An accurate diagnosis and timely surgical intervention may provide the patient the best chance for regression of symptoms and a satisfactory outcome. T1-T2 disc herniation: Report of four cases and review of the literature. (f) Postoperative T1-weighted MRI, at 3-year follow-up, note clearance of the cord. (b) Axial view showing the central location of the disc. (b) Axial view shows the posterolaterally located disc is on the left side. The same decay can be age related too. Introduction Surgical intervention is the treatment of choice in patients with thoracic disc herniation with refractory symptoms and progressive myelopathy. Numbness or tingling in areas of one or both legs. Wolters Kluwer Health (g) Post-operative CT AP X-ray: shows the cage in T1T2 disc space. 16. The https:// ensures that you are connecting to the There is no charge to read or download any SNI content, but registering for a free membership will provide you with additional special features. J Neurosurg Spine. J Neurosurg. 1980. Both of these signs were absent in our patients. Bransford R, Zhang F, Bellabarba C, Konodi M, Chapman JR. J Neurosurg Spine. Nishimura Y, Thani NB, Tochigi S, Ahn H, Ginsberg HJ. your express consent. Careful radiographic analysis is needed preoperatively to identify the upper limit of the sternum. The 12 thoracic vertebrae (T1 just below the neck down to T12 just above the lumbar spine) make up the largest and least flexible area of the spine. Get new journal Tables of Contents sent right to your email inbox, Creative Commons Attribution License 4.0 (CCBY), T1-T2 Disk Herniation Presenting With Horner Syndrome: A Case Report With Literary Review, Articles in Google Scholar by Daniel Possley, DO, Other articles in this journal by Daniel Possley, DO, Privacy Policy (Updated December 15, 2022). The annular tear can be confirmed with a discogram followed with a CT scan. Available from: http://surgicalneurologyint.com/surgicalint-articles/9301/. If the C8 nerve is compressed or irritated, additional symptoms may occur, such as: If the spinal cord is injured, the upper and/or lower limbs and the torso may be completely or partially paralyzed.2 There may also be changes in bowel and/or bladder functions. Apply an ice pack or cold compress to the affected area for 15- to 20-minute intervals every two hours. 49: 599-606, 23. Hagerstown, MD, Harper & Row, 1978. sharing sensitive information, make sure youre on a federal [ 15 ] Patients with thoracic discs typically present with neck pain (i.e. We report two cases of exceptional first thoracic disc herniation in a 60-year-old man and a 55-year-old woman. (b) Sagittal cervical fat saturated MRI shows the same. Intradural disc herniations comprise 0.26-0.30% of all herniated discs. 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. J Neurosurg. C8 and T1 nerve roots compound both ulnar and median nerves.3 Therefore C8 and T1 radiculopathies . There are some simple things that you can do at home to help alleviate the pain. (e) Axial CT scan shows a pedicle screw in an upper thoracic vertebra. The T1-T2 interspace is not fully visualized on a cervical MRI; therefore, a thoracic MRI scan can be helpful. Pain can radiate in the upper 2nd and 3rd ribs , just below the shoulder joint. T1-T2 slip disc or disc protrusion is a common word for all these conditions. Your back has many interconnected bones, nerves, muscles, ligaments and tendons that protect your spinal cord. HHS Vulnerability Disclosure, Help Pain is usually the first symptom. 42: 193-5, 26. Keachie K, Shahlaie K, Muizelaar JP. Shortly after the postganglionic fibers leave the superior cervical ganglion, vasomotor and sudomotor fibers branch off to travel along the external carotid artery to innervate the blood vessels and sweat glands of the face. Report of four cases and literature review. The symptoms often follow a dermatomal distribution, . Barrow Neurological Institute. These disc problems in thoracic region remains silent in most of the case. This the next process of degenerative disc disease is- disc bulge. Two of the most common causes of thoracic radiculopathy are from compression caused by a herniated disc or from a narrowing of the spinal foramen, an opening through which these nerves pass. Disc herniation at T1-2 in: Journal of Neurosurgery Volume 88 - jns Intervertebral thoracic disk herniation is rare. and transmitted securely. 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. 6: 1-10, 2. Objective: To present the unique case of a collegiate wrestler with C7 neurologic symptoms due to T1-T2 disc herniation. Herniated Disc Symptoms in the Lumbar Spine The most common symptom associated with a herniated disc in the lumbar spine is leg pain (also known as sciatica). This narrows the space between your vertebrae, causing certain issues. Surgery was done 8 days from the onset of symptoms. -, Bransford R, Zhang F, Bellabarba C, Konodi M, Chapman JR. Vaidya Ji is well known for his specialisation in Ayurvedic treatment of different ailments. 3. Evaluation of the degeneration of the multifidus and erector spinae Clin Neurol Neurosurg. Nonsurgical treatments are usually tried first to treat CTJ injuries. So just go to contact us and send all your reports so that we will be able to guide you in a better way for your problem and Ayurvedic treatment of T1-T2 slip disc problem. The one interesting aspect about a bulge is that it is an MRI finding that can correlate with an annular tear that causes deep midline low back pain. Introduction. An accurate diagnosis and timely surgical intervention may provide the patient the best chance for regression of symptoms and a satisfactory outcome. Case report. J Orthop Sci. Before Spine (Phila Pa 1976). MeSH Would you like email updates of new search results? 92: 715-8, 9. 35: 329-31, 11. Morgan H, Abood C: Disc herniation at T1-2: Report of four cases and literature review. Both were approached anteriorly with low cervical-suprasternal approaches and accompanied by cage application. The arc begins in the hypothalamus and synapses in the intermediolateral gray substance at C8-T2 levels (ciliospinal center of budge). Because your thoracic spine is much more rigid and stable, your thoracic spinal area is much less frequently injured than your lumbar and cervical spine. T1-T2 Disk Herniation Presenting With Horner Syndrome: A Cas - LWW The tough outer layer (annulus fibrosus) loses elasticity with age, increasing the risk of tears that can result in herniation. (h) Postoperative T2-weighted MRI: showing appropriate decompression of the spinal cord at T1T2 level. Love JG, Kiefer EJ: Root pain and paraplegia due to protrusions of thoracic intervertebral disks. official website and that any information you provide is encrypted 48: 710-5, 18. Physical examination revealed pain in the left upper paraspinal and scapular region radiating to the left shoulder with mild improvement of the pain with abduction of the left shoulder above the head. (a) T2-weighted sagittal image demonstrating a disc herniation at T1T2 level with considerable cord compression. Abbott KH, Retter RH. eCollection 2021. What are the symptoms of a t2-t3 disc problem? - Answers After literature review, 39 cases of T1-2 disk herniation were discovered.1 Only seven of these cases presented with an associated Horner syndrome (Table 1). The rest of the postganglionic fibers travel along the internal carotid artery and enter the cavernous sinus. Massage and acupuncture can be useful in managing pain. Save my name, email, and website in this browser for the next time I comment. Would you like email updates of new search results? 2009. (a) T2-weighted sagittal magnetic resonance imaging (MRI) of the second case showing a hard disc at T1T2 level. Following adjustment for the localisation, shots were taken with the patient positioned supine, with a routine protocol for the lumbar spine with the measurement level between L3-S1 at the center of the disc (Fig. Natalie Evenson MSN, BSN, RN is a health content writer. 2001. Rahimizadeh A. Thoracic disc herniation:20 years experience in 82 cases. J Orthop Sci 2009;14:103-106. Upper thoracic spine arthroplasty via the anterior approach. J Neurosurg. Where. The rib cage adds extra protection, support, and stabilization to the spine, making it less susceptible to damage in general and disc trouble in particular. T1-2 disk herniation diagnosis is often delayed because of its prevalence and misdiagnosis. Background: A cervical herniated disc may cause a number of symptoms in different parts of the body. 1952. But they can also happen after more severe trauma in the absence of osteoporosis or as a result of tumors on your spine. Preganglionic sympathetic neurons exit the spinal cord and ascend up the carotid sheath to the superior cervical ganglion at the level of the bifurcation of the common carotid artery. J Neurosurg. Thoracic Herniated Disc: Symptoms and Treatment Croat Med J. Thoracic disc herniation:Operative approaches and results. Your message has been successfully sent to your colleague. J Glob Spine J. The four cases of T1T2 discs included two females and two males who ranged in the age group from 36 to 67 years (average: 47 years). Multiple protrusions of intervertebral disks in the upper thoracic region:Report of case. 6. With cervical disc herniations, the nerve affected by the condition is the one that exits at that specific level of the spine. Symptoms of thoracolumbar junction disc herniation. Surgery for T1T2 posterolateral herniated discs may require transfacet pedicle-sparing decompression with pedicle screw fixation. High thoracic disc herniation. A spine surgeon or spinal neurosurgeon can assess your herniated thoracic disc and help you decide if it would be best to have surgery or to try conservative treatment. Modified anterior approach to the cervicothoracic junction. If you have a thoracic herniated disc, you may feel these symptoms circumferentially around your rib cage or upper abdominal area. Herniated discs affect 5 to 20 per 1000 adults annually. If the disc is severely degenerated, bone spurs can form and limit the mobility of the thoracic spine. Conclusions: 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. 5. Withawin Kesornsak, Kanthika Wasinpongwanich & Verapan Kuansongtham, Teresa Plancha da Silva, Marta Amaral Silva, Ftima Carvalho, Guillermo Alejandro Ricciardi, Ignacio Gabriel Garfinkel, Daniel Oscar Ricciardi, Kalyan Kumar Varma Kalidindi, Mayank Gupta & Harvinder Singh Chhabra, Lance L. Goetz, Sean McAvoy & Kate Zakrzewski, Kevin Hines, Karim Hafazalla, Jack Jallo. He is an M.D. government site. Myelopathy is rare. 4: 366-7, 25. JAAOS Global Research & Reviews2(11):e016, November 2018. 18: 782-4, Your email address will not be published. Posted by mlerin @mlerin, Nov 4, 2019. 2014 Oct;21(4):568-76. doi: 10.3171/2014.6.SPINE13682. 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. 6: 199-202. The video can be found here1). Thoracic Disc Degeneration - Spine Care | UCLA Health Oral steroids can also decrease inflammation, which will help alleviate pain. This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 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. Cervical radiculopathy is a disease process marked by nerve compression from herniated disk material or arthritic bone spurs. Hann EC. This may be evident by sensory disturbances below the level of compression, difficulty with balance and walking, lower extremity weakness, or bowel or bladder dysfunction. 18. (d) Chest X-ray showing that T1T2 disc space is far enough above biclavicular line. Anto M, Manuel A, Jayachandran A, Thomas SG, Joseph A, Thankachan A, Bahuleyan B. Surg Neurol Int. An orthopedic or neurologic physical therapist can customize a treatment plan of safe herniated disc exercises to help decrease pain, improve strength and posture, and increase mobility. Signs and Symptoms of a T1-T2 Herniated Nucleus Pulposis in the Literature (n = 21). When the inner core of the disc when stops getting proper nutrition, than it starts decaying further. posterolateral discs) and, in some cases, spontaneously resolved (2 of 36 cases). Horner syndrome or oculosympathetic paresis is evident because of interruption of sympathetic nerve supply to the eye, which consists of a 3-neuron pathway. Causes of T1 nerve root compression has been summarized in the literature (Table 2). Intradural disc herniation at the T1-T2 level. | Semantic Scholar (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. MRI provides the diagnosis. 4 ' 5 The first T1-2 disc herniation case was reported in 1954 by Sivien and Karavitis. It is causing burning/tingling up my neck to my ear and jaw area. Careful radiographic analysis is needed preoperatively to identify the upper limit of the sternum. A working differential diagnosis can guide management. t1-2 disc herniation - Neurology - MedHelp Find out how, and what you can do to treat them. This process of desiccation starts due to the pressure on the spinal arteries. 1960. Can J Neurol Sci. Thoracic spinal cord injuries are rare and only account for 10 15 percent of all spinal cord injuries. A herniation here may cause pain at the back or chest around the first rib, or pain in the ring and/or pinky fingers. (b) Sagittal, (a) T2-weighted sagittal magnetic resonance imaging shows a T1T2 extruded disc migrated up., MeSH There might be some other reasons like- some addiction or something like this, that causes the desiccation of the T1-T2 disc. If the disc herniates into the spinal cord area, the thoracic herniated disk may also present with myelopathy . 1978. T1T2 disc herniation: Report of four cases and review of the literature. 7: 495-7, 37. Although posterior approach surgery is most commonly used for laminectomy and/or foraminotomy, successful anterior approaches to upper thoracic lesions are valid as well. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). C8 root pathology will result in weakness in all three of these muscles with manual muscle testing. (f) Postoperative T1-weighted MRI, at 3-year follow-up, note clearance of the cord. (i) Postoperative T2-weighted MRI demonstrates the cage in T1T2 interspace. First thoracic disc protrusion. Proc Staff Meet Mayo Clin. But they can happen. Your doctor may use the following to diagnose a thoracic herniated disc: Sometimes other tests may be ordered because herniated thoracic disc pain and symptoms can mimic heart, lung, and stomach conditions. 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. After talking about your symptoms and . Most studies report improvement in pain and neurologic dysfunction, but Horner syndrome can be refractory to surgical decompression.12,18 Similarly, our patient at 6 weeks postoperative had resolution of his pain, motor, and sensory deficits but persistent Horner syndrome at nine months postoperatively. 84-A: 1013-7, 21. Thoracic spinal cord injuries are typically less severe than injuries to the cervical spinal cord. Kanno H, Aizawa T, Tanaka Y, Hoshikawa T, Ozawa H, Itoi E. T1 radiculopathy caused by intervertebral disc herniation:Symptomatic and neurological features. After confirming the diagnosis with MRI, the patient was treated with standard posterior approach with laminoforaminotomy and diskectomy. 12. doi: 10.1097/00007632-200111150-00021. to maintaining your privacy and will not share your personal information without 12: 303-5, 31. She underwent T1-T2 anterior discectomy and fusion. Rarely, C8 nerve injury may cause Horners syndrome characterized by drooping eyelids, small pupils, and sunken eyeballs usually affecting one side of the face.7. Evid Based Spine Care J 2010;1:21-28. 8600 Rockville Pike Patients demographic data and common clinical features of the corresponding location at which they generate. Protrusions of thoracic intervertebral disks. T1 T2 Disc Herniation Symptoms - SymptomsTalk.net 1998. Accessibility (e) Intraoperative clearance of the disc space from both hard disc and osteophytes. Br J Neurosurg 1993;7:189-192. An official website of the United States government. Br J Neurosurg. t1-2 disc herniation. 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. Non-surgical treatment options for symptoms of a thoracic herniated disc will typically include one or a combination of the following: A short period of rest (e.g. Magnetic resonance imaging revealed a left-sided T1-T2 herniated disc compressing the T1 nerve root. Proc Staff Meet Mayo Clin 1954;29:375-378. Pain can radiate in the upper 2nd and 3rd ribs , just below the shoulder joint. However, it is most common in men between the ages of 40 and 60. Neurosurgery. 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. Learn more by subscribing now. You may be trying to access this site from a secured browser on the server. Compression fractures are especially common in the lower thoracic area, and they often result from osteoporosis and mild trauma. J Neurosurg Spine. 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. Band-like pain travelling from the back to the abdomen/chest on one or both sides of the body Headaches when you sit or lie in certain positions Numbness, tingling, or a burning feeling in your legs Trouble walking or moving your legs Weakness in your arms or legs Trouble urinating or having a bowel movement 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. The support that the rib cage provides to the thoracic spine means it experiences less wear and tear than the other segments of the spine, making it less likely for the thoracic segment to develop thoracic herniated discs and other conditions. A herniated thoracic disc is considered giant if it obstructs more than 50% of the central canal of the spine . 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). It is important to understand the symptoms, causes, and treatments for a bulging disc to prevent the condition from worsening. As we all know there are only few chances of the disc problems in dorsal spine, because this area is fixed in comparison to the cervical spine and lumbar spine. To report a rare thoracic intervertebral disc herniation followed by acutely progressing paraplegia. However, the onset of paralysis in this condition is gradual. A magnetic resonance imaging scan revealed a large focal paracentral herniated disc at the T2-3 level. Lloyd TV, Johnson JC, Paul DJ, Hunt W. Horner's syndrome secondary to herniated disc at T1--T2. Herniated Disc (Cervical, Thoracic, Lumbar) - Columbia Neurosurgery in 2). I've been in excruciating pain in the right shoulder and throughout the arm and hand for months. Symptoms such as these are primarily determined by the location of the cervical herniated disc. (d) Axial T2-weighted axial view also confirms disappearance of the disc. 1993. (a) T2-weighted sagittal magnetic resonance imaging (MRI) of the second case showing a hard disc at T1T2 level. 1954. Successful Smith-Robinson approaches to T1-T2 have been achieved, whereas partial sternotomy has been used in others.9,14 Thoracic disk herniations can be approached posteriorly when little to no retraction of the spinal cord is necessary for disk access. While the diagnosed problems at the C7-T1 level are less common,2 research suggests that CTJ injuries may be missed during due to difficulties in visualizing this region on plain X-Ray films.3 A few conditions that may affect the CTJ are: In severe cases, CTJ injuries may affect the spinal cord or the C8 nerve roots. : T1 radiculopathy caused by intervertebral disc herniation: Symptomatic and neurological features. In one case, a central disc fragment extended through the dura. Asian Spine J 2012;6:199-202. According to the American Association of Neurological Surgeons, about 75 - 85% of people in the U.S. suffer from back pain at some point in their lifetime. Data is temporarily unavailable. Arts MP, Bartels RH: Anterior or posterior approach of thoracic disc herniation? -, Alberico AM, Sahni KS, Hall JA, Jr, Young HF. (a) T2-weighted sagittal magnetic resonance imaging (MRI) shows T1T2 disc herniation. Watch: Thoracic Herniated Disc Video Thoracic back pain may be exacerbated when coughing or sneezing. [ 1 , 2 , 4 , 5 , 7 , 8 , 10 - 17 , 21 , 24 - 26 , 29 , 31 - 33 , 35 - 37 ] There were 24 males and 12 females averaging 49.1 years of age (range 2372 years of age) [ Table 2 ]. 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. 2016. 6: s-0036, 29. Surgical Treatment of T1-2 Disc Herniation with T1 Radiculopathy: A Case Report with Review . Acute traumatic sequestrated thoracic disc herniation: A case report and review. 1980. All rights reserved. Vaidya Dr. Pardeep does it according to the scientific principles of Ayurveda. According to Christopher Good, MD, FACS President of Virginia Spine Institute, often the most optimal treatment is to allow the body to heal naturally with time. Surgery should occur only when objective findings of structural defects are correlated with the patients symptoms and signs. T1T2 thoracic disc herniations are an extremely rare, and optimal results depend on the central and centrolateral location of the discs and the operative/nonoperative choices were made based on the clinical presentation. Symptomatic T1-T2 disc herniations are rare and, in most cases, are located posterolaterally. Cervical Radiculopathy: Nonoperative Management of Neck Pain and - AAFP Due to high occurrence of complications from open surgery, minimally invasive approaches are desirable. If the lower thoracic region is involved, a patient may encounter pain radiating to one or both lower extremities. For example, T3 radiculopathy could radiate pain and other symptoms into the chest via the branch of the nerve root that becomes an intercostal nerve traveling along the route between the third and fourth ribs. Caner H, Kilinoglu BF, Benli S, Altinrs N, Bavbek M. Magnetic resonance image findings and surgical considerations in T1-2 disc herniation. (c) Axial T2-weighted MRI shows a hyperintense disc on the left side. We focused on the clinical presentation, e.g. When we discuss about D1-D2 disc problem or T1-T2 disc problem, symptoms are more like- cervical disc herniation. Please try after some time. Although . So when we provideAyurvedic treatment of T1-T2 slip disc we are careful about providing a proper solution. The main concept ofAyurvedic treatment of T1-T2 slip disc problem is based on the cause of the problem. Herniated discs in the thoracic region account for less than 1% overall. (b) Sagittal cervical fat saturated MRI shows the same. Herniated discs in the thoracic region account for less than 1 percent of all herniated discs. Posterior approaches may utilize transfacet pedicle-sparing techniques, while the less frequent central/anterolateral discs may warrant anterior surgery. (c) Axial T2-weighted MRI shows a hyperintense disc on the left side. (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. T1 and T2 - These lead into nerves that go into the top of your chest and into the arms and hands. To keep your spine neutral and avoid putting pressure on any herniated discs, place a small pillow under your head and knees. Vertebral compression fractures are the most common injury to the thoracic spine. [ 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. The most common areas to have a herniated disc are the cervical and lumbar areas of the spine. Symptoms characteristic of T1 disk herniation can often overlap with other maladies. 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). When Natalie is not working, you can find her gardening and taking care of her animals on her mini farm. sharing sensitive information, make sure youre on a federal Weakness with finger abduction results from C8 radiculopathy and/or peripheral ulnar nerve entrapment. Because this nerve root is the part of the brachial plexus. 8600 Rockville Pike If youre between the ages of 30 and 50, youre more likely to be affected. J Neurosurg 1978;48:128-130. This is the American ICD-10-CM version of M51.24 - other international versions of ICD-10 M51.24 may differ. Here, we reviewed four cases of symptomatic T1-T2 disc herniations; two patients were paraparetic due to central discs and underwent anterior surgery utilizing a cage construct. 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. Copyright Surgical Neurology International. Local MD says he is not fimilar with T1-2. Avoid lifting, twisting, or straining the back. She also works as an Adult and Pediatric Sexual Assault Nurse Examiner. Horner's syndrome secondary to T1-T2 intervertebral disc prolapse. Symptomatic disc herniation in the upper thoracic spine from T1 to T4 is rare, with most occurring at T1T2 levels[ 3 , 6 , 19 , 28 , 30 , 34 ] [ Table 1 ]. 1960;17:41830. This distinction is made by David F. Fardon, MD, and Pierre C. Milette, MD in their Combined Task Forces of the North American Spine Society. J Neurosurg. Please enable it to take advantage of the complete set of features! Under his, Cost effective alternative for spinal surgery. 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. 1995. Please try again soon. Thoracic disc herniations make up 0.25%0.75% of all disc ruptures. Thoracic region is the first segment of the thoracic or dorsal spine. (c) Manubrium line and cervicothoracic (CT) angle on T2-weight magnetic resonance imaging (MRI): manubrium line intersects T2 vertebral body near to T2T3 disc, CT angle is about 38. This typically breaks down as such: Herniated discs are very common, but they usually occur in the lumbar spine as opposed to the thoracic region. Report of four cases and literature review. Hamlyn PJ, Zeital T, King TT. All the discs in the spine, have an inner soft part with harder shell outside.