Thoracic Spine Herniated disc
Thoracic Spine Herniated Disc
When a thoracic spine herniated disc occurs, it is extremely serious. The thoracic area is the middle back, and there is very little extra space around the spinal cord in this region.
What is a herniated disc?
The intervertebral discs are quarter-sized cushions that are filled with a soft, gel-like substance composed mostly of water. The inner portion is called the nucleus pulposus, and the tough, fibrous outer ring of layers compose the annulus. The annulus helps connect each vertebra to the one above and below it, and the watery nucleus serves as a shock absorber. When the inner soft material ruptures out through the annulus, it is considered “herniated.”
What causes a thoracic spine herniated disc?
Discs can rupture suddenly due to too much pressure all at one on the spine, such as with a fall from a ladder or landing in a sitting position. Discs rupture from bending over, lifting something too heavy, force on the disc, or from repeated injuries that weaken the annulus fibers over time. The material that ruptures into the spinal canal can pose pressure on the nerves in the canal. In addition, the chemical makeup of the nucleus is known to irritate the nerve roots. The pressure and irritation in combination can lead to pain, as well as weakness and numbness of an extremity.
What are the symptoms of a thoracic spine herniated disc?
Back pain is the main symptoms of a thoracic herniated disc. The symptoms of tingling, weakness, and numbness that affect an extremity occur from irritation and pressure on nerves. In addition, a thoracic herniated disc can lead to total paralysis of the legs due to spinal cord involvement. Other symptoms include muscle weakness in one or both legs, increased reflexes in one or both legs, spasticity of the legs, and pain that travels around the trunk of the body and into one or both legs.
How is a thoracic spine herniated disc diagnosed?
Making the diagnosis of a herniated disc begins with a thorough history of the problem as well as a comprehensive physical examination. The doctor will ask questions about bowel and bladder issues as well. X-rays will not show a herniated disc, but the doctor can see if the spine has much wear and tear. The test used to diagnose a herniated disc is a MRI scan, which shows 3-D images of the spinal components. Finally, nerve conduction studies are used to assess nerve involvement.
How is a thoracic spine herniated disc treated?
Not everyone who has a herniated disc undergoes surgery. However, surgery may be required. The orthopedic specialist may use a combination of treatment measures, including:
- Medications – The doctor will recommend non-narcotic pain medicines, such as ibuprofen, indomethacin, and acetaminophen. Narcotic analgesics are reserved for severe pain. For nerve-related pain, certain anticonvulsants and antidepressants help.
- Epidural steroid injection (ESI) – With this procedure, the doctor uses x-ray guidance to inject a steroidal agent into the space around the spinal cord (epidural space). While an anesthetic is often added, this measure relieves pain and swelling of the nerves.
- Laminotomy – With this surgery, the orthopedic specialist makes an opening in the lamina of the posterior vertebra to make more room in the spinal canal for nerves. A small amount of bone must be removed so there is an opening where the disc has ruptured.
- Microdiscectomy – With this procedure, the surgeon removes the ruptured disc material through a small incision in the back. Microscopic technology is used during the surgery.
How common is a thoracic herniated disc?
Herniations along the thoracic spine are not as common as those of the lumbar (lower) spine. According to statistics, thoracic disc herniation accounts for less than 1% of disc protrusions, with the majority of these occurring below the 8th thoracic vertebra.
Perez-Lara FJ, Berges AF, Quesada JQ, et al. (2012). Thoracic Disk Herniation, a not Infrequent Cause of Chronic Abdominal Pain. Int Surg, 97(1), 27-33.