Thoracic disks are usually very stable, which means herniations in this area are very rare. Herniation of the uppermost thoracic disks can mimic cervical disk herniations, while herniation of the other disks can mimic lumbar herniations.
There are three types of thoracic herniations that may occur:
A central disc protrusion may cause upper back pain as there is limited room around the spinal cord. A herniated disk in the thoracic spine may affect nerve functioning and can even lead to paralysis.
A lateral disc herniation occurs when the disk herniates laterally, impinging on the root of the nerve. This may cause chest or abdominal pain.
A centro-lateral disc herniation on the other hand may cause a combination of upper back and radiating pain.
Symptoms of a herniation of thoracic disk may include:
- Chest or back pain
- Pain that is worsened by coughing or sneezing
- Arm pain
- Numbness or sensation changes
- Bowel and bladder changes
- Sexual dysfunction
Dr Lamprecht will conduct an MRI to get a better view of the spine and the disks that may be herniated.
The treatment depends on the amount of pressure on the cord or nerves. If there is cord compression surgery is indicated since this can cause paralysis. If there is only nerve pressure then pain medication and physiotherapy may be used to treat the symptoms during the waiting period. The waiting period is used to see if this will resolve with conservative treatment. Manipulation of the spine is not recommended since this can cause permanent damage to the nerve.
Thoracic disc herniation treatment depends on the seriousness of the herniation. Usually, thoracic disk herniation is treated with thoracic spine surgery to treat a herniation that will not repair itself and is causing painful symptoms and dysfunction.
- Discectomy: A discectomy is surgery done to remove a herniated disk from the spinal canal. When a disk herniation occurs, a fragment of the normal spinal disk is dislodged. This fragment may press against the spinal cord or the nerves that surround the spinal cord.
- Laminectomy: A surgical procedure in which the posterior arch of a vertebra is removed. Laminectomy is done to relieve pressure on the spinal cord or on the nerve roots that emerge from the spinal canal. The procedure may be used to treat a slipped or herniated disk or to treat spinal stenosis.
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