Rahimizadeh A, Saghri M. Spontaneous resolution of sequestrated lumbar disc herniation:A prospective cohort study. Both of these signs were absent in our patients. Magnetic resonance imaging revealed a left-sided T1-T2 herniated disc compressing the T1 nerve root. 88: 148-50, 22. Reflex examination was 2/4 in C 6, 7, and 8 roots. 6: 1-10, 2. Neurology. The 12 thoracic vertebrae (T1 just below the neck down to T12 just above the lumbar spine) make up the largest and least flexible area of the spine. Asian Spine J 2012;6:199-202. Eur Spine J. Also, patients commonly feel a band of pain that goes around the front of the chest. 11. 11: 499-501, 17. Doctors order these vertebrae from C1 to C7, starting at the base of the skull and extending downward. (c) T2-weighted sagittal image shows complete resolution of the disc at 5-month follow-up. Bransford R, Zhang F, Bellabarba C, Konodi M, Chapman JR. J Neurosurg Spine. This is the reason in few reports it is mentioned as D1-D2 region also. In one case, a central disc fragment extended through the dura. None of the following authors or any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Possley, Dr. Luczak, Dr. Angus, and Dr. Montgomery. Extruded upper thoracic disc causing horner's syndrome:Report of a case. T1T2 myelopathy and/or radiculopathy, magnetic resonance (MR) localization (anterior/anterolateral/lateral posterior), and optimal surgical management. Sharan AD, Przybylski GJ, Tartaglino L. Approaching the upper thoracic vertebrae without sternotomy or thoracotomy:A radiographic analysis with clinical application. 1952. Under his, Cost effective alternative for spinal surgery. Following adjustment for the localisation, shots were taken with the patient positioned supine, with a routine protocol for the lumbar spine with the measurement level between L3-S1 at the center of the disc (Fig. The rib cage adds extra protection, support, and stabilization to the spine, making it less susceptible to damage in general and disc trouble in particular. Surgery should occur only when objective findings of structural defects are correlated with the patients symptoms and signs. -. A pinched nerve may cause pain in the back or chest at the first rib, or pain in the ring and/or pinky fingers. To report a rare thoracic intervertebral disc herniation followed by acutely progressing paraplegia. This is disc herniation. T1-2 disk herniation diagnosis is often delayed because of its prevalence and misdiagnosis. Protrusions of thoracic intervertebral disks. Successful Smith-Robinson approaches to T1-T2 have been achieved, whereas partial sternotomy has been used in others.9,14 Thoracic disk herniations can be approached posteriorly when little to no retraction of the spinal cord is necessary for disk access. Surgical approaches to thoracic disk herniations correlate with patient anatomy, location of nerve root compression, and surgeon familiarity. Differentiating motor function from the C8-T1 nerve roots and ulnar nerve pathology can be assessed with motor testing. Cervical radiculopathy is a disease process marked by nerve compression from herniated disk material or arthritic bone spurs. Cervical radiographs are not usually clinically useful because of the difficulty in visualizing through the shoulders. The preganglionic fibers then exit the spinal cord and enter the cervical sympathetic chain. Negoveti L, Cerina V, Sajko T, Glavi Z. Intradural disc herniation at the T1-T2 level. Symptoms such as these are primarily determined by the location of the cervical herniated disc. Signs and Symptoms of a T1-T2 Herniated Nucleus Pulposis in the Literature (n = 21). Tokuhashi Y, Matsuzaki H, Uematsu Y, Oda H. Spine (Phila Pa 1976). He is an M.D. Disclaimer. The site is secure. Shortly after the postganglionic fibers leave the superior cervical ganglion, vasomotor and sudomotor fibers branch off to travel along external carotid artery to innervate the blood vessels and sweat glands of the face. Postoperative MR imaging (MRI) studies in the first two patients showed adequate cord decompression following placement of T1T2 anterior interbody cages [Figures 1 and 2 ]. Surgical options will vary based on the size, type, and location of the injury, but the most common are. -, Alberico AM, Sahni KS, Hall JA, Jr, Young HF. (d) Three-dimensional cervical computed tomography (CT) scan shows T1T2 and T3 screw rod fixation on the left side. The discussion about a disc herniation is much more comprehensive and complicated since there are so many ways and places that a disc can herniate. With cervical disc herniations, the nerve affected by the condition is the one that exits at that specific level of the spine. Weakness. i have a t1-2 herniated disc pinching a nerve, possible thoracic outlet. The further down the spine the injury occurs, the greater chance for at least partial recovery. Most studies report improvement in pain and neurologic dysfunction, but Horner syndrome can be refractory to surgical decompression.12,18 Similarly, our patient at 6 weeks postoperative had resolution of his pain, motor, and sensory deficits but persistent Horner syndrome at nine months postoperatively. Numbness or tingling. Thoracic Herniated Disc Symptoms. (b) Axial view showing the central location of the disc. The levels affected are often T11 and T12, with 75% occurring below T8comparatively closer to the more flexible lumbar spine. (c) Reconstructed sagittal computed tomography (CT) scan of the CT region showing T1T2 hard disc, indicating that the compression, also note that CT angle is 10. Unable to load your collection due to an error, Unable to load your delegates due to an error. This pain is typically felt toward the back or side of the neck. Careful radiographic analysis is needed preoperatively to identify the upper limit of the sternum. (g) Plain CT radiograph showing that the cage is located at bicalvicular line. 34: 68-77, 7. Background:Symptomatic T1T2 disc herniations are rare and, in most cases, are located posterolaterally. A comparative cohort of mini-transthoracic versus transpedicular discectomies. There might be some other reasons like- some addiction or something like this, that causes the desiccation of the T1-T2 disc. Herniated discs in the thoracic region account for less than 1 percent of all herniated discs. MRI provides the diagnosis. 6 Approximately more than 70 . 15. Objectives: To evaluate the clinical features of thoracolumbar junction disc herniation and to prepare a chart for the level diagnosis in the neurologic findings and symptoms. An MRI showing a herniated thoracic disc compressing the spinal cord.An MRI from the same patient shown above after minimally invasive lateral thoracic discectomy and fusion. Surgical repair carries a risk of complications, including worsening neurological outcomes due to the close proximity to the spinal cord. (e) Showing removal of the sequestrated disc fragment. So the treatment is dependent on the following parameters-. Anterior approach to the cervicothoracic junction by unilateral or bilateral manubriotomy. Get new journal Tables of Contents sent right to your email inbox, Creative Commons Attribution License 4.0 (CCBY), T1-T2 Disk Herniation Presenting With Horner Syndrome: A Case Report With Literary Review, Articles in Google Scholar by Daniel Possley, DO, Other articles in this journal by Daniel Possley, DO, Privacy Policy (Updated December 15, 2022). Results: The patient's symptoms resolved completely. Postfixed brachial plexus radiculopathy due to thoracic disc herniation in a collegiate wrestler: a case report. Caner H, Kilinoglu BF, Benli S, Altinrs N, Bavbek M. Magnetic resonance image findings and surgical considerations in T1-2 disc herniation. Croat Med J. For example, you may feel pain in your neck, arms, hands, fingers, or parts of the shoulder. (d) Chest X-ray shows that T1T2 disc is a few mm above the manubrium. Copyright Surgical Neurology International. Int J Spine Surg. Pain can radiate in the upper 2nd and 3rd ribs , just below the shoulder joint. A standard posterior approach with laminoforaminotomy and diskectomy was done. These symptoms typically follow a pattern as noted above, based on the affected nerve roots location and functions. High thoracic disc herniation. Therefore, once muscles and ligaments are relaxed around the T1-T2, we start working on the kyphotic curve of the spine. Thoracic back pain may be exacerbated when coughing or sneezing. 10. Biousse V, Touboul PJ, D'Anglejan-Chatillon J, Levy C, Schaison M, Bousser MG: Ophthalmologic manifestations of internal carotid artery dissection. Kanno H, Aizawa T, Tanaka Y, Hoshikawa T, Ozawa H, Itoi E. T1 radiculopathy caused by intervertebral disc herniation:Symptomatic and neurological features. In a systematic review and meta-analysis by Brooks et al, disk height index, Modic changes, and sagittal range of motion were found to be significantly correlated with an increased rate of recurrent lumbar disk herniation. The patient understand that her name and initial will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Pain just below the spine of the scapula. Would you like email updates of new search results? Sitting in chairs with a firm back to support the spine will help alleviate back pain. Court, C., E. Mansour, and C. Bouthors. -, Arseni C, Nash F. Thoracic intervertebral disc protrusion:A clinical study. Your email address will not be published. J Glob Spine J. 9. MR studies documented a soft central disc in one patient, and a calcified central disc in the second [Figures 1 and 2 ]. Approximately 75% of all thoracic disc herniations are seen below T8. Spacey K, Zaidan A, Khazim R, Dannawi Z. Horner's syndrome secondary to intervertebral disc herniation at the level of T1-2. Follow-up magnetic resonance studies documented full resolution for the patient with . Svien HJ, Karavitis AL. The spurs may cause narrowing of the spinal canal and impinge on the spinal cord. 15: 227-41, 20. Oral steroids can also decrease inflammation, which will help alleviate pain. Hoffman's sign was negative. This clinical condition can commonly be a consequence of cervical sympathetic chain injury, which runs along the lateral aspect of the vertebral body. Medications, traction, dry needling, and epidural spinal injections can be used with physical therapy to help manage pain and allow the body to heal on its own, says Dr. Good. Herniated Disc Symptoms in the Lumbar Spine The most common symptom associated with a herniated disc in the lumbar spine is leg pain (also known as sciatica). The number one prevention is not smoking. This pain might shoot into your arm or leg when you cough, sneeze or move into certain positions. If you are experiencing pain or others symptoms of a herniated thoracic disc, you should make an appointment to see your primary care doctor. From the Department of Orthopaedic Spine Surgery (Dr. Possley), Department of Orthopaedic Surgery (Dr. Luczak), Department of General Surgery (Dr. Angus), and Department of Orthopaedic Spine Surgery (Dr. Montgomery), Beaumont Health, Royal Oak, MI. The pain may be centered over the injured disc but may spread to one or both sides of the mid-back. You May Like: Parvo Symptoms In Older Dogs. 1960;17:41830. Turbo spin-echo T1 and T2-weighted sagittal and turbo spin-echo T2 axial 4 mm sections parallel to the disc spaces were taken. Osteoarthritis appeared to be the predominant cause of the disc herniation in both patients. Posterior approaches may utilize transfacet pedicle-sparing techniques, while the less frequent central/anterolateral discs may warrant anterior surgery. Spine (Phila Pa 1976) 1991;16(10 suppl):S542-S547. 4 ' 5 The first T1-2 disc herniation case was reported in 1954 by Sivien and Karavitis. The goal of surgery is to remove all or part of the herniated disc that is compressing a nerve root. The .gov means its official. Bulge is a term for an image and can be a normal variant . 28: 322-30, 14. However, it is most common in men between the ages of 40 and 60. Most people dont need surgery for a thoracic herniated disc. If you have a thoracic herniated disc, you may feel these symptoms circumferentially around your rib cage or upper abdominal area. But they can happen. If there is some deformity behind T1-T2 slip disc than we aim to restore the kyphotic changes. This site needs JavaScript to work properly. The symptoms began as dull back pain, which the patient initially attributed to a muscle strain, but progressively worsened throughout a 24-hour period. Report of four cases and literature review. Learn more by subscribing now. (h) Postoperative T2-weighted MRI: showing appropriate decompression of the spinal cord at T1T2 level. J Neurosurg. 1995. We present a rare case of a patient with T1-T2 intervertebral disk herniation and Horner syndrome who was treated surgically. Thoracic disc herniations are rare conditions compared with other disc herniations seen at cervical and lumbar spine levels. This may be evident by sensory disturbances below the level of compression, difficulty with balance and walking, lower extremity weakness, or bowel or bladder dysfunction. Eur Spine J. Herniated Discs: When Is Surgery Necessary?. Winter RB, Siebert R. Herniated thoracic disc at T1-T2 with paraparesis. Nakahara S, Sato T. First thoracic disc herniation with myelopathy. Contained Discs: The disc has not broken through the outer wall of the intervertebral disc, which means the inner gel-like material remains contained. Background: Symptomatic T1-T2 disc herniations are rare and, in most cases, are located posterolaterally. We added our cases (four cases) of T1T2 disc herniations to those 32 cases found in the literature. Keywords: Disc herniation, spontaneous resolution, sternal splitting approach, T1T2 disc space, thoracic disc, upper thoracic disc herniation. The physician explained that you have a Bulging Disc, but you may still have questions that have been unanswered. 24-Apr-2019;10:56, How to cite this URL: Abolfazl Rahimizadeh, Amir Hossein Zohrevand, Nima Mohseni Kabir, Naser Asgari. The first reported case was in 1945; since then, only 31 additional cases have been published. The authors certify that they have obtained all appropriate patient consent forms. (d) Chest X-ray showing that T1T2 disc space is far enough above biclavicular line. Wolters Kluwer Health
Arts MP, Bartels RH: Anterior or posterior approach of thoracic disc herniation? Unlike the usual calcification in the medioposterior position for middle or lower thoracic spine herniations, a soft posterolateral herniation was observed here. 49: 599-606, 23. Myelopathy is rare. Ayurvedic treatment of T1-T2 slip disc problem due to process of ageing is all about slowing down the process of ageing and in deletion of the marks of age. Symptomatic disc herniation in the upper thoracic spine from T1 to T4 is rare, with most occurring at T1T2 levels[ 3 , 6 , 19 , 28 , 30 , 34 ] [ Table 1 ]. While the diagnosed problems at the C7-T1 level are less common,2 research suggests that CTJ injuries may be missed during due to difficulties in visualizing this region on plain X-Ray films.3 A few conditions that may affect the CTJ are: In severe cases, CTJ injuries may affect the spinal cord or the C8 nerve roots. Horner's syndrome secondary to T1-T2 intervertebral disc prolapse. Some error has occurred while processing your request. Thoracic disc herniations make up 0.25%0.75% of all disc ruptures. A magnetic resonance imaging scan revealed a large focal paracentral herniated disc at the T2-3 level. 2013 Sep-Oct;48(5):710-5. doi: 10.4085/1062-6050-48.5.03. (a) T2-weighted sagittal image demonstrating, (a) T2-weighted sagittal image demonstrating a disc herniation at T1T2 level with considerable, (a) T2-weighted sagittal magnetic resonance, (a) T2-weighted sagittal magnetic resonance imaging (MRI) of the second case showing a, (a) T2-weighted sagittal magnetic resonance imaging (MRI) shows T1T2 disc herniation. Weakness with finger abduction results from C8 radiculopathy and/or peripheral ulnar nerve entrapment. 1978. Some common signs and symptoms of a cervical herniated disc include: Neck pain. Two females aged 67 and 48 years presented with acute cord infarction and paraparesis, respectively; the modified Japanese Orthopaedic Association (JOA) score for thoracic myelopathy (maximum 11) was 6 and the second patient was 7 [ Table 1 ]. Back, Lower Limb, and Upper Limb Pain among U.S. This is a rarest condition in case of all thoracic discs, but can appear in this reason due to trauma. Bethesda, MD 20894, Web Policies a = artery, n = nerve. Surgical Treatment of T1-2 Disc Herniation with T1 Radiculopathy: A Case Report with Review . 7: 189-92, 30. Because in this case, a patient might get back all those symptoms of T1-T2 slip disc come back again. PMC Symptomatic thoracic disc herniation is uncommon and has been estimated to less than 0.75% of all symptomatic spinal disc herniations. A very subtle ptosis and miosis remained. 2010. Herniated thoracic disc at T1-2 level associated with horner's syndrome. (a) T2-weighted sagittal magnetic resonance imaging (MRI) of the second case showing a hard disc at T1T2 level. Background: While the anterior approach tends to be a more familiar approach to most spine surgeons, certain anatomic restrictions may limit its use for T1-T2. The presence of an accurate and reproducible radiologic description is essential for the success of any interventional therapy, in addition to disc removal. 2014: 34. The clinical signs and symptoms of T-1 radiculopathy are similar to those of C-8 radiculopathy; however, distinguishing features can frequently be found on neurological examination. Therefore an MRI scan is important to find our the proper cause behind the problem. Acute traumatic sequestrated thoracic disc herniation: A case report and review. J Bone Joint Surg Am 1983;65:992-997. Although posterior approach surgery is most commonly used for laminectomy and/or foraminotomy, successful anterior approaches to upper thoracic lesions are valid as well. Good office ergonomics, such as a supportive chair, can reduce the risk of thoracic herniated discs, which are already rare. 2013. The exception to this is for a giant herniated thoracic disc, which almost always requires surgery. Bransford RJ, Zhang F, Bellabarba C, Lee MJ. These all symptoms always confuse before the proper diagnosis of slip disc in D1-D2. There was a decreased sensation noted along the left medial forearm and hypothenar region. 84-A: 1013-7, 21. 1993. Please try after some time. Its not easy figuring out how to sleep with a herniated disc. Conclusion: Adjacent-segment degeneration after cervical spine fusion may rarely occur even at T1-T2, and the unusual symptoms of a T1 . MRI best documents soft T1T2 thoracic discs, while computed tomography is typically optimal for calcified herniations. Stillerman CB, Chen TC, Couldwell WT, Zhang W, Weiss MH: Experience in the surgical management of 82 symptomatic herniated thoracic discs and review of the literature. Transthoracic excision and fusion, case report with 4-year follow-up. This is the T1 nerve root which originates from the T1-T2 region. doi: 10.1136/bcr-2014-204820. Anterior surgery can be achieved without sternotomy. 2000. Evid Based Spine Care J 2010;1:21-28. Clipboard, Search History, and several other advanced features are temporarily unavailable. Remember, the cervical spine is composed of 7 bones stacked one on top of each other. There is no charge to read or download any SNI content, but registering for a free membership will provide you with additional special features. 1956;6:110. Herniated thoracic discs can cause paralysis. 1954. Although . Careful radiographic analysis is needed preoperatively to identify the upper limit of the sternum. Avoid lifting, twisting, or straining the back. 24/36 patients). sharing sensitive information, make sure youre on a federal We focused on the clinical presentation, e.g. Symptomatic Lumbar Disc Herniation MadanMohanSahoo,MSOrth1,SudhirKumarMahapatra,DNBOrth1, Sheetal Kaur, MD1, Jitendra Sarangi, . It can also occur with ligamentous laxity in response to loading. CT can be used to complement MRI in cases of thoracic disk herniations. If the herniation compresses a thoracic spinal nerve, it can cause radiculopathypain that radiates down the nerve and away from the spinewith pain, numbness, and tingling. The symptoms are limited, as observed in both patients, to a T1 radiculopathy, to be distinguished from C8 radicopathy. J Neurosurg 1950;7:62-69. Radiation of pain in the upper arm on the front side. Patients with cervical radiculopathy symptoms and physical examination findings consistent with Horner syndrome should be evaluated with a MRI that includes the upper thoracic spine. The one interesting aspect about a bulge is that it is an MRI finding that can correlate with an annular tear that causes deep midline low back pain. Herniated discs affect 5 to 20 per 1000 adults annually. Given the neurologic findings on examination, a cervical and thoracic MRI was obtained which revealed T1-T2 left paracentral disk extrusion with mild superior migration and left intraforaminal extension causing moderate left lateral recess stenosis and abutment of the left T1 nerve root (Figure 2). This is the least common location for radiculopathy. The incidence of a herniated disc may disrupt activities of daily living and sleep. Non-surgical treatment options for symptoms of a thoracic herniated disc will typically include one or a combination of the following: A short period of rest (e.g. Background: T1-T2 intervertebral disc prolapse (IVDP) is a rare clinical condition.Horner's syndrome is an extremely rare clinical finding in these patients. 2003. See All About Neck Pain Radicular pain. 1955. 12: 303-5, 31. Six weeks after surgery, the patient had complete resolution of his left-hand weakness and paresthesias, zero back pain, and some significant improvement in the ptosis and miosis (Figure 1, B). For the fourth patient, the sequestrated disc disappeared 5 months later [Figures 4c and d ]. (a) T2-weighted sagittal magnetic resonance imaging shows a T1T2 extruded disc migrated up. Am J Ophthalmol 1980;90:394-402. Radiation of pain in the upper arm on the front side. 1971. Thoracic region is the first segment of the thoracic or dorsal spine. This process of desiccation starts due to the pressure on the spinal arteries. 2019 Apr 24;10:56. doi: 10.25259/SNI-34-2019. Nowadays, endoscopic techniques have become increasingly popular and full-endoscopic surgery can be performed in the thoracic spine . 1991. Proc Staff Meet Mayo Clin 1954;29:375-378. Signs and Symptoms of a T1-T2 Herniated Nucleus Pulposis in the Literature (n = 21) Case A 29-year-old surgical resident presented to the emergency department complaining of acute onset left periscapular back pain, along with progressive left medial forearm and fourth and fifth digit numbness with grip weakness of the left hand. If any of the thoracic nerves become inflamed, such as from a thoracic herniated disc or a narrowing of the foramen, thoracic radiculopathy can develop with symptoms of pain, tingling, numbness, and/or weakness radiating along the nerve root. Historically, symptomatic thoracic disk herniation occurred with a frequency of 2 to 3/1,000 cases of disk herniation.2 This is likely even less frequent with the advent of MRI use in diagnosis. J Neurosurg. Trauma, such as a motor vehicle crash or fall can also cause a thoracic herniated disc. Within the spine itself there are also many other disorders that can have similar presenting symptoms of upper back pain and/or radiating pain, such as a spine fracture , infection, tumor, and certain metabolic disorders. FOIA 17: 418-30, 4. 1983. [ 15 ] Patients with thoracic discs typically present with neck pain (i.e. J Orthop Sci. National Library of Medicine The C8 nerve root innervates the extensor indicus and abductor pollicis brevis from the radial and median nerves, respectively, in addition to finger flexion (ulnar nerve). The tough outer layer (annulus fibrosus) loses elasticity with age, increasing the risk of tears that can result in herniation. [ 1 , 2 , 4 , 5 , 7 , 8 , 11 - 15 , 17 , 18 , 25 , 26 , 29 , 32 , 33 , 35 - 37 ] T1T2 disc herniation can present with either radiculopathy or myelopathy. (b) The disc space is a little bit above the manubrium line and cervicothoracic (CT) angle is 27. Vaidya Dr. Pardeep Sharma is Chief Ayurvedic Physician at Sukhayu Ayurved Jaipur. Symptoms can also include numbness, tingling, or muscle weakness in one or both lower extremities. Herniated discs happen when the soft, jellylike inner layer of a shock-absorbing intervertebral disc bulges into or breaks through the discs tough outer layer. 2010;12:22131. AJR Am J Roentgenol. T1 and T2 - These lead into nerves that go into the top of your chest and into the arms and hands. For example, you may feel pain in your neck, arms, hands, fingers, or parts of the shoulder. This the next process of degenerative disc disease is- disc bulge. J Neurosurg Spine. The oculosympathetic pathway then joins the ophthalmic division of the fifth cranial nerve (V1) and travels into the orbit through the superior orbital fissure to provide innervation to the iris dilator muscle and Mueller's muscle; a small smooth muscle in the eyelid responsible for a minor portion of upper lid elevation and lower lid retraction. 2017. A large herniated disc can compress the spinal cord within the spinal canala condition called myelopathyresulting in numbness, tingling, and or weakness in one or both lower extremities, and sometimes bowel and bladder dysfunction, and in extreme cases, paralysis. 4. They can help rule out other conditions and give you a referral to a specialist. Experience in the surgical management of 82 symptomatic herniated thoracic discs and review of the literature. Clin Neurol Neurosurg. 1998 Jan;88(1):148-50. doi: 10.3171/jns.1998.88.1.0148. (h) Postoperative T2-weighted MRI: showing appropriate decompression of the spinal cord at T1T2 level. According to Dr. Good, here are some healthy habits you can build that will help keep your discs healthy. A, Right parasagittal T1-, T2-, and STIR-weighted images that demonstrate a discrete fracture line through the pedicles of L4 bilaterally without pedicle marrow signal intensity changes (long arrow) and a less obvious fracture line on T1 images through the L5 pedicle with concomitant type 1 pedicle marrow changes (short arrows). (i) Postoperative T2-weighted MRI demonstrates the cage in T1T2 interspace. In cases where instability of the CTJ occurs or when nonsurgical treatments do not provide relief, surgery may be considered. This impingement typically produces neck and radiating arm pain or. She underwent T1-T2 anterior discectomy and fusion. They occur when a vertebra in your spine collapses, which can lead to severe pain, deformity and loss of height. Careers. You may have pain in your lower back, numbness or pain in your leg, or loss of bladder control. J Neurosurg 1978;48:128-130. Bethesda, MD 20894, Web Policies A spine surgeon or spinal neurosurgeon can assess your herniated thoracic disc and help you decide if it would be best to have surgery or to try conservative treatment. 1998. 14: 103-6, 15. Posterior approach surgery has most commonly been used for laminectomy and/or foraminotomy.1,5,11-13 Adequate disk access of more central disk herniations may not be accomplished without excessive facet resection leading to hypermobility. Correspondence Address:Naser AsgariPars Advanced and Minimally Invasive Medical Manners Research Center, Iran University of Medical Sciences, Tehran, Iran, How to cite this article: Abolfazl Rahimizadeh, Amir Hossein Zohrevand, Nima Mohseni Kabir, Naser Asgari. Conclusions: We reviewed 4 cervical T1-T2 disc herniations; two central/anterolateral lesions warranting anterior surgical approaches/cages, and 2 lateral discs treated with a posterolateral transfacet, pedicle-sparing procedure and no surgery respectively. (e) Axial CT scan shows a pedicle screw in an upper thoracic vertebra. Because this nerve root is the part of the brachial plexus. 16. Degenerative disease and trauma are the most common causes of herniated discs in the thoracic spine. Conclusions: Furthermore, more than 75% of thoracic protrusions are located below T8, and only approximately 3% occur at the T1-T2 level, as in our patient. Report of four cases and literature review. MRI diagnosis is C7/T1 and C6-C7 severe foraminal narrowing and stenosis. She also works as an Adult and Pediatric Sexual Assault Nurse Examiner. (f) Postoperative T1-weighted MRI, at 3-year follow-up, note clearance of the cord. Two of the most common causes of thoracic radiculopathy are from compression caused by a herniated disc or from a narrowing of the spinal foramen, an opening through which these nerves pass. J Neurosurg. Introduction Surgical intervention is the treatment of choice in patients with thoracic disc herniation with refractory symptoms and progressive myelopathy.
Hudson's Happy Hour Menu Hilton Head,
Articles T