Thoracic spine is composed of 12 vertebrae located in the chest area. Approximately 0.25-0.75% of all disc hernias of spine are located in this area. Low frequency of occurrence depends on biomechanical stability of thoracic area and being a less moving area. 80% of hernias occur at the ages between 30 and 50. Previous trauma in the history can be explored up to 25% of patients. The loss of disc height in patients results progression of kyphotic deformity.
The nerve roots between the vertebrae extends to chest area and cause pain and burning sensation along the ribs, which is called dermatomal pain, due to compression on the nerve roots caused by the herniated disc. The most common signs in the patients include dermatomal pain and sensation changes accompanied with loss of movement and sensation in lower extremities.
It is highly important to make differential diagnosis of disc hernias of this area. The approach to complaints that can be confused with many serious diseases requires a strong communication among various specialist doctors. Making diagnosis is based on a detailed physical examination. The diagnosis is confirmed by examination of thoracic vertebrae with MRI and EMG in required patients.
The primary treatment involves using appropriate drugs and eliminating the pain with relaxation. Physical therapy exercises can be useful. If the complaints persist and gain a progressive character then the disc needs to be removed by a surgical procedure. It is possible to remove the material causing compression using microscopic or endoscopic methods.