Benchmarking surgical approaches to thoracic disc herniation: A retrospective database study

Area of Science:

• Neurosurgery
• Spinal Surgery
• Degenerative Spine Disease

Background:

• Thoracic disc herniations are rare, accounting for 0.1-3% of all spinal disc herniations.
• Surgical approaches include anterior, lateral, and posterior/posterolateral, with selection based on various factors.

Purpose of the Study:

• To investigate national trends in surgical approach utilization for thoracic disc herniations.
• To identify patient characteristics predicting the use of specific surgical approaches.

Main Methods:

• Retrospective study utilizing the TriNetX national database.
• Patient identification via ICD-9 codes for degenerative thoracic disc herniation and CPT codes for thoracic spinal procedures.

Main Results:

• Posterior/posterolateral approaches were used in 89.8% of 3009 patients.
• Anterior approaches were used in 7.4%, and lateral extracavitary in 2.8%.
• Posterior/posterolateral surgeries increased significantly from 2010 to 2022-2024, while anterior approaches declined after 2017.

Conclusions:

• The posterior or posterolateral approach is the predominant method for surgical decompression in thoracic disc herniation.
• Despite an overall increase in surgeries, anterior approach utilization has decreased.
• Posterolateral-based approaches are widely adopted for managing thoracic disc herniations.