High Thoracic Disc Herniation

Abstract A case of T-1, T-2 disc herniation is reported. The patient presented with diminished hand strength, medial arm and shoulder pain, and medial arm, forearm, and hand paresthesias. After surgical decompression and removal of a disc fragment, the patient made a complete recovery. Routine cervical myelography was considered inadequate in view of this patient's symptoms. High thoracic myelography followed by computed tomographic scanning should be considered for patients with this presentation. Improved diagnosis with myelography and computed tomography is discussed.

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THORACIC DISC HERNIATION: SURGICAL DECOMPRESSION BY POSTERIOR APPROACH A LA CARTE

Coluna/Columna ◽

10.1590/s1808-185120161503157849 ◽

2016 ◽

Vol 15 (3) ◽

pp. 213-218 ◽

Cited By ~ 1

Author(s):

MURILO TAVARES DAHER ◽

PEDRO FELISBINO JUNIOR ◽

ADRIANO PASSÁGLIA ESPERIDIÃO ◽

BRENDA CRISTINA RIBEIRO ARAÚJO ◽

ANDRÉ LUIZ PASSOS CARDOSO ◽

...

Keyword(s):

Disc Herniation ◽

Posterior Approach ◽

Surgical Decompression ◽

Thoracic Disc Herniation ◽

Transpedicular Approach ◽

Partial Body ◽

The Mean ◽

Thoracic Disc ◽

A La Carte

ABSTRACT Objectives: To present the clinical and radiographic results of patients with thoracic disc herniation treated by the posterior approach, according to location and type of hernia (à la carte). Methods: We evaluated thirteen patients (14 hernias) treated by the posterior approach. Eight (61.5%) patients were male and the mean age was 53 years (34-81). Clinical evaluation was performed by the Frankel and JOA modified scales. All the patients underwent the posterior approach, which was performed by facetectomy, transpedicular approach, transpedicular + partial body resection, costotransversectomy or costotransversectomy + reconstruction with CAGE. Results: The mean follow-up was 2 years and 6 months (11-77 months). Of the 14 operated hernias, six (43%) were lateral, 2 (14%) paramedian, and 6 (43%) central. Seven were soft (50%) and seven were calcified. The transfacet approach was carried out in 5 cases (36%), transpedicular in 1 case (7%), transpedicular + partial body resection in 4 (29%), costotransversectomy in 3 (21%), and costotransversectomy + CAGE in one case (7%). The majority of patients with lateral hernia (5/6) were subjected to transfacet decompression and in cases of central and paramedian hernias, all patients underwent decompression, which is more extensive. Conclusions: The posterior approach is safe and effective, and the best approach must be chosen based on location and type of the herniation and the surgeon's experience.

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Lateral Extracavitary Approach to the Spine for Thoracic Disc Herniation: Report of 23 Cases

Neurosurgery ◽

10.1227/00006123-198402000-00010 ◽

1984 ◽

Vol 14 (2) ◽

pp. 178-182 ◽

Cited By ~ 144

Author(s):

Dennis J. Maiman ◽

Sanford J. Larson ◽

Elizabeth Luck ◽

A. El-Ghatit

Keyword(s):

Computed Tomography ◽

Disc Herniation ◽

Vertebral Column ◽

Lateral Approach ◽

Thoracic Disc Herniation ◽

Local Pain ◽

Motor Paralysis ◽

Thoracic Disc

Abstract Twenty-three patients were operated upon for thoracic disc herniation between 1973 and 1982. The lateral approach to the vertebral column was used in each. Most patients had severe local pain; 13 had severe myelopathy or complete motor paralysis, including 4 who had become paraplegic after laminectomy. Eleven patients had calcified discs or osteophytic ridges. Air myelography and computed tomography were diagnostic in all cases. Postoperatively, 17 patients achieved significant relief of pain, 20 improved neurologically, and none became worse. Complications of the operation were minimal. The lateral extracavitary approach to the spine is a valuable technique for the management of thoracic disc herniation.

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Transforaminal Endoscopic Foraminoplasty and Discectomy for the Treatment of a Thoracic Disc Herniation

World Neurosurgery ◽

10.1016/j.wneu.2016.02.086 ◽

2016 ◽

Vol 90 ◽

pp. 194-198 ◽

Cited By ~ 25

Author(s):

Ralf Wagner ◽

Albert E. Telfeian ◽

Menno Iprenburg ◽

Guntram Krzok ◽

Ziya Gokaslan ◽

...

Keyword(s):

Disc Herniation ◽

Thoracic Disc Herniation ◽

Thoracic Disc

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Surgical treatment of thoracic disc herniation using the anterior approach

Journal of Bone and Joint Surgery - British Volume ◽

10.1302/0301-620x.64b3.7096401 ◽

1982 ◽

Vol 64-B (3) ◽

pp. 340-343 ◽

Cited By ~ 31

Author(s):

K Otani ◽

S Nakai ◽

Y Fujimura ◽

S Manzoku ◽

K Shibasaki

Keyword(s):

Surgical Treatment ◽

Disc Herniation ◽

Anterior Approach ◽

Thoracic Disc Herniation ◽

Thoracic Disc

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A Case of Thoracic Arachnoid Cyst with Thoracic Disc Herniation Presenting as Angina-like Pain

Spinal Surgery ◽

10.2531/spinalsurg.35.212 ◽

2021 ◽

Vol 35 (2) ◽

pp. 212-214

Author(s):

Nobuhiro Sasaki ◽

Atsuhiko Toyoshima ◽

Kiminori Sakurai ◽

Ryota Motoie ◽

Ryo Akiyama ◽

...

Keyword(s):

Arachnoid Cyst ◽

Disc Herniation ◽

Thoracic Disc Herniation ◽

Thoracic Disc

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Sleep Apnea and Unilateral Upper and Lower Extremity Allodynia as a Result of a Large Thoracic Disc Herniation: A Case Report

10.21203/rs.3.rs-233683/v1 ◽

2021 ◽

Author(s):

Tyler D. Alexander ◽

Anthony Stefanelli ◽

Sara Thalheimer ◽

Joshua E. Heller

Keyword(s):

Spinal Cord ◽

Sleep Apnea ◽

Sexual Dysfunction ◽

Lower Extremity ◽

Disc Herniation ◽

Cord Compression ◽

Thoracic Disc Herniation ◽

Lower Extremity Weakness ◽

Disc Herniations ◽

Thoracic Disc

Abstract BackgroundClinically significant disc herniations in the thoracic spine are rare accounting for approximately 1% of all disc herniations. In patients with significant spinal cord compression, presenting symptoms typically include ambulatory dysfunction, lower extremity weakness, lower extremity sensory changes, as well as bowl, bladder, or sexual dysfunction. Thoracic disc herniations can also present with thoracic radiculopathy including midback pain and radiating pain wrapping around the chest or abdomen. The association between thoracic disc herniation with cord compression and sleep apnea is not well described.Case PresentationThe following is a case of a young male patient with high grade spinal cord compression at T7-8, as a result of a large thoracic disc herniation. The patient presented with complaints of upper and lower extremity unilateral allodynia and sleep apnea. Diagnosis was only made once the patient manifested more common symptoms of thoracic stenosis including left lower extremity weakness and sexual dysfunction. Following decompression and fusion the patient’s allodynia and sleep apnea quickly resolved.ConclusionsThoracic disc herniations can present atypically with sleep apnea – a symptom which may resolve with surgical treatment.

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Management of single-level thoracic disc herniation through a modified transfacet approach: A review of 86 patients

Surgical Neurology International ◽

10.25259/sni_94_2021 ◽

2021 ◽

Vol 12 ◽

pp. 338

Author(s):

Samir Kashyap ◽

Andrew G. Webb ◽

Elizabeth A. Friis ◽

Paul M. Arnold

Keyword(s):

Disc Herniation ◽

Significant Risk ◽

Length Of Hospital Stay ◽

Thoracic Disc Herniation ◽

Estimated Blood Loss ◽

Surgeon Experience ◽

Thoracic Disc ◽

Stay Hospital ◽

Pain Improvement ◽

Selection Of

Background: Symptomatic thoracic disc herniation (TDH) is rare and does not typically resolve with conservative management. Traditional surgical management is the transthoracic approach; however, this approach can carry significant risk. Posterolateral approaches are less invasive, but no single approach has proven to be more effective than the other results are often dependent on surgeon experience with a particular approach, as well as the location and characteristics of the disc herniation. Methods: This was retrospective review of a prospectively collected database. Eighty-six patients with TDH treated surgically through the modified transfacet approach were reviewed and evaluated for pain improvement, Nurick grade, and neurological symptoms. Patients were followed for 12 months postoperatively; estimated blood loss, length of hospital stay, hospital course, and postoperative complications were also assessed. Results: All attempts at disc resection were successful. Most patients reported improvement in pain, sensory involvement, and strength. Seventy-nine patients had complete resolution of their symptoms while four patients had unchanged symptoms. Three patients experienced mild neurologic worsening postoperatively, but this resolved back to baseline. One patient experienced myelopathy during the postoperative period that resolved with steroid administration. The procedure was well tolerated with minimal complications. Conclusion: TDH can be managed surgically through a variety of approaches. The selection of approach is dependent on surgeon experience with an approach, the patient’s health, and the location and type of disc. The transfacet approach is safe and efficacious.

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