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Surgical management of thoracic disc herniation
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In this film we demonstrate how to perform a thoracic partial vertebrectomy and interbody instrumented fusion to preserve segmental thoracic stability and spinal canal clearance. History of thoracic disc herniation is similar to cervical and lumbar disc herniation, as only a low percentage of patients develop symptomatic spinal cord compression.
The patient is a 54-year-old woman with progressive middle thoracic back pain and bilateral lower limb paraesthesia and stiffness. Her medical history includes C5/C6 anterior cervical discectomy and fusion (ACDF) following a traffic accident. She had C4/C5 ACDF in 2013 due to symptomatic adjacent segment disc degeneration. MRIs of the whole spine show a left-sided disc herniation, with compression on the spinal cord at T7/T8 and small disc bulges at adjacent levels. A CT scan of the thoracic spine confirms the non-calcific nature of the disc herniation at T7/T8 level.