C8 root pathology will result in weakness in all three of these muscles with manual muscle testing. Symptoms such as these are primarily determined by the location of the cervical herniated disc. 2001. Gille O, Razafimahandry HJ, Sderlund C, Gangnet N, Vital JM. Upper back pain is usually attributed to minor injuries, such as muscle strain, sprain, poor posture, improper lifting, or twisting, but not often a herniated disc. A large herniated disc can compress the spinal cord within the spinal canala condition called myelopathyresulting in numbness, tingling, and or weakness in one or both lower extremities, and sometimes bowel and bladder dysfunction, and in extreme cases, paralysis. Adults, 2019. NCHS Data Brief, Number 415,July 2021, July 2021. 1968. Also, patients commonly feel a band of pain that goes around the front of the chest. 1978. Horner's syndrome secondary to intervertebral disc herniation at the level of T1-2. Sekhar LN, Jannetta PJ. Intervertebral thoracic disk herniation is rare. -, Caner H, Kilinoglu BF, Benli S, Altinrs N, Bavbek M. Magnetic resonance image findings and surgical considerations in T1-2 disc herniation. Delineating the location of nerve compression begins with assessing sites of peripheral compression with physical examination. The pain may be centered over the injured disc but may spread to one or both sides of the mid-back. 1960;17:41830. Herniated Disc Symptoms & More - FREE MRI Review Please enable it to take advantage of the complete set of features! There will be pain in the front side of Arm Pit. Herniated Disc (Cervical, Thoracic, Lumbar) - Columbia Neurosurgery in (f) After placement of a large cage. The https:// ensures that you are connecting to the . 2016 May;25 Suppl 1:204-8. doi: 10.1007/s00586-016-4402-y. doi: 10.1136/bcr-2014-204820. J Bone Joint Surg Am. Can J Neurol Sci. Postoperative MR imaging (MRI) studies in the first two patients showed adequate cord decompression following placement of T1T2 anterior interbody cages [Figures 1 and 2 ]. J Bone Joint Surg Am 1983;65:992-997. Weakness. Posterior approaches may utilize transfacet pedicle-sparing techniques, while the less frequent central/anterolateral discs may warrant anterior surgery. 11. Background:Symptomatic T1T2 disc herniations are rare and, in most cases, are located posterolaterally. At 9 months postoperatively, the patient continued to be pain free with full strength and intact sensation. Epub 2014 Jul 18. So there is no difference in T1-T2 and D1-D2 discs. Compression fractures are especially common in the lower thoracic area, and they often result from osteoporosis and mild trauma. The C8 nerve root innervates the extensor indicus and abductor pollicis brevis from the radial and median nerves, respectively, in addition to finger flexion (ulnar nerve). M51.24 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 18. Posterior approach surgery has most commonly been used for laminectomy and/or foraminotomy.1,5,11-13 Adequate disk access of more central disk herniations may not be accomplished without excessive facet resection leading to hypermobility. High thoracic disc herniation. Informed consent to present the data concerning the case for publication was obtained by the patient. Bransford R, Zhang F, Bellabarba C, Konodi M, Chapman JR. J Neurosurg Spine. It can also occur with ligamentous laxity in response to loading. If the disc herniates into the spinal cord area, the thoracic herniated disk may also present with myelopathy . 88: 623-33, 35. Claude-Bernard-Horner syndrome is not constant but highly suggestive. Herniated thoracic discs can cause paralysis. (f) Postoperative T1-weighted MRI, at 3-year follow-up, note clearance of the cord. The rest of the postganglionic fibers travel along the internal carotid artery and enter the cavernous sinus. JAMA 1965;191:627-631. This is the condition, which is more common than other conditions in the T1-T2 disc. The location of the pain depends on the location of the herniated disc. Correspondence Address:Naser AsgariPars Advanced and Minimally Invasive Medical Manners Research Center, Iran University of Medical Sciences, Tehran, Iran, How to cite this article: Abolfazl Rahimizadeh, Amir Hossein Zohrevand, Nima Mohseni Kabir, Naser Asgari. Federal government websites often end in .gov or .mil. Historically, symptomatic thoracic disk herniation occurred with a frequency of 2 to 3/1,000 cases of disk herniation.2 This is likely even less frequent with the advent of MRI use in diagnosis. Pedicle Marrow Signal Hyperintensity on Short Tau Inversion Recovery 8. This narrows the space between your vertebrae, causing certain issues. Extruded upper thoracic disc causing horner's syndrome:Report of a case. Objectives: To evaluate the clinical features of thoracolumbar junction disc herniation and to prepare a chart for the level diagnosis in the neurologic findings and symptoms. Herniated discs affect 5 to 20 per 1000 adults annually. The symptoms often follow a dermatomal distribution, . Approximately 90% of herniated discs occur at L4-L5 and L5-S1, causing pain in the L5 or S1 nerve that radiates down the sciatic nerve. Patients demographic data and common clinical features of the corresponding location at which they generate. A disc bulge is not a disc herniation. Publication types Case Reports Winter RB, Siebert R. Herniated thoracic disc at T1-T2 with paraparesis. (d) Chest X-ray showing that T1T2 disc space is far enough above biclavicular line. The .gov means its official. The main symptoms of lumbar disc herniation would radiate based on the location of the disc herniation . The symptoms of a herniated disc depends on either the size and position of the disc. (a) T2-weighted sagittal magnetic resonance imaging (MRI) shows T1T2 disc herniation. Lloyd TV, Johnson JC, Paul DJ, Hunt W: Horner's syndrome secondary to herniated disc at T1-T2. Diagnosis and treatment of thoracic intervertebral disc protrusions. Horner's syndrome secondary to T1-T2 intervertebral disc prolapse. (i) Postoperative T2-weighted MRI demonstrates the cage in T1T2 interspace. 1971. 9. All the discs in the spine, have an inner soft part with harder shell outside. Gelch MM: Herniated thoracic disc at T1-2 level associated with Horner's syndrome: Case report. 13. Please try again soon. Your back has many interconnected bones, nerves, muscles, ligaments and tendons that protect your spinal cord. 15. Wolters Kluwer Health Correspondence to Dr. Luczak: [emailprotected]. Symptoms of thoracolumbar junction disc herniation. These disc problems in thoracic region remains silent in most of the case. Contained Discs: The disc has not broken through the outer wall of the intervertebral disc, which means the inner gel-like material remains contained. Pain can radiate in the upper 2nd and 3rd ribs , just below the shoulder joint. Movement the inner soft part of the disc jelly- nucleus pulposus tears the annular ligament and starts coming out in the spinal canal or in lateral foramina. Follow-up magnetic resonance studies documented full resolution for the patient with radiculopathy and a posterolateral disc. This is a rarest condition in case of all thoracic discs, but can appear in this reason due to trauma. Pain is the most common symptom of a thoracic herniated disc and may be isolated to the upper back or radiate in a dermatomal (single nerve root) pattern. Generally speaking, most neurosurgeons will advise against surgery if you are not experiencing pain or symptoms. This clinical condition can commonly be a consequence of cervical sympathetic chain injury, which runs along the lateral aspect of the vertebral body. Rev Chir Orthop Reparatrice Appar Mot. 1993. 14. 17: 418-30, 4. 2000. (a) T2-weighted sagittal magnetic resonance imaging shows a T1T2 extruded disc migrated up. They can help rule out other conditions and give you a referral to a specialist. Symptoms characteristic of T1 disk herniation can often overlap with other maladies. 1978. She also works as an Adult and Pediatric Sexual Assault Nurse Examiner. t1-2 disc herniation - Neurology - MedHelp (a) T2-weighted sagittal image demonstrating a disc herniation at T1T2 level with considerable cord compression. Neurosurgery. Am J Ophthalmol 1998;126:565-577. The symptoms of T1-T2 slip disc depends on the severity of the problem. (e) Intraoperative clearance of the disc space from both hard disc and osteophytes. 11: 499-501, 17. The oculosympathetic pathway then joins the ophthalmic division of the fifth cranial nerve (V1) and travels into the orbit through the superior orbital fissure to provide innervation to the iris dilator muscle and Mueller's muscle; a small smooth muscle in the eyelid responsible for a minor portion of upper lid elevation and lower lid retraction. J Orthop Sci 2009;14:103-106. There is no medicine or procedure to reverse the process of ageing. Non-Contained Discs: The inner gel-like material has broken through the outer wall of the intervertebral disc. Am J Ophthalmol 1980;90:394-402. 1986;19:44951. After talking about your symptoms and . 2010 Feb;12(2):221-31. doi: 10.3171/2009.9.SPINE09476. Lloyd TV, Johnson JC, Paul DJ, Hunt W. Horner's syndrome secondary to herniated disc at T1--T2. (c) Reconstructed sagittal computed tomography (CT) scan of the CT region showing T1T2 hard disc, indicating that the compression, also note that CT angle is 10. Given the neurologic findings on examination, a cervical and thoracic MRI was obtained which revealed T1-T2 left paracentral disk extrusion with mild superior migration and left intraforaminal extension causing moderate left lateral recess stenosis and abutment of the left T1 nerve root (Figure 2). BecauseAyurvedic treatment of T1-T2 slip disc problem is not about suppression of signs and symptoms alone. Disk herniation at T1/T2 can compress the preganglionic fibers of the oculosympathetic pathway causing the classic Horner syndrome presentation of enopthalmos, miosis, blepharoptosis, and facial anhidrosis5,8,9 (Figure 3). This displacement can cause inflammation and compression to the spinal nerves or spinal cord, resulting in pain and possible neurological deficits like tingling, numbness, or weakness somewhere down the nerve. 29: 375-8, 36. J Neurosurg. We present a patient with thoracic disk herniation and Horner syndrome who was treated surgically. Hann EC. 2001 Nov 15;26(22):E512-8. 2002. Herniated thoracic disc at T1-2 level associated with horner's syndrome. 6 Approximately more than 70 . Some research has shown that herniated discs run in families, suggesting that your genes can make it more likely that you will develop a herniated thoracic disc. On examination, she had lower extremity hyperreflexia, an abnormal gait, and lower lumbar pain but lacked any radicular findings. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). 134: 184-5, 19. Copyright Surgical Neurology International. We report two cases of exceptional first thoracic disc herniation in a 60-year-old man and a 55-year-old woman. Summary of background data: Thoracolumbar junction disc herniations show a variety of signs and symptoms because of . Thoracic Radiculopathy - Physiopedia sharing sensitive information, make sure youre on a federal Symptomatic thoracic disc herniation is uncommon and has been estimated to less than 0.75% of all symptomatic spinal disc herniations. eCollection 2021. Both of these signs were absent in our patients. Its not easy figuring out how to sleep with a herniated disc. GUIDE: Physical Therapy Guide to Herniated Disk. Choose PT, August 26, 2021. A working differential diagnosis can guide management. Accessibility 2010. 1, 3, 4, 5 Although uncommon, T1-T2 disk herniation should be suspected if a patient presents with Horner syndrome and upper extremity pain. Herniated Thoracic Disc. Barrow Neurological Institute, August 3, 2022. The majority of herniated thoracic discs are diagnosed and treated before they progress to even partial paralysis. The most common symptom of a thoracic herniated disc is pain. HHS Vulnerability Disclosure, Help This pain is typically felt toward the back or side of the neck. We reviewed 4 cervical T1-T2 disc herniations; two central/anterolateral lesions warranting anterior surgical approaches/cages, and 2 lateral discs treated with a posterolateral transfacet, pedicle-sparing procedure and no surgery respectively. Weakness with finger abduction results from C8 radiculopathy and/or peripheral ulnar nerve entrapment. Posterior approaches may utilize transfacet pedicle-sparing techniques, while the less frequent central/anterolateral discs may warrant anterior surgery. 2019 Apr 24;10:56. doi: 10.25259/SNI-34-2019. [ 1 , 2 , 4 , 5 , 7 , 8 , 11 - 15 , 17 , 18 , 25 , 26 , 29 , 32 , 33 , 35 - 37 ] T1T2 disc herniation can present with either radiculopathy or myelopathy. Sometimes, there may be difficulty in breathing if the first rib or rib muscles are injured. MRI best documents soft T1T2 thoracic discs, while computed tomography is typically optimal for calcified herniations. This is possible through panchakarma procedures and Rasyana therapies later on. Symptoms Thoracic disc degeneration can be a cause of upper or mid back pain. 1998 Jan;88(1):148-50. doi: 10.3171/jns.1998.88.1.0148. An official website of the United States government. People who have a herniated disk often have radiating numbness or tingling in the body part served by the affected nerves. If youre between the ages of 30 and 50, youre more likely to be affected. This study can distinguish calcified disk herniations, which may lead to modified treatment strategies and surgical approach.3 The T1 nerve root supplies the ulnar nerve with C8 at a root level, the medial pectoral, medial brachial cutaneous, the medial antebrachial cutaneous nerves at a cord level, and the first intercostal nerve. Thoracic Spinal Nerves | Spine-health Opioids are most useful in the acute phase and generally not recommended for long-term use. Careful radiographic analysis is needed preoperatively to identify the upper limit of the sternum. There might be some other reasons like- some addiction or something like this, that causes the desiccation of the T1-T2 disc. She underwent T1-T2 anterior discectomy and fusion. 1956. 2). Furthermore, more than 75% of thoracic protrusions are located below T8, and only approximately 3% occur at the T1-T2 level, as in our patient. Micheli LJ, Hood RW: Anterior exposure of the cervicothoracic spine using a combined cervical and thoracic approach. Croat Med J. posterolateral discs) and, in some cases, spontaneously resolved (2 of 36 cases). J Orthop Sci. a = artery, n = nerve. Magnetic resonance imaging revealed a left-sided T1-T2 herniated disc compressing the T1 nerve root. Thoracic Disc Herniation: Surgical Treatment.. Due to the location of the thoracic spine, a herniated disc can cause pain to the mid-back, unilateral or bilateral chest wall, or abdominal areas around the affected vertebrae. By specifically examining these five muscles, one can differentiate between cubital tunnel syndrome, which leaves their motor strength intact, and C8-T1 radiculopathy. Despite having a long learning curve, the surgical technique described herein can be even used in patients with complex and calcified thoracic disc herniations. The details of 36 cases with T1T2 disc herniation. (b) Sagittal cervical fat saturated MRI shows the same. Nishimura Y, Thani NB, Tochigi S, Ahn H, Ginsberg HJ. 6: s-0036, 29. He is an M.D. The arc begins in the hypothalamus and synapses in the intermediolateral gray substance at C8-T2 levels (ciliospinal center of budge). The rest of the postganglionic fibers travel along the internal carotid artery and enter the cavernous sinus. (d) Chest X-ray showing that T1T2 disc space is far enough above biclavicular line. Symptomatic Lumbar Disc Herniation MadanMohanSahoo,MSOrth1,SudhirKumarMahapatra,DNBOrth1, Sheetal Kaur, MD1, Jitendra Sarangi, . The exception to this is for a giant herniated thoracic disc, which almost always requires surgery. Bethesda, MD 20894, Web Policies Both were approached anteriorly with low cervical-suprasternal approaches and accompanied by cage application. t1-2 disc herniation. Sitting in chairs with a firm back to support the spine will help alleviate back pain. This condition can happen to anyone at any age but is more prevalent in older populations or with those who are involved in strenuous physical activity for extended periods of time. The latter two cases had posterolateral discs contributing to a Brown-Sequard syndrome and radiculopathy, respectively; one patient required a transfacet pedicle-sparing procedure, while the second case was managed conservatively. to maintaining your privacy and will not share your personal information without Symptoms can also include numbness, tingling, or muscle weakness in one or both lower extremities. Careful radiographic analysis is needed preoperatively to identify the upper limit of the sternum. Svien HJ, Karavitis AL. The 2023 edition of ICD-10-CM M51.24 became effective on October 1, 2022. 3. Horner syndrome or oculosympathetic paresis is evident because of interruption of sympathetic nerve supply to the eye, which consists of a 3-neuron pathway. Vaidya Dr. Pardeep does it according to the scientific principles of Ayurveda. Love JG, Schorn VG: Thoracic-disk protrusions. Horwitz NH, Whitcomb BB, Reilly FG. Keywords: Unlike the usual calcification in the medioposterior position for middle or lower thoracic spine herniations, a soft posterolateral herniation was observed here. If any of the thoracic nerves become inflamed, such as from a thoracic herniated disc or a narrowing of the foramen, thoracic radiculopathy can develop with symptoms of pain, tingling, numbness, and/or weakness radiating along the nerve root. J Neurosurg 1978;48:128-130. A case of the patient with severe neurological deficits, caused by intradural thoracic disc herniation at T1-T2 interspace, which required surgical treatment and the symptoms were relieved immediately after surgery. Neurosurgery. [ 3 , 6 , 19 , 28 , 30 , 34 ] T1T2 discs account for only approximately 13% of all thoracic discs. Objective: To present the unique case of a collegiate wrestler with C7 neurologic symptoms due to T1-T2 disc herniation. 1. With age, the discs soft inner layer (nucleus pulposus) becomes less hydrated, making it less gelatinous and effective as a shock absorber. I've been in excruciating pain in the right shoulder and throughout the arm and hand for months. 1-3 The most affected area in the thoracic region is the T11-12 level. and transmitted securely. J Athl Train. As people age, their thoracic intervertebral discs may lose their cushioning ability and become more likely to rupture. When there is a compression on the disc, it starts decaying. The preganglionic fibers then exit the spinal cord and enter the cervical sympathetic chain. Son ES, Lee SH, Park SY, Kim KT, Kang CH, Cho SW. Surgical treatment of t1-2 disc herniation with t1 radiculopathy:A case report with review of the literature. 1986. FOIA According to Dr. Good, here are some healthy habits you can build that will help keep your discs healthy. An MRI showing a herniated thoracic disc compressing the spinal cord.An MRI from the same patient shown above after minimally invasive lateral thoracic discectomy and fusion. Recommended Reading: Chronic Bronchitis Signs And Symptoms, A limited description of the specific lumbar spinal nerves includes: L1 innervates the abdominal internal obliques via the ilioinguinal nerve L2-4 innervates iliopsoas, a hip flexor, and other muscles via the femoral nerve L2-4 innervates adductor longus, a hip adductor, and other muscles via the obturator nerve L5. Your message has been successfully sent to your colleague. Along with this when we work with pronated shoulders and fixed neck- chances of problem with D1-D2 disc increases in same frequency. Myelopathy is rare. Hammon WM. Negoveti L, Cerina V, Sajko T, Glavi Z. Intradural disc herniation at the T1-T2 level. Follow-up magnetic resonance studies documented full resolution for the patient with radiculopathy and a posterolateral disc. PMC This impingement typically produces neck and radiating arm pain or. Although posterior approach surgery is most commonly used for laminectomy and/or foraminotomy, successful anterior approaches to upper thoracic lesions are valid as well. Surg Neurol. The thoracic spine is surrounded by the rib cage and it is much harder to damage the spinal cord in this area. The symptoms of T1-T2 slip disc are-. J Neurosurg Spine. Experience with ruptured T1-T2 discs. 2010. Radiation of pain in the upper arm on the front side. SignificanceofVertebral EndplateFailurein The Author(s) 2017 There was a decreased sensation noted along the left medial forearm and hypothenar region. Reflex examination was 2/4 in C 6, 7, and 8 roots. Numbness or tingling in areas of one or both legs. A 29-year-old surgical resident presented to the emergency department complaining of acute onset left periscapular back pain, along with progressive left medial forearm and fourth and fifth digit numbness with grip weakness of the left hand. your express consent. Eur Spine J. (g) Plain CT radiograph showing that the cage is located at bicalvicular line. Rahimizadeh A. Thoracic disc herniation:20 years experience in 82 cases. All but five intrinsic hand muscles are innervated by the ulnar nerve; abductor pollicus brevis, flexor pollicis brevis, opponens pollicis, and lateral lumbricals. A standard posterior approach with laminoforaminotomy and diskectomy was done. Rahimizadeh A, Zohrevand AH, Kabir NM, Asgari N. Surg Neurol Int. In simple terms, a disc bulge refers to an apparent generalized extension of disc tissues beyond the edges of the edge of vertebrae, usually less than 3mm. Cervical Herniated Disc Symptoms & Treatments | Advanced Spine Vaidya Ji is well known for his specialisation in Ayurvedic treatment of different ailments. 1998. Mulpuri K, LeBlanc JG, Reilly CW, Poskitt KJ, Choit RL, Sahajpal V. Sternal split approach to the cervicothoracic junction in children. The patient was then discharged from the emergency center with oral methylprednisolone and follow-up with an orthopaedic spine surgeon. Court, C., E. Mansour, and C. Bouthors. When there is some problem in the T1-T2 diss, it gives similar symptoms to cervical problem. [ 4 , 6 , 27 , 30 , 34 ] However, for central T1T2 disc herniations, resulting in significant myelopathy, anterior surgery may be warranted (e.g., the low cervical-manubrium method and/or limited sternal splitting procedures). The most common areas to have a herniated disc are the cervical and lumbar areas of the spine. Posterior-only approach for the treatment of symptomatic central thoracic disc herniation regardless of calcification: A consecutive case series of 30 cases over five years. Global Spine J. Rossitti S, Stephensen H, Ekholm S, von Essen C. The anterior approach to high thoracic (T1-T2) disc herniation. Bulge is a term for an image and can be a normal variant . Calcific discitis with giant thoracic disc herniations in adults. The incidence of a herniated disc may disrupt activities of daily living and sleep. 1993. Christopher Good, MD, FACS President of Virginia Spine Institute, https://www.barrowneuro.org/condition/thoracic-disc-herniation/, https://doi.org/10.1016/j.otsr.2017.04.022, https://www.ncbi.nlm.nih.gov/books/NBK441822/, https://www.choosept.com/guide/physical-therapy-guide-herniated-disk, https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Low-Back-Pain, https://www.cdc.gov/nchs/data/databriefs/db415-H.pdf, https://doi.org/10.1302/2058-5241.6.210020, Upper Back Pain Causes, Risk Factors, Diagnosis and Treatment, Spondylosis Symptoms, Causes, Diagnosis and Treatment, 7 Lower Back Pain Causes That Affect Women, Muscle Relaxants for Back Pain and Neck Pain, Herniated Disc: Symptoms, Causes, Diagnosis, and Treatment. Experiencing pain in your thoracic region could be due to many conditions that can affect these tissues, including: More common causes of thoracic spine pain that directly involve your spinal column include: Conditions that specifically affect your vertebrae, spinal cord and/or nerve roots in your thoracic spine, include: Other conditions that can affect any region of your spine, including your thoracic region, include: You may have had a medical exam that revealed an underlying health problem. T1-T2 Herniated Disk Presenting with Horner Syndrome J Neurosurg. (c) Axial T2-weighted MRI shows a hyperintense disc on the left side. [ 15 ] Patients with thoracic discs typically present with neck pain (i.e. -. (g) Post-operative CT AP X-ray: shows the cage in T1T2 disc space. Arseni C, Nash F. Thoracic intervertebral disc protrusion:A clinical study. T2-3 Thoracic disc herniation with myelopathy - PubMed Clinical Reasoning: Partial Horner syndrome and upper right limb -, Alberico AM, Sahni KS, Hall JA, Jr, Young HF. Full-endoscopic discectomy for thoracic disc herniations: a single-arm Trauma, such as a motor vehicle crash or fall can also cause a thoracic herniated disc. Six weeks after surgery, the patient had complete resolution of his left-hand weakness and paresthesias, zero back pain, and some significant improvement in the ptosis and miosis (Figure 1, B). Thanks to the rigidity of the thoracic spine and the size of thoracic vertebrae, a thoracic herniated disc is a lot less likely to happen than a lumbar (lower back) or cervical (neck) herniated disc. 2014 Oct;21(4):568-76. doi: 10.3171/2014.6.SPINE13682. Because in this case, a patient might get back all those symptoms of T1-T2 slip disc come back again. Neurosurgical Developments on the Horizon, Leksell Gamma Knife Society Meeting Series, Dubai, 2018, Mayo Clinic Neuroscience Neurosurgery Lecture Series, http://surgicalneurologyint.com/surgicalint-articles/9301/, Pars Advanced and Minimally Invasive Medical Manners Research Center, Iran University of Medical Sciences, Tehran, Iran. T1-T2 slip disc or disc protrusion is a common word for all these conditions. government site. official website and that any information you provide is encrypted T1-T2 disc herniation should be suspected in patients presenting cervico-brachial medial neuralgia. Transthoracic excision and fusion, case report with 4-year follow-up. But they can happen. [ 1 , 2 , 4 , 5 , 7 - 9 , 11 - 15 , 17 , 18 , 21 , 24 - 26 , 29 , 31 - 33 , 35 - 37 ]. If the herniation compresses a thoracic spinal nerve, it can cause radiculopathypain that radiates down the nerve and away from the spinewith pain, numbness, and tingling. Due to high occurrence of complications from open surgery, minimally invasive approaches are desirable. Carr DA, Volkov AA, Rhoiney DL, Setty P, Barrett RJ, Claybrooks R, Bono PL, Tong D, Soo TM.