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Surgical Treatment for Thoracic Disc Herniation: An Update

Yoshihara, Hiroyuki MD, PhD*,†

Spine:
doi: 10.1097/BRS.0000000000000171
Literature Review
Abstract

Study Design. Retrospective review of the literature.

Objective. To update recent trends in the surgical treatment for thoracic disc herniation (TDH).

Summary of Background Data. TDH is rare; however, it is usually accompanied by myelopathy and is indicated for surgical treatment. A variety of surgical approaches have been described to reach these anatomically challenging lesions.

Methods. Review of the literature.

Results. Recently, minimally invasive techniques for TDH have gained popularity. These include thoracoscopic and mini-open anterolateral retropleural approaches, as well as microscopic and endoscopic surgery. In addition, this article updates important aspects of surgical treatment for TDH such as definition of surgical level, treatment of calcified and/or giant disc, multilevel lesions, and fusion requirements.

Conclusion. Definition of surgical level is imperative in the surgical treatment for TDH. Outcomes of minimum invasive surgery are satisfactory. Type of disc herniation and biomechanical stability are the important factors for surgical planning.

Level of Evidence: N/A

In Brief

The recent trends in the surgical treatment for thoracic disc herniation (TDH) are updated. Definition of surgical level is imperative in the surgical treatment for TDH. Outcomes of minimum invasive surgery are satisfactory. Type of disc herniation and biomechanical stability are the important factors for surgical planning.

Author Information

*Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, NY; and

Department of Orthopaedic Surgery, SUNY Downstate Medical Center, Brooklyn, NY.

Address correspondence and reprint requests to Hiroyuki Yoshihara, MD, PhD, 301 East 17th St., New York, NY 10003; E-mail: hiroyoshihara55@yahoo.co.jp

Acknowledgment date: November 25, 2013. Acceptance date: December 8, 2013.

The manuscript submitted does not contain information about medical device(s)/drug(s).

No funds were received in support of this work.

No relevant financial activities outside the submitted work.

© 2014 by Lippincott Williams & Wilkins