Thoracic disc herniations: diagnosis, surgical techniques, and complication insights

Thoracic disc herniations (TDHs) are rare conditions, comprising 0.1% to 5% of all reported herniation cases, and affecting up to 1 in 1,000,000 individuals. The mid to lower thoracic spine, particularly between the T11 and T12 vertebrae, is most frequently affected and often associated with trauma. Conditions like Scheuermann's disease can predispose patients to TDHs. This study explores the clinical manifestations, diagnostic methods, surgical techniques, and complications associated with TDHs. Diagnosis relies on magnetic resonance imaging and computed tomography myelography to identify the level and nature of the herniation. Various surgical approaches, including posterolateral, lateral, and anterior, have been implemented, each with specific indications, advantages, and pitfalls. Complications range from lung-associated to neurological deterioration to dural breaches. Clinical presentation primarily includes thoracic back pain. Patients can present with significant neurological deficits depending on the herniation's characteristics, namely giant centrally located. Surgical intervention is indicated in cases of failed conservative treatment or acute trauma with significant cord compression. This review aimed to delve into the literature to provide insights into the clinical manifestations of TDHs, diagnosis, surgical techniques, and associated complications.