authorization to allow stakeholders to control their own resources. In this environment, access to services is stressed rather than data or software portability