Diagnosis and treatment of thoracic intervertebral disc protrusions

A series of 14 patients with a protruded thoracic intervertebral disc is reported. We believe that the true incidence may be as high as one patient per million population per annum. Trauma, sometimes mild, seems to have played a significant role in this series. This fact coupled with pronounced numbness and disagreeable paraesthesiae should suggest the diagnosis with thoracic spinal lesions. Armed with clinical suspicion, radiological verification of the lesion can be expected using a thorough myelographic technique supported if necessary by tomography. A posterolateral approach which combines laminectomy, complete excision of the ligamentum flavum, and the extradural removal of protruded disc is described. The technique is safe and effective.