Spine Education

Thoracic Disc Herniation

Disc herniation disc is a condition in which the outer fibers (annulus) of the intervertebral disc are damaged causing the soft inner material of the nucleus pulposus to rupture out of its space. This condition can be extremely serious if it occurs in the thoracic spine. Thoracic disc herniation is a relatively uncommon condition.

Thoracic disc herniation may be result from following conditions:

• Degenerative disc disease: Most commonly, thoracic herniated discs occur due to gradual wear and tear of the disc.
• Trauma to the upper back: A traumatic event such as a fall from a height can also cause herniated disc.

The symptoms of a disc herniation in the thoracic spine include:

• Pain in one or both legs
• Numbness or tingling sensation in one or both legs
• Weakness in certain muscles of one or both legs
• Spasticity in the legs because of increased reflexes

Proper diagnosis of the condition requires a complete medical history and a careful physical examination by your physician. Some of the additional diagnostic tests your physician may suggest include:

• X-ray of the middle-back: X-rays help to detect the amount of wear and tear present and to rule out other conditions.
• CT and MRI scan: These tests are done to confirm the diagnosis of herniated disc.

Treatment for disc herniation depends on the severity of symptoms and includes conservative approaches and surgical procedures.

Conservative treatment

Conservative treatment includes pain medications such as ibuprofen, Tylenol and avoiding strenuous activity if the pain is severe.

Epidural steroid injection

Epidural steroid injection can be considered if the pain is intolerable even with medications and rest.

Surgical Treatment

• Laminotomy and Discectomy: Laminotomy is a procedure in which a small opening is made between the two vertebrae where there is a disc rupture. This helps the surgeon to see into the spinal canal and makes room to work.

  Then the surgeon moves the nerve roots away and locates the disc material that has ruptured into the spinal canal and removes it. This is done to relieve any pressure and irritation on the nerves of the spine. This procedure is known as discectomy.

• Microdiscectomy

  This procedure is same as the traditional laminotomy and discectomy, but a smaller incision is sufficient. There is less damage to the spine during the operation and faster recovery.

  The surgeon uses an operating microscope for visibility through smaller incision (two inches).