• Spine · Mar 2014

    Review

    Surgical treatment for thoracic disc herniation: an update.

    • Hiroyuki Yoshihara.
    • *Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, NY; and †Department of Orthopaedic Surgery, SUNY Downstate Medical Center, Brooklyn, NY.
    • Spine. 2014 Mar 15;39(6):E406-12.

    Study DesignRetrospective review of the literature.ObjectiveTo update recent trends in the surgical treatment for thoracic disc herniation (TDH).Summary Of Background DataTDH 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.MethodsReview of the literature.ResultsRecently, 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.ConclusionDefinition 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.

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