TRANSTHORACIC DISC EXCISION WITH INTERBODY FUSION - 12 PATIENTS WITH SYMPTOMATIC DISC HERNIATION FOLLOWED FOR 2-8 YEARS

Thoracic disc herniation is a rare and slowly progressing disease, com monest at the lower thoracic spine. We performed transthoracic discect omy and interbody fusion in 12 patients with an average age of 46 year s suffering from symptomatic herniated thoracic disc. Pain and neurolo gic impairment were the commonest symptoms at admission. The outcome a t a mean follow-up of 4 (2-8) years concerning pain were excellent or good in 10 patients, fair in 1 and unchanged in 1 patient. There were no approach-related complications. All 7 patients with incomplete neur ologic impairment preoperatively improved postoperatively at least 1 F rankel grade. Posterior complementary fusion at the thoracolumbar junc tion was necessary in 2 patients because of increasing symptomatic loc al kyphosis. Although the number of patients is small, due to the rari ty of the disease, it seems that the transthoracic approach for anteri or discectomy and fusion is an appropriate treatment for symptomatic t horacic disc herniation. Proper patient selection, preoperative planni ng and surgical technique resulted in good pain relief, neurologic rec overy in cases associated with incomplete neurologic impairment and re storation of the sagittal profile of the thoracolumbar spine.