Thoracic herniated discs: review of the literature and 12 cases.

In comparison with herniations of lumbar or cervical intervertebral discs, symptomatic thoracic disc herniation is rare. Between 1986 and 1991, 12 cases of thoracic herniated discs were treated at The Mount Sinai Hospital, New York City. Most patients had back pain or myelopathy. Nine of the disc herniations occurred at the lowest six thoracic interspaces. Eight patients underwent costotransversectomy and discectomy. Seven of these patients improved without complication. One patient was subsequently found to have a spinal arteriovenous malformation below an incidental herniation that had been identified by magnetic resonance imaging. Because of the nonspecificity of the signs and symptoms, as well as the prevalence of incidental herniations on imaging, a careful clinical and radiologic correlation is mandatory when diagnosing this uncommon pathology.