Thoracic spinal stenosis: diagnostic and treatment challenges

Area of Science:

• Neurosurgery
• Spinal Imaging
• Radiology

Background:

• Thoracic stenosis involves narrowing of the thoracic spinal canal (AP diameter < 10 mm).
• Primary thoracic stenosis is often found with lumbar stenosis.
• Secondary thoracic stenosis is associated with systemic diseases and can affect the entire spinal canal.

Observation:

• This review examined nine cases of primary thoracic stenosis and one case of secondary thoracic stenosis.
• Seven of nine patients with primary thoracic stenosis also had lumbar involvement.
• The patient with secondary stenosis (acromegaly) presented with cervical, thoracic, and lumbar stenosis.

Findings:

• Primary thoracic stenosis frequently coexists with lumbar spinal stenosis.
• Secondary thoracic stenosis, though less common, can present as a pan-spinal condition.
• Accurate diagnosis of thoracic stenosis extent is crucial for surgical planning.

Implications:

• Understanding the extent of thoracic stenosis, whether primary or secondary, is vital for effective surgical intervention.
• Associated conditions in adjacent spinal regions (cervical, lumbar) must be identified.
• This highlights the importance of comprehensive spinal imaging in diagnosing thoracic stenosis.