Surgical treatment of the symptomatic herniated thoracic disk

Symptomatic herniated thoracic disks are rare, for their incidence is calculated at about one in 1,000,000 persons per year. Although these are usually associated with degenerative disease, there are a number of other conditions in which thoracic disk herniation is now recognized as being an uncommon but important feature. Increased use of noninvasive scanning techniques, together with greater clinical awareness, is likely to disclose more cases of herniated disks. Surgical treatment of these herniated disks has undergone extensive modification during the past 50 years. Microsurgical approaches applied to the spine are major contributors to reduced neurologic morbidity. The authors prefer to use the transthoracic approach for surgery. High, low, and far lateral approaches are also discussed, however, as are other surgical approaches used in the mid to low region. Treatment of this difficult diagnostic and management problem is ideally managed by a team of medical professionals which includes highly specialized surgeons.