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Hirotaka Haro, Toru Domoto, Shingo Maekawa, Tadahiro Horiuchi, Hiromichi Komori, and Yoshiki Hamada

activation of VEGF and MMP cascades might result. The present report demonstrates that even thoracic herniated discs are capable of undergoing herniated disc resorption. Thus, deferring surgery and starting with conservative treatment should be considered in patients with moderate thoracic myelopathy without progressive motor paralysis or bladder dysfunction because thoracic herniated discs might spontaneously gradually decrease in size while symptoms improve. However, cases of thoracic disc herniation

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Roque Carlos Fernández, Miguel Mesa, Daniel Rosenthal, and Victor Rodrigo Paradells

Transcript This is a video to present an anterolateral transthoracic endoscopic approach for a calcified thoracic disc herniation (TDH). 0:29 Case Description. This is a 65-year-old woman with a past medical history of asthma, right nephrectomy, and pulmonary embolism (PE). She was diagnosed of a large, calcified T5–6 TDH, after a chest CT done as a follow-up for her pulmonary embolism. The neurological examination was within normal limits, without motor or sensitive

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Angelo Rusconi, Paolo Roccucci, Stefano Peron, and Roberto Stefini

The surgical treatment of thoracic disc herniation (TDH) represents a challenge for the spinal surgeon. This is mainly due to the rarity of the condition, the vulnerability of the thoracic spinal cord, and the consequent high risk of neurological deterioration. 1–5 Several surgical approaches have been developed, in order to achieve proper TDH exposure and cord decompression, increase the safety of the procedure, and ameliorate postoperative outcomes. 6–9 In addition, intraoperative

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Richard Bransford, Fangyi Zhang, Carlo Bellabarba, Mark Konodi, and Jens R. Chapman

T horacic disc herniations are rare in comparison with their cervical or lumbar counterparts and are thought to constitute 0.1–4% of all disc herniations. 1 , 25 The annual incidence of TDH has been estimated at approximately 1 patient per million population. 5 Thoracic disc herniations affect men more frequently than women, with a peak age of 40–50 years. 1 , 22 Most (75%) symptomatic TDHs involve the lower levels (T8–9 to T11–12) with the highest propensity at T11–12. 1 These lesions

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Erwin M. J. Cornips, Marcus L. F. Janssen, and Emile A. M. Beuls

surgical treatment are only a fraction of those actually having a thoracic disc herniation. 26 , 27 On the other hand, there is little doubt that such patients are at risk, and therefore they should at least be carefully counseled. We suggest balancing factors such as age, comorbidity, and occupation with the perceived risks of surgery on an individual basis. Conclusions Approximately 4% of TDHs present with an acute myelopathy. They are often situated between T9–10 and T11–12, are large or

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Juan S. Uribe, William D. Smith, Luiz Pimenta, Roger Härtl, Elias Dakwar, Urvij M. Modhia, Glen A. Pollock, Vamsi Nagineni, Ryan Smith, Ginger Christian, Leonardo Oliveira, Luis Marchi, and Vedat Deviren

S ymptomatic thoracic disc herniation is a disease of middle to late adult life that affects men and women in approximately equal distribution and is not the result of a precipitating or traumatic event in a majority of cases. 19 , 31 , 40 , 49 Despite over 100 years of study and treatment, 41 the symptom complex and pathophysiology of TDH remain unclear. Estimates of the incidence of symptomatic TDH range from 2 to 44 per 1000 2 , 4 , 49 of all herniated discs (including cervical and

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Stuart C. A. Winter, Nicholas F. Maartens, Philip Anslow, and Peter J. Teddy

infusions or an epidural blood patch can be effective at stopping the leak, 1, 6, 16 even if the source of the CSF fistula has not been demonstrated. Occasionally, open surgical procedures are required. 10, 11 In our case definitive surgery was not undertaken because the thoracic disc herniation was otherwise asymptomatic, and formal dural repair involved major surgery with unacceptable risk. In summary, transdural thoracic disc herniation can be a cause of CSF fistula and spontaneous intracranial

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Stéphane Fuentes, Phillipe Metellus, Henry Dufour, and François Grisoli

The authors present the case of traumatic thoracic disc herniation in a 39-year-old man who was involved in a high-speed motorcycle accident. The patient presented with complete paraplegia and loss of sensorimotor function from the T-10 level down, priapism, and imperforate anus. Emergency spinal magnetic resonance (MR) imaging demonstrated the presence of a predominantly left-sided T9–10 intervertebral disc herniation associated with spinal cord contusion ( Fig. 1 ). Computerized tomography

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Lawrence S. Chin, Keith L. Black, and Julian T. Hoff

T horacic disc protrusions account for less than 4% of all disc herniations. Multiple thoracic disc herniations are decidedly rare and can be difficult to distinguish from other extradural masses at the thoracic level. 16 In the case presented here, the preoperative studies did not clearly indicate multiple thoracic disc herniations; however, a wide laminectomy with adequate lateral exposure allowed successful removal of the disc herniations at adjacent levels. Case Report This 32

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Sanjay Konakondla, Nelson Sofoluke, Sean M. Barber, Sarah A. Rimini, and Jonathan R. Slotkin

( 6 ): 918 – 924 . 10.1177/2192568220933275 32677524 6 Oltulu I , Cil H , Berven S , Surgical management of thoracic disc herniation: anterior vs posterior approach . Turk Neurosurg . 2019 ; 29 ( 4 ): 584 – 593 . 31270797 7 Nayak NR , Bauman JA , Stein SC , Thawani JP , Malhotra NR . Surgical approaches for the treatment of thoracic disk herniation: results of a decision analysis . Clin Spine Surg . 2017 ; 30 ( 7 ): E901 – E908 . 27018910 10.1097/BSD