THORACIC DISC HERNIATION - REEVALUATION OF THE POSTERIOR APPROACH USING A MODIFIED COSTOTRANSVERSECTOMY

A consecutive series of 23 thoracic disc herniations in 21 patients tr eated between 1980 and 1988 were reviewed. All patients were decompres sed through a posterolateral approach (costotransversectomy or transpe dicular). Pain and weakness were the most common presenting symptoms. Twenty-one thoracic disc herniations in 19 patients were available for long-term follow-up, averaging 58.1 months. Sixteen patients had an e xcellent or good result. Three patients had a fair result. There were no poor results. All six patients with significant preoperative lower extremity weakness improved. Pain was relieved in 16 patients and redu ced in three. There were no significant neurologic complications assoc iated with the procedure. Posterolateral decompression for thoracic di sc herniation remains a viable alternative without the inherent risk a nd morbidity of the transthoracic approach.