Thoracic disc prolapse

Thoracic disc prolapse is a rare complaint owing to the relative rigidity of the thoracic spine. It accounts for 0.2% of all disc lesions.

Presentation:

• root pain and/or
• progressive, fluctuating paraparesis

Investigation:

• axial CT / MRI - demonstrates a midline thoracic disc protrusion
• myelography - demonstrates an anterior filling defect at the level of the disc space

Treatment:

• surgery - indicated if there is cord compression or unremitting root pain. An anterior transthoracic decompression provides the safest approach. Laminectomy carries a high risk of paraplegia.