Thoracic Discectomy

  • Jason E. McGowan
  • Islam Fayed
  • Marcelle Altschuler
  • Faheem A. Sandhu


Disc herniation is a fairly common condition with a frequency of 40 to 50 per 100,000 people. Conversely, symptomatic thoracic disc herniation (TDH) is significantly less common. It is most commonly seen in mid-to-late adult life, with the peak of 80% occurring between 40 and 50 years of age. There is no significant difference in gender. Surgical procedures for symptomatic TDH represent only 0.15% to 4% of all surgeries for intervertebral disc herniation.


Thoracic disc herniation Centrolateral Transpedicular Costotransversectomy Lateral extracavitary Lateral retropleural Transthoracic 


  1. 1.
    Court C, Mansour E, Bouthors C. Thoracic disc herniation: surgical treatment. Orthop Traumatol Surg Res. 2018 Feb;104(1S):S31–40.CrossRefGoogle Scholar
  2. 2.
    Simpson JM, Silveri CP, Simeone FA, Balderston RA, An HS. Thoracic disc herniation. Spine (Phila Pa 1976). 1993;18(13):1872–7.CrossRefGoogle Scholar
  3. 3.
    El-Kalliny M, Tew JM, van Loveren H, Dunsker S. Surgical approaches to thoracic disk herniations. Acta Neurochir. 1991;111:22–32.CrossRefGoogle Scholar
  4. 4.
    Yoshihara H. Surgical treatment for thoracic disc herniation: an update. Spine (Phila Pa 1976). 2014;39(6):E406–12.CrossRefGoogle Scholar
  5. 5.
    Uribe JS, Smith WD, Pimenta L, Härtl R, Dakwar E, Modhia UM, Pollock GA, Nagineni V, Smith R, Christian G, Oliveira L, Marchi L, Deviren V. Minimally invasive lateral approach for symptomatic thoracic disc herniation: initial multicentral clinical experience. J Neurosurg Spine. 2012;16:264–79.CrossRefGoogle Scholar
  6. 6.
    Yoshihara H, Yoneoka D. Comparison of in-hospital morbidity and mortality rates between anterior and nonanterior approach procedures for thoracic disc herniation. Spine (Phila Pa 1976). 2014;39(12):E728–33.CrossRefGoogle Scholar
  7. 7.
    Stillerman CB, Chen TC, Couldwell WT, Zhang W, Weiss MH. Experience in the surgical management of 82 symptomatic herniated thoracic discs and review of the literature. J Neurosurg. 1998;88:623–33.CrossRefGoogle Scholar
  8. 8.
    Quint U, Bordon G, Preissl I, Sanner C, Rosenthal D. Thoracoscopic treatment for single level symptomatic thoracic disc herniation: a prospective followed cohort study in a group of 167 consecutive cases. Eur Spine J. 2012 Apr;21(4):637–45.CrossRefGoogle Scholar
  9. 9.
    Shirzadi A, Drazin D, Jeswani S, Lovely L, Liu J. Atypical presentation of thoracic disc herniation: case series and review of the literature. Case Rep Orthop. 2013;2013:621476.PubMedPubMedCentralGoogle Scholar
  10. 10.
    Arce CA, Dohrmann GJ. Herniated thoracic disks. Neurol Clin. 1985;3(2):383–92.CrossRefGoogle Scholar
  11. 11.
    Elhadi AM, Zehri AH, Zaidi HA, Almefty KK, Preul MC, Theodore N, Dickman C. Surgical efficacy of minimally invasive thoracic discectomy. J Clin Neurosci. 2015;22:1708–13.CrossRefGoogle Scholar
  12. 12.
    Jain A, Menga EN, Hassanzadeh H, Jain P, Lemma MA, Mesfin A. Thoracic disc disorders with myelopathy: treatment trends, patient characteristics, and complications. Spine (Phila Pa 1976). 2014;39(20):E1233–8.CrossRefGoogle Scholar
  13. 13.
    McCormick WE, Will SF, Benzel EC. Surgery for thoracic disc disease. Complication avoidance: overview and management. Neurosurg Focus. 2000;9(4):e13.CrossRefGoogle Scholar
  14. 14.
    Dietze DD Jr, Fessler RG. Thoracic disc herniations. Neurosurg Clin North Am. 1993;4:75–90.CrossRefGoogle Scholar
  15. 15.
    Stillerman CB, Chen TC, Couldwell WT, et al. Experience in the surgical management of 82 symptomatic herniated thoracic discs and review of the literature. J Neurosurg. 1998;88:623–33.CrossRefGoogle Scholar
  16. 16.
    Maiman DJ, Larson SJ, Luck E, et al. Lateral extracavitary approach to the spine for thoracic disc herniation: report of 23 cases. Neurosurgery. 1984;14:178–82.CrossRefGoogle Scholar
  17. 17.
    Willson MC, Ross JS. Postoperative spine complications. Neuroimaging Clin N Am. 2014;24(2):305–26.CrossRefGoogle Scholar
  18. 18.
    Mody MG, Nourbakhsh A, Stahl DL, et al. The prevalence of wrong level surgery among spine surgeons. Spine. 2008;33:194–8.CrossRefGoogle Scholar
  19. 19.
    Upadhyaya CD, Wu JC, Chin CT, et al. Avoidance of wrong-level thoracic spine surgery: intraoperative localization with preoperative percutaneous fiducial screw placement. J Neurosurg Spine. 2012;16:280–4.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Jason E. McGowan
    • 1
  • Islam Fayed
    • 1
  • Marcelle Altschuler
    • 2
  • Faheem A. Sandhu
    • 1
  1. 1.Department of NeurosurgeryMedStar Georgetown University HospitalWashington, DCUSA
  2. 2.Georgetown University School of MedicineWashington, DCUSA

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