Arce C A, Dohrmann G J
Surg Neurol. 1985 Apr;23(4):356-61. doi: 10.1016/0090-3019(85)90206-x.
Thoracic disc herniation is uncommon. One of the main problems in the treatment of thoracic disc herniation has been the lack of accuracy of diagnostic tests. Now, with the use of computed tomographic scanning with and without metrizamide in the subarachnoid space, this accuracy has greatly improved. Computed tomography scanning can demonstrate the type and level of the lesion even when the myelographic study is negative. We have reviewed 280 cases; a peak incidence was noted in the fourth decade with 75% of the protruded discs occurring below T-8. Back pain was the most common presenting symptom followed by sensory disturbances. By the time of diagnosis, 70% of the patients had signs of spinal cord compression. A small group of patients could be identified that invariably had a good prognosis. They had a history of trauma, symptoms lasting less than a month, and soft disc herniation. Regarding the results of surgical treatment, there was a success rate ranging from 57% for decompressive laminectomy to over 80% for the posterolateral, lateral, and transthoracic approaches.
胸椎间盘突出症并不常见。胸椎间盘突出症治疗中的主要问题之一一直是诊断检查缺乏准确性。现在，通过在蛛网膜下腔使用含与不含甲泛葡胺的计算机断层扫描，这种准确性有了很大提高。即使脊髓造影检查结果为阴性，计算机断层扫描也能显示病变的类型和部位。我们回顾了280例病例；发病高峰在40岁，75%的突出椎间盘发生在T-8以下。背痛是最常见的首发症状，其次是感觉障碍。到诊断时，70%的患者有脊髓受压体征。可以识别出一小部分预后始终良好的患者。他们有外伤史，症状持续时间不到一个月，且为软性椎间盘突出。关于手术治疗结果，减压性椎板切除术的成功率为57%，后外侧、外侧和经胸入路的成功率超过80%。
