• Kareem Khalifeh, Burak Ozgur, and Adam Kanter.
• Department of Neurosurgery, University of California San Diego School of Medicine, La Jolla, California, USA.
• Neurosurgery. 2025 Mar 1; 96 (3S): S69S74S69-S74.

AbstractSymptomatic thoracic disc herniation (TDH) is relatively uncommon, and surgical management poses significant challenges owing to restricted anatomic corridors, limited space within the spinal canal, tenuous blood supply, and proximity to vital organs and vasculature. Calcified TDH adds further complexity, necessitating meticulous preoperative planning to determine the safest and most effective approach. Although various techniques have been described for managing TDH, many are associated with high complication rates, increased blood loss, and extended hospitalizations. Recent studies suggest that the minimally invasive lateral retropleural approach for calcified TDH offers notable advantages, improving clinical and operative outcomes. However, research specifically focusing on the efficacy of this technique remains limited. This narrative review examines the existing literature on the lateral retropleural approach, discussing reported outcomes, technical considerations, and potential challenges.Copyright © Congress of Neurological Surgeons 2025. All rights reserved.

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