Thoracic disc prolapse / Thoracic disc herniation is rare when compared with the lumbar and cervical discs; this is due to the anatomic structure of the thoracic spine being less mobile and protected from excessive stresses by the ribs cage as a unit.
However, the thoracic disc prolapse carries particular risk of spinal cord compression and require particular surgical technique when surgery is indicated.
Conservative Management of Thoracic Disc prolapse:
The conservative management is the main stay of treatment in cases of radicular pain, which is pain across the pathway of thoracic nerves, which travel around the chest wall. Of course symptoms and signs of thoracic spinal cord compression should be excluded, as this can be a relative or absolute indication of surgical treatment. The conservative management is effective in most cases of radiculopathy and we seldom operate on thoracic disc prolapses. Thanks again for the god gift of autoimmune absorption mechanism.
Symptoms and Signs of thoracic spinal cord compression:
There are many symptoms and signs, which can vary according to the degree of spinal cord compression. The expert doctors would be able to determine the degree of compression and the urgency of the case by testing the sensation and motor power levels in the trunk and lower extremities in addition to reflexes testing. What is important to realize for every patient is the early sign of compression, which is imbalance feeling when walking. We advise immediate visit to an orthopedic spinal surgeon at the earliest before it is too late.
Surgical Treatment of Thoracic Disc prolapse:
This surgery is particular as the disc is anterior to the spinal cords which is very sensitive tissue to even touch, therefore the access to the disc is either anterior through the chest with the help of endoscopic surgery or via costo-transvers lateral approach. The risk of serious complication in this surgery is 2-3% and neuro-monitoring during surgery is clearly an advantage to minimize the risk of complication.
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