The thoracic spine is the area of your spine below your neck connected to your ribs. It is made up of 12 vertebral bodies with intervening discs. The disc is a cartilage, gristle like material that sits between your vertebral bodies in all parts of your spine. The disc acts like a cushion and also allows flexibility in your spine. The disc can wear over time as we age or earlier if it is injured. As it wears, or degenerates, the space between the vertebral bodies is reduced.
The symptoms of a true herniated disc may not include back pain at all. The symptoms of a herniated disc come from pressure on, and irritation of, the nerves. In the thoracic spine area, this can include total paralysis of the legs. The symptoms of a herniated disc in the thoracic area usually include:
- Pain that travels around the body and into one or both legs
- Numbness or tingling in areas of one or both legs
- Muscle weakness in certain muscles of one or both legs
- Increased reflexes in one or both legs that can cause spasticity in the legs
Where these symptoms occur depends on which nerve(s) has been affected in the thoracic spine and whether the disc has ruptured enough to put pressure on the spinal cord itself. Where the symptoms occur helps your doctor with the diagnosis to determine which disc has probably ruptured.
In most patients, thoracic disc degeneration is treated non-surgically. Non-impact aerobic exercise (walking, bicycling), back and core strengthening are typically recommended with a physical therapist. If large bone spurs have formed and caused compression on the spinal cord, then surgery may be indicated if there are neurologic symptoms like numbness, tingling, and weakness in the legs. The surgery can be performed anteriorly through the chest cavity, or posterior. The goal of surgery is to remove pressure on the spinal cord. The surgery usually involves a fusion, whereby bone graft is placed along the spine along with rods or a plate to stop motion of the spine in the area of the spine causing the symptoms. If the disc is completely removed, a graft or cage device may be inserted in its place to help the bone fuse or heal. There are no total disc replacements designed or utilized in the thoracic spine.