[Transthoracic approach to dorsal disc hernias]

Area of Science:

• Neurosurgery
• Spinal Surgery

Background:

• Thoracic disc protrusions are rare but can cause significant neurological deficits.
• Accurate diagnosis and surgical approach are crucial for optimal patient outcomes.

Observation:

• Three patients with thoracic disc protrusions underwent transthoracic surgery.
• Clinical presentation was similar to other intraspinal thoracic lesions.
• High-resolution computed axial tomography (CT) provided detailed diagnostic information.

Findings:

• The transthoracic approach provided excellent surgical access to median thoracic disc protrusions.
• A right lateral transthoracic approach was preferred due to aortic proximity on the left.
• Preoperative spinal angiography is recommended for left lateral approaches to identify the artery of Adamkiewicz.

Implications:

• Transthoracic surgery is a viable and effective treatment for thoracic disc protrusions.
• High-resolution CT may reduce the need for myelography in diagnosing thoracic spinal lesions.
• Surgical approach selection should consider anatomical variations for improved safety and efficacy.