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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thoracic disc herniation is uncommon. An incidence of 0.25 to 0.75 per cent of protruded disks are in the thoracic region. A peak incidence is noted in the fourth decade with 75 per cent of the protruded disks occurring below T8. Pain is the most common initial symptom, present in 57 per cent of the cases, followed by sensory disturbances and motor involvement. By the time of diagnosis, 90 per cent of the patients have signs of spinal-cord compression. Although myelography has been considered the test of choice, 8 per cent false negative results and a correct preoperative diagnosis of 56 per cent has been reported. Now, with CT scanning with and without metrizamide, more accurate diagnoses can be achieved, even with cases in which myelography is negative. There has been a considerable improvement in the surgical treatment of herniated thoracic disks with over an 80 per cent rate of success for surgical approaches other than the posterior approach (decompressive laminectomy). An early and accurate diagnosis, coupled with improvement in the surgical approach, offers a much better prognosis for patients with thoracic disk herniation.
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PMID:Herniated thoracic disks. 389 22

Thoracic disc herniation is a rare and slowly progressing disease, commonest at the lower thoracic spine. We performed transthoracic discectomy and interbody fusion in 12 patients with an average age of 46 years suffering from symptomatic herniated thoracic disc. Pain and neurologic impairment were the commonest symptoms at admission. The outcome at a mean follow-up of 4 (2-8) years concerning pain were excellent or good in 10 patients, fair in 1 and unchanged in 1 patient. There were no approach-related complications. All 7 patients with incomplete neurologic impairment preoperatively improved postoperatively at least 1 Frankel grade. Posterior complementary fusion at the thoracolumbar junction was necessary in 2 patients because of increasing symptomatic local kyphosis. Although the number of patients is small, due to the rarity of the disease, it seems that the transthoracic approach for anterior discectomy and fusion is an appropriate treatment for symptomatic thoracic disc herniation. Proper patient selection, preoperative planning and surgical technique resulted in good pain relief, neurologic recovery in cases associated with incomplete neurologic impairment and restoration of the sagittal profile of the thoracolumbar spine.
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PMID:Transthoracic disc excision with interbody fusion. 12 patients with symptomatic disc herniation followed for 2-8 years. 938 57

We report a case of thoracic disc herniation in a 53-year-old woman who presented to the Emergency Department (ED) with a 2-week history of acute lower back numbness and intermittent fecal incontinence. On examination, she had lower extremity hyperreflexia, an abnormal gait, and lower lumbar pain but lacked any radicular findings. A magnetic resonance imaging scan revealed a large focal paracentral herniated disc at the T2-3 level. The patient underwent successful T2-3 anterior discectomy with T2-3 rib autograft fusion. Nine months after surgery her weakness and gait had improved, but she continued to have recurrent intermittent fecal incontinence. Thoracic disc herniation is an uncommon, but treatable cause of spinal cord compression. Prompt recognition and early treatment are the keys to preventing permanent neurologic sequelae.
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PMID:T2-3 Thoracic disc herniation with myelopathy. 1797 78