Thoracic Disc Herniation
Thoracic disc herniation is a spinal condition in which the soft center of an intervertebral disc (the nucleus pulposus) pushes through a tear in the tough outer layer of the disc (the annulus fibrosus) and into the spinal canal. The protruding disc fragment can put pressure on the spinal cord, causing upper back and chest pain and spinal cord dysfunction.
Intervertebral discs act as shock absorbers for the spine and enable its movement. These discs can tear due to degeneration, injury, or a combination of both.
Herniated discs can occur in the lumbar spine (lower back), cervical spine (neck), or thoracic spine (mid-back).
How common is thoracic disc herniation?
Herniated discs are very common, but they usually occur in the lumbar spine. Herniated discs in the thoracic region account for less than 1 percent of all herniated discs. The thoracic region, which is the largest segment of the spinal column, is the least mobile region and therefore the least susceptible to disc herniation. Herniated discs in the thoracic region have a tendency to become calcified, also known as hard disc herniation.
Who gets thoracic disc herniation?
Because thoracic disc herniation can be caused by an injury, it can affect anyone. However, it is most common in men between the ages of 40 and 60. As people age, their intervertebral discs may lose their cushioning ability and become more vulnerable to rupture. Research has shown that herniated discs run in families, suggesting a genetic predisposition.
How is thoracic disc herniation diagnosed?
Your doctor may use the following to diagnose a thoracic disc herniation:
- Imaging tests, such as X-ray, myelography, magnetic resonance imaging (MRI), or computed tomography (CT)
- Medical history
- Physical examination
Symptoms of thoracic disc herniation may include:
- Bowel and bladder dysfunction
- Pain in the mid-back, which may wrap around the chest
- Progressive weakness and numbness in the lower extremities
- Difficulty walking
Symptoms vary depending on the quantity of disc material that has escaped and which structures the escaped material is putting pressure on. In some instances, thoracic disc herniation may not produce any symptoms.
The symptoms listed above could be caused by other medical conditions. Only a medical professional can confirm or rule out a diagnosis of herniated thoracic disc.
Most cases of thoracic disc herniation can be treated with a nonsurgical approach, which usually consists of rest, anti-inflammatory medication, and physical therapy. However, you may be a candidate for surgery if you have severe back pain and/or neurological symptoms that are not responding to conservative treatment.
Surgical treatments include:
Discectomy – In this procedure, the neurosurgeon removes the protruding fragment of the disc that is compressing the spinal cord or spinal nerves and causing symptoms. Traditionally, thoracic discectomy has been performed through an anterior (front) approach or a posterior (back) approach. Our spinal surgeons are leaders in minimally invasive techniques, including mini open lateral thoracic discectomy. The benefits of this approach, in which the spine surgeon accesses the spine through the side of the body using a less disruptive approach, include:
- A shorter hospital stay
- Less post-operative pain
- Less time in surgery
- Reduced blood loss
- Usually no need for chest tubes
Fusion – In some cases, a degenerated disc may need to be removed entirely and the adjacent vertebrae fused together to stabilize the spine. Spinal fusion can also be performed with emerging minimally invasive techniques.
Information & Resources About Thoracic Disc Herniation
- Date of last review: June 4, 2018
- Author: Juan Uribe, MD