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Calcified Thoracic Disc Herniation: Surgical Management, Surgical Approaches, and Decision-Making
Stylianos Kapetanakis1,2, Mikail Chatzivasiliadis1, Benjamin Cappin1
1Department of Spine and Deformities, Interbalkan Medical Center, Thessaloniki, Greece.
Orthopedic Reviews
|August 15, 2026
Summary
Surgical management of calcified thoracic disc herniation is complex due to rigid, adherent lesions. Optimal approach selection for spinal cord decompression is individualized based on lesion characteristics and surgeon expertise.
Area of Science:
- Neurosurgery
- Spinal Surgery
- Radiology
Background:
- Calcified thoracic disc herniation presents unique surgical challenges.
- These lesions are often rigid, centrally located, and adherent to the dura, complicating decompression.
- Existing surgical approaches lack universal consensus.
Purpose of the Study:
- To review current evidence on surgical management of calcified thoracic disc herniation.
- To emphasize preoperative evaluation and decision-making variables.
- To discuss indications, limitations, and outcomes of various surgical corridors.
Main Methods:
- Narrative review of existing literature.
- Analysis of surgical approaches including anterior, anterolateral, posterolateral, minimally invasive, and endoscopic techniques.
- Emphasis on factors influencing approach selection.
Main Results:
- No single surgical strategy is universally accepted for calcified thoracic disc herniation.
- Approach selection depends on lesion morphology, calcification, canal compromise, and patient factors.
- Anterior/anterolateral approaches suit central, giant lesions; posterolateral/minimally invasive/endoscopic for paracentral/lateral lesions.
Conclusions:
- Individualized surgical management is crucial for calcified thoracic disc herniation.
- Balancing neural decompression with approach-related morbidity is key.
- Experienced surgeons may utilize posterior and endoscopic techniques for complex cases.
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