San Francisco Spine Surgeons

Herniated Disc Treatment


Herniated Disc Treatment in San Francisco

Even though the herniated disc is a common pathology we see in the cervical and lumbar spine, thoracic disc herniation is quite infrequent, at least in part due to the fact that the thoracic spine does not move much due to the rigidity offered by the ribcage.

Having said that, we occasionally need to operate on symptomatic thoracic disc herniations. Because of the presence of the spinal cord in the thoracic spine, approach to the thoracic disc herniations usually is dictated by the location of the herniation.

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Thoracic OPLL causing severe spinal cord compression

Occasionally it is necessary to operate from the front, meaning going through the chest, to access safely the disc herniation. The main reason for that is that the spinal cord cannot be manipulated; therefore, if the thoracic disc herniation is not accessible from the back (posterior approach), either lateral or anterior approach is necessary to ensure neurological safety.

Sometimes removing thoracic disc herniations necessitates concomitant fusion with placement of instrumentation and/or a cage. Occasionally, to safely access the disc herniation from the back, it is necessary to resect a section of the patient’s rib, usually on the side of the herniation. The rib that is harvested during the approach sometimes can be used for bone grafting to join two vertebrae together in the place where the disc herniated.

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to find out which surgical options for thoracic disc herniation might be helpful.

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