| Definitions: Thoracic Herniated Disc |
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Definition Herniated disc means displacement of the nucleus from its normal position within the boundaries of its outer fibrous ring (the annulus). The disc structure is composed of the soft centered nucleus and the outer fibrous ring (the annulus). The disc structure is positioned in between the vertebra. Herniations commonly occur posteriorly(towards the back of the body) due to a thinner boundary. The spinal nerves and dura (fluid filled sack containing spinal cord and thoracic spinal nerves at this level of the spine) are located behind the disc structure. Diagnosis The diagnosis is made from the history, physical exam performed by the doctor and diagnostic imaging studies (MRI, myelogram, CAT scan with contrast). If the herniation puts pressure on a thoracic spinal nerve, then the patient may complain of chest pain, abdominal pain or numbness of the chest wall or abdomen. If the herniation puts pressure on the spinal cord, then the patient may have difficulty walking, numbness in the legs, weakness in the legs or bowel and bladder symptoms or leg paralysis. Non-Surgery Treatment Most thoracic disc herniations put pressure on a single thoracic nerve and those patients can be treated with non-operative measures: restriction of activity, medications, physical therapy and injection therapy. A thoracic disc herniation that produces symptoms from the spinal cord is usually operated on. Surgical Treatment The surgical indications for thoracic disc herniation is indicated for nerve root symptoms that fail to improve or spinal cord symptoms. Prognosis Many patients with thoracic disc herniations effecting a thoracic spinal nerve improve without surgery. In those patients undergoing surgery for nerve decompression, the surgical results are generally good. Patient with a thoracic disc herniation producing pressure and symptoms from the spinal cord, the surgical results depend on many different factors. |