Dützmann Stephan, Rosenthal Daniel
Neurochirurgische Praxis Bad Homburg, Zeppelinstr. 24, 61352, Bad Homburg, Deutschland.
Orthopadie (Heidelb). 2025 Jan;54(1):18-25. doi: 10.1007/s00132-024-04585-5. Epub 2024 Nov 29.
Contrary to traditional opinion thoracic herniation is more frequent than expected. The disease poses two main challenges: (1) surgical removal and (2) early and correct diagnosis. It is without a doubt that herniated thoracic discs can be difficult to remove. Often enough, it is equally challenging to attribute the correct symptoms to the disease to reach the diagnosis, because there is a great variability and supposedly low specificity of the clinical symptoms, especially concerning pain related symptoms, which are often attributed to muscular or joint related causes. However, radicular complaints and myelopathic deficits usually predominate, but also algetic symptoms exist in patients harboring this disease. The surgical approach should be a ventral one. The postoperative prognosis is mostly good after adequate decompression.
与传统观点相反，胸椎间盘突出症比预期更为常见。该疾病带来两个主要挑战：（1）手术切除；（2）早期正确诊断。毫无疑问，突出的胸椎间盘可能难以切除。通常，将正确的症状归因于该疾病以做出诊断同样具有挑战性，因为临床症状具有很大的变异性且特异性可能较低，尤其是与疼痛相关的症状，这些症状常常被归因于肌肉或关节相关原因。然而，神经根性症状和脊髓病性缺损通常占主导，但患有这种疾病的患者也存在疼痛症状。手术方式应选择前路。充分减压后，术后预后大多良好。
