3 percent of individuals with progressive curvature may eventually experience severe problems that can include scoliosis and back pain, spinal problems, and nerve compression causing numbness, weakness, and leg pain.
The vertebrae and spinal column are protected and supported by the spinal discs. Injuries, disease, and degeneration can all cause disc damage, resulting in bulging or herniated discs. Spinal discs that are damaged may protrude into the spinal space, putting pressure on the spinal cord or spinal nerve roots. The cause of herniated or bulging discs can be attributed to age. The discs can wear and tear, causing the soft spongy tissue in the center to squeeze (herniate) from a tear on the side of the disc. Disc herniation can also occur as a result of an injury, such as a car accident or a fall, a sudden and forceful twist of the mid-back, or thoracic spine disease, such as Scheuermann’s disease.
The herniated disc protrudes into the spinal canal, a hollow tube in the spinal column, and directly pushes against the spinal cord as it passes through the spinal column. This can cause spinal cord damage. Herniated discs can also block blood flow from a blood vessel in the thoracic region of the spine. That blood vessel passes to the front of the spinal cord and if blocked will cause nerve tissues in the spinal cord to die.
When conservative treatments fail to relieve chronic pain or other symptoms caused by a herniated disc, doctors may recommend a discectomy. Surgeons perform a discectomy to repair herniated discs. To access the damaged disc, surgeons use open surgery or minimally invasive surgery. The protruding spinal disc material, as well as any pieces that may compress the nerves or spinal cord, gets removed. This procedure provides a very less invasive operation than when the surgeon removes the disc and fuses the vertebrae or uses an artificial disc replacement for damaged discs.
Symptoms and Treatment
Symptoms of thoracic disc herniation vary depending on the position and size of the disc herniation. Disc herniation will also cause nerve irritation or nerve injury and spinal cord damage. Additionally, mid-back pain, chest pain, groin pain, numbness, and weakness in the legs and arms all suggest possible symptoms. It may also impair bowel and bladder function.
Conservative treatment for thoracic disc herniation typically includes rest, a back brace, medication, and physical therapy. Doctors recommend surgery when conservative treatments fail to relieve pain, the condition gets worse, or it affects the spinal cord.
The human spine supports the body and allows it to stand upright, bend, and twist. The spine divides into three main sectors: cervical, thoracic, and lumbar. The rib cage protects the thoracic spine and is located in the mid-back region between the neck and lower back. A spinal column includes 24 spinal bones called vertebrae that stack on top of one another. An intervertebral disc contains a cartilaginous tissue that sits between two vertebrae. The intervertebral disc acts as a shock absorber and protects the spine during activities such as jumping, running, and lifting.
Who Needs Thoracic Discectomy?
Symptoms of thoracic disc herniation typically appear two years before the patient seeks treatment. These signs vary depending on the location, position, size of the degenerative disc, nerve irritation, or spinal cord injury.
- Radicular pain, mid-back pain
- Numbness and muscle weakness
- Bladder problems.
- Lower extremity ailment.
Thoracic Discectomy Procedure
Thoracic discectomy uses laser ablation and a percutaneous needle to open the disc. For example, it is specifically indicated when the disc herniation occurs within the nucleus pulpous and is contraindicated when free disc disintegration is visible. Doctors perform thoracic discectomy using either an anterior (front side) or a posterolateral approach (backside).
Doctors usually approach a herniated disc through the chest cavity, which involves a video assisted open thoracotomy. Doctors consider this as minimally invasive spine surgery. Furthermore, the surgeon uses a thoracoscope, which provides a video. Thoracoscopies get placed in the thorax through a small cut to display actual images of the surgical part or area on a screen. These images aid the surgeon in removing the herniated disc by inserting several instruments through small incisions. Moreover, this procedure constitutes the least invasive and results in the quickest recovery of any procedure.
The posterolateral strategy means removing the chest cavity through the thoracic spine’s backside. A small trocar (a drainage outlet) gets incised on the backside of the affected area for the transpedicular thoracic discectomy. The surgeon can see the protruded disc through the lens of a 70° endoscope. This minimally invasive method helps patients by avoiding the need for a complicated postoperative chest operation. For calcified or soft discs, the recovery time for a thoracic discectomy occurs quickly. According to research, while the posterolateral approach is appropriate for these types of discs, the anterior approach is appropriate for removing calcified discs in the inner core.
Finally, an expert surgeon must perform this sensitive surgery for a positive thoracic discectomy success rate. Find a board-certified neurological surgeon who specializes in the treatment of spinal conditions like herniated discs as well as degenerative disc disease and spinal tumors. Surgeons should have a background in neurosurgical operations as our surgeons at Medical City Children’s Orthopedics and Spine Surgeons do.
The Advantages of a Thoracic Discectomy
Benefits of these procedures include the patient’s pain relief without the recovery time and pain associated with open surgery. Doctors can usually access the disc in question using minimally invasive techniques without causing the disruption caused by traditional surgery. With the Thoracic Discectomy, a Thulium laser can disable the pain nerves in the disc. Then, the laser can char the annulus and seal the blood vessels, and therefore, the patient can often avoid the more involved surgical processes of eliminating a herniated disc and fusing the 2 vertebrae. For example, fusions can take up to a year to recover from.
Thoracic Discectomy Risks
Remember, these are minimally invasive pain relief methods. For instance, they do not require long incisions, the removal of the herniated disc, the removal of bone fragments (such as the lamina), or fusion. As a result, despite being spinal surgery, these are extremely low-risk treatments. Damage to the spinal discs beyond the pain receptors can occur but very rarely.
We’re here to help STOP THE PAIN
If you are an adult living with scoliosis or have a child with this condition and need a doctor who specializes in orthopedic surgery,
call the Southwest Scoliosis and Spine Institute at 214-556-0555 to make an appointment today.