Surgical Treatment for Thoracic Disc Herniation

STUDY DESIGN: Retrospective review of the literature. OBJECTIVE: To update recent trends in the surgical treatment for thoracic disc herniation (TDH). SUMMARY OF BACKGROUND DATA: TDH is rare; however, it is usually accompanied by myelopathy and is indicated for surgical treatment. A variety of surgical approaches have been described to reach these anatomically challenging lesions. METHODS: Review of the literature. RESULTS: Recently, minimally invasive techniques for TDH have gained popularity. These include thoracoscopic and mini-open anterolateral retropleural approaches, as well as microscopic and endoscopic surgery. In addition, this article updates important aspects of surgical treatment for TDH such as definition of surgical level, treatment of calcified and/or giant disc, multilevel lesions, and fusion requirements. CONCLUSION: Definition of surgical level is imperative in the surgical treatment for TDH. Outcomes of minimum invasive surgery are satisfactory. Type of disc herniation and biomechanical stability are the important factors for surgical planning.