Transthoracic Discectomy for Symptomatic Thoracic Disc Herniation: 2-Dimensional Operative Video

Thoracic disc herniations are an infrequent occurrence, but can be a cause of significant myelopathy. Diagnosis typically requires a high clinical suspicion that is confirmed with appropriate imaging. Classically, the transthoracic approach for discectomy is the treatment of choice for symptomatic cases. This video concerns a 48-yr-old woman who presented with worsening mid-back pain and progressive gait difficulty. Her examination was significant for proximal lower extremity muscle weakness, difficulty with tandem gait, and urinary incontinence. Imaging demonstrated a large T7-8 disc herniation causing severe spinal cord compression. The patient underwent T7-8 transthoracic discectomy and interbody fusion. She tolerated the procedure well without complication, and postoperative imaging demonstrated decompression of her spinal cord. On follow-up, she had improved mid-back pain, strength, and ambulatory function. The patient consented to the recording of this surgical video for potential publication.