An Operative Case of Soft Disc Protrusion in Upper Thoracic Level: A Case Report

A case of T3-4 disc herniation is reported as follows. A 23 year-old patient was presented with paraparesis and anterior chest pain. With the anterolateral approach(transthoracic transpleural approach), decompression and removal of a disc fragment was refered; which resulted is an almost complete recovery of the patient. MRI of the thoracic spine suggested a soft disc herniation. In addition, literatures were reviewed in conjunction with this case report.

Transthoracic Interbody Fusion with Carbon Cage for Thoracic Disc Herniation Which was Downward Migrated

The authors report a case of thoracic disc herniation at T11/12 level which was downward migrated, presenting with signs of progressive spinal cord compression. The lesion was diagnosed by MRI. The operation was done by transthoracic transpleural approach using surgical microscope and the rib was not resected due to floating ribs of T11, 12. A Carbon cage with cancellous bones were used for the graft at the partial corpectomy site. The result of operation was good.

Thoracic Disc Herniation Treated by Transthoracic Transpleural Approach

Thoracic disc herniation is uncommon disease and its diagnosis and treatment still remain difficult. We present a case of thoracic disc herniation at T7-8 vertebral level presenting with signs of spinal cord compression. The lesion was diagnosed by magnetic resonance image(MRI) and iopamidol-enhanced computed tomography(CT). The patient was operated by transthoracic transpleural approach using the surgical microscope. the operative result was excellent. A brief review of the literature is given.

Thoracic Disc Herniations

Thoracic disc herniation is so uncommon that only four cases have been literally reported to Korean Neurosurgical Journal Since 1972. Authors report here another 7 cases of thoracic disc herniation and analyse clinical findings and surgical outcome of 11 cases including 4 cases previously reported from other hospitals. Results are as follows: 1) Male dominancy in incidence was quite evident(10 : 1), and most patients were middle aged(30-50). 2) About a half of the patients had sudden onset of spinal cord compression symptoms, and the remaining half had insidious onset. 3) In 7 of 11 patients, diagnosis could be done by myelography alone, but in 4 of 11 cases, myelographic findings were equivocal and contrast CT scan were required for confirmation. 4) Thoracic disc herniations were more frequent in mid-thoracic discs(T5-T8 disc). 5) Considering the direction and location of disc herniations, 7 cases were paramedian, 2 cases central and 1 case was posterolateral. 6) Transthoracic transpleural approach were adequate for central or paramedian disc herniations, and posterolateral or transpedicular approach for lateral herniations.

A Case of Thoracic Disc Herniation Treated by Transthoracic Transpleural Approach

Thoracic disc herniation is uncommon and only represents 0.25% to 0.75% of all symptomatic disc lesions. The difficulty in diagnosis has been the one of the major problems in the treatment of thoracic disc herniation. But at now, the use of computed tomography with or without water soluble contrast media makes the diagnosis more acurate. Recently, we diagnosed a case of T4, T5 disc herniation by computed tomography with iopamidol. Operation by transthoracic, transpleural approach was done with microsurgical technique, and the result was good. The case is reviewed and other surgical techniques on the literature is discussed.

A Case of Typical Thoracic Disc Herniation Treated by Transthoracic Transpleural Approach

Herniated thoracic discs are a rare cause of spinal cord compression. The lesions occur predominantly the fourth decade and protrusions between T9 and T12 account for approximated two thirds of cases. The diagnosis is difficult to make clinically due to variable presented symptoms. The myelography and spine CT scan are the most useful diagnostic aids. The authors present a case of typical herniated thoracic disc at T11/T12 who was treated by transthoracic transpleural approach with anterior fusion. The operative result was excellent.