Thoracic spine and thoraco-lumbar junction

Thoracic disc herniation

What is it ?

As in the case of cervical or lumbar herniations, thoracic disc herniation is due to natural aging of the spine. Many studies on mono-zygotic (real) twins have shown that disc degeneration is mostly genetically programmed. Statistically, the thoracic disc herniation is less frequent than the lumbar or cervical hernia. And as in these two anatomical regions, many radiologically visible herniated discs are asymptomatic.

Clinical presentation

A herniated thoracic disc produce radicular pain, as in the case of the C7-Th1 disc for example, which can cause pain in the axilla. Or it may be intercostal pain resistant to drug treatment. Rarely, there may be a myelopathy thoracic spinal cord: gait disturbances in particular, or other neurological symptoms.

When to consult a specialist?

Thoracic disc herniations are rare and when diagnosed as symptomatic, patients are usually referred to a specialized spine surgeon for treatment if the pain is disabling.

Non surgical treatment

It includes classic painkillers and physiotherapy or other methods (osteopathy etc.)

Surgical treatment

Surgery will be necessary in case of myelopathy (irritation of the spinal cord) or persistent disabling pain (> 2 months). This type of hernia requires a small thoracotomy (minimally invasive surgery) on the same side as the hernia. The classic posterior approach used for lumbar disc herniations being impossible, due to the presence of the thoracic spinal cord.

Postoperative follow-up

Patients resume walking very soon after the surgery and can go back home after a few days.

Risks and complications

The complication rate is low and mainly related to the surgical approach (mini-thoracotomy), but serious neurological complications are very low (close to 0%).