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. Early experience treating thoracic disc herniations using a modified transfacet pedicle-sparing decompression and fusion. Clipboard, Search History, and several other advanced features are temporarily unavailable. These symptoms typically follow a pattern as noted above, based on the affected nerve roots location and functions. Surgery for T1T2 posterolateral herniated discs may require transfacet pedicle-sparing decompression with pedicle screw fixation. A working differential diagnosis can guide management. This process of desiccation starts due to the pressure on the spinal arteries. Case Description:Here, we reviewed four cases of symptomatic T1T2 disc herniations; two patients were paraparetic due to central discs and underwent anterior surgery utilizing a cage construct. For example, you may feel pain in your neck, arms, hands, fingers, or parts of the shoulder. 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. Copyright Surgical Neurology International. An official website of the United States government. You may be trying to access this site from a secured browser on the server. (c) T2-weighted sagittal image shows complete resolution of the disc at 5-month follow-up. A magnetic resonance imaging scan revealed a large focal paracentral herniated disc at the T2-3 level. Horwitz NH, Whitcomb BB, Reilly FG. Am J Ophthalmol 1998;126:565-577. Please try again soon. 18: 782-4, Your email address will not be published. The exception to this is for a giant herniated thoracic disc, which almost always requires surgery. FOIA Compression fractures are especially common in the lower thoracic area, and they often result from osteoporosis and mild trauma. Local MD says he is not fimilar with T1-2. MR studies documented a soft central disc in one patient, and a calcified central disc in the second [Figures 1 and 2 ]. GUIDE: Physical Therapy Guide to Herniated Disk. Choose PT, August 26, 2021. Degenerative changes of the spine is the same condition as spinal osteoarthritis, spondylosis and degenerative disk disease. But not in case of T1-T2 slip disc. Symptoms can also include numbness, tingling, or muscle weakness in one or both lower extremities. Svien HJ, Karavitis AL: Multiple protrusions of intervertebral disks in the upper thoracic region: Report of case. T1-T2 slip disc or disc protrusion is a common word for all these conditions. Good office ergonomics, such as a supportive chair, can reduce the risk of thoracic herniated discs, which are already rare. (b) The disc space is a little bit above the manubrium line and cervicothoracic (CT) angle is 27. Early experience treating thoracic disc herniations using a modified transfacet pedicle-sparing decompression and fusion. Symptomatic Lumbar Disc Herniation MadanMohanSahoo,MSOrth1,SudhirKumarMahapatra,DNBOrth1, Sheetal Kaur, MD1, Jitendra Sarangi, . Symptomatic T1-T2 disc herniations are rare and, in most cases, are located posterolaterally. T1 and T2 - These lead into nerves that go into the top of your chest and into the arms and hands. The clinical signs and symptoms of T-1 radiculopathy are similar to those of C-8 radiculopathy; however, distinguishing features can frequently be found on neurological examination. Delineating the location of nerve compression begins with assessing sites of peripheral compression with physical examination. 92: 715-8, 9. Due to high occurrence of complications from open surgery, minimally invasive approaches are desirable. Movement the blood supply to the disc is interrupted it causes the desiccation of the disc. Abbott KH, Retter RH. Avoid lifting, twisting, or straining the back. Symptoms such as these are primarily determined by the location of the cervical herniated disc. If there is some deformity behind T1-T2 slip disc than we aim to restore the kyphotic changes. Bulge is a term for an image and can be a normal variant . Herniated discs happen when the soft, jellylike inner layer of a shock-absorbing intervertebral disc bulges into or breaks through the discs tough outer layer. 2002. Patients with cervical radiculopathy symptoms and physical examination findings consistent with Horner syndrome should be evaluated with a MRI that includes the upper thoracic spine. 2013. T1-T2 Pinched Nerve: The T1 spinal nerve is responsible for the ring and pinky fingers and the area at the first rib. 1986. The reason, why T1-T2 disc problem- bulge or herniation mimics the cervical disc problems is- the nerve root from D1-D2 disc is- T1 and this is part of the brachial plexus. 8. This is the T1 nerve root which originates from the T1-T2 region. (Ayurveda) doctor. Central disk herniations or those that compromise up to 50% across the disk space are often approached through an anterior approach as effective decompression cannot be completed from a posterior only approach. The rest of the postganglionic fibers travel along the internal carotid artery and enter the cavernous sinus. Epub 2013 Aug 16. Over-the-counter or prescription meds such as acetaminophen and NSAIDs like ibuprofen are common medicinal treatments. 2003;30:1524. Patients demographic data and common clinical features of the corresponding location at which they generate. Introduction Surgical intervention is the treatment of choice in patients with thoracic disc herniation with refractory symptoms and progressive myelopathy. T1-2 disk herniation diagnosis is often delayed because of its prevalence and misdiagnosis. Recommended Reading: Heart Disease Symptoms In Dogs. J Athl Train. Protrusion of the first thoracic disk. Neurology. A herniation here may cause pain at the back or chest around the first rib, or pain in the ring and/or pinky fingers. (e) Intraoperative clearance of the disc space from both hard disc and osteophytes. Fortschr Neurol Psychiatr 2001;69:236-241. 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. Intradural disc herniations comprise 0.26-0.30% of all herniated discs. 2014: 34. At 1-week postoperatively, he had near complete improvement in his left-hand strength with mild forearm paresthesias and persistent ptosis and miosis of the left eye. If you have a thoracic herniated disc, you may feel these symptoms circumferentially around your rib cage or upper abdominal area. J Orthop Sci 2009;14:103-106. Postfixed brachial plexus radiculopathy due to thoracic disc herniation in a collegiate wrestler: a case report. This is a rarest condition in case of all thoracic discs, but can appear in this reason due to trauma. 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. Croat Med J. She has 24 years of experience in various areas, including Trauma, Neuro, Orthopedics, Critical Care, Emergency and Perioperative nursing. 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. Radiation of pain in the upper arm on the front side. There are several treatment options for thoracic herniated discs. Correlating history, examination, and imaging will guide toward a successful diagnosis. 18. Causes of T1 nerve root compression has been summarized in the literature (Table 2). These all symptoms always confuse before the proper diagnosis of slip disc in D1-D2. Luk KD, Cheung KM, Leong JC. This fact is most likely explained by the restricted mobility and facet orientation of the thoracic spine. 6: s-0036, 29. So there is no difference in T1-T2 and D1-D2 discs. The majority of herniated thoracic discs are diagnosed and treated before they progress to even partial paralysis. 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. Because this nerve root is the part of the brachial plexus. Although . 2012. If you begin to experience symptoms, or if your mild symptoms like pain, radiculopathy, myelopathy become worse, it may be time to consider surgery. Use the Previous and Next buttons to navigate three slides at a time, or the slide dot buttons at the end to jump three slides at a time. 2022 Sep 9;13:412. doi: 10.25259/SNI_580_2022. Contained Discs: The disc has not broken through the outer wall of the intervertebral disc, which means the inner gel-like material remains contained. Also, if the branch of the thoracic nerve going toward the back becomes inflamed, pain and other symptoms could be felt in the back at or near the location of the inflammation. (a) T2-weighted sagittal image demonstrating, (a) T2-weighted sagittal image demonstrating a disc herniation at T1T2 level with considerable, (a) T2-weighted sagittal magnetic resonance, (a) T2-weighted sagittal magnetic resonance imaging (MRI) of the second case showing a, (a) T2-weighted sagittal magnetic resonance imaging (MRI) shows T1T2 disc herniation. 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. An accurate diagnosis and timely surgical intervention may provide the patient the best chance for regression of symptoms and a satisfactory outcome. eCollection 2022. 24-Apr-2019;10:56, How to cite this URL: Abolfazl Rahimizadeh, Amir Hossein Zohrevand, Nima Mohseni Kabir, Naser Asgari. Am J Ophthalmol 1980;90:394-402. 28: 322-30, 14. M51.24 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Thoracic discectomy by posterior pedicle-sparing, transfacet approach with real-time intraoperative ultrasonography: Clinical article. A herniated thoracic disc is considered giant if it obstructs more than 50% of the central canal of the spine . 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. Muscle weakness in certain muscles of one or both legs. 12: 303-5, 31. (g) Post-operative CT AP X-ray: shows the cage in T1T2 disc space. T1T2 disc herniation: Report of four cases and review of the literature. 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. Symptoms such as these are primarily determined by the location of the cervical herniated disc. All the discs in the spine, have an inner soft part with harder shell outside. T1-T2 disc herniation should be suspected in patients presenting cervico-brachial medial neuralgia. [ 3 , 6 , 19 , 28 , 30 , 34 ] T1T2 discs account for only approximately 13% of all thoracic discs. 1980. 14: 103-6, 15. As people age, their thoracic intervertebral discs may lose their cushioning ability and become more likely to rupture. Careful radiographic analysis is needed preoperatively to identify the upper limit of the sternum. This sympathetic pathway begins in the hypothalamus and synapses in the intermediolateral gray substance of the spinal cord at C8-T2 levels making it susceptible to disruption via a high thoracic intervertebral disk herniation. Gelch MM. So the treatment is dependent on the following parameters-. At his follow-up appointment, there was no improvement of his symptoms; therefore, the decision was made to intervene surgically given his persistent pain, weakness, and Horner syndrome. Med Ann Dist Columbia. 1993. 37: 541-2, 12. : T1 radiculopathy caused by intervertebral disc herniation: Symptomatic and neurological features. Regular exercise and strengthening the core abdominal muscles will help stabilize the spine. 8600 Rockville Pike J Neurol Neurosurg Psychiatry. Sekhar LN, Jannetta PJ. Would you like email updates of new search results? The site is secure. Non-Contained Discs: The inner gel-like material has broken through the outer wall of the intervertebral disc. The https:// ensures that you are connecting to the She underwent T1-T2 anterior discectomy and fusion. Lumbar diskectomy is a common procedure for the management of lumbar radiculopathy, but recurrent lumbar disk herniation is one of the most common complications of the procedure, sometimes necessitating repeat surgery. This is the condition, which is more common than other conditions in the T1-T2 disc. J Neurosurg. 15. Please enable it to take advantage of the complete set of features! 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). one or two days) and activity modification (eliminating the activities and positions that worsen or cause the thoracic back pain). (b) Axial view shows the posterolaterally located disc is on the left side. (i) Postoperative T2-weighted MRI demonstrates the cage in T1T2 interspace. Spine (Phila Pa 1976). Practice short intervals of gentle exercise. If we just suppress the pain and associated discomfort due to T1-T2 slip disc, that wont be a permanent solution of the problem. A very subtle ptosis and miosis remained. 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. Anterior surgery can be achieved without sternotomy. Follow-up magnetic resonance studies documented full resolution for the patient with radiculopathy and a posterolateral disc. (d) Chest X-ray showing that T1T2 disc space is far enough above biclavicular line. Court, C., E. Mansour, and C. Bouthors. Alberico AM, Sahni KS, Hall JA, Young HF. 2006. According to Dr. Good, here are some healthy habits you can build that will help keep your discs healthy. Gokcen HB, Erdogan S, Gumussuyu G, Ozturk S, Ozturk C. A rare case of T1-2 thoracic disc herniation mimicking cervical radiculopathy. 12: 221-31, 5. They can help rule out other conditions and give you a referral to a specialist. (f) After placement of a large cage. 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. Herniated Thoracic Disc. Barrow Neurological Institute, August 3, 2022. Thoracic disc herniation:Operative approaches and results. Surgical options will vary based on the size, type, and location of the injury, but the most common are. Carr DA, Volkov AA, Rhoiney DL, Setty P, Barrett RJ, Claybrooks R, Bono PL, Tong D, Soo TM. Signal . 6: 1-10, 2. J Neurol Neurosurg Psychiatry. Herniated discs in the thoracic region account for less than 1 percent of all herniated discs. Hamlyn PJ, Zeital T, King TT. Signs and Symptoms of a T1-T2 Herniated Nucleus Pulposis in the Literature (n = 21). (b) Sagittal cervical fat saturated MRI shows the same. Yoon, Wai Weng, and Jonathan Koch. (d) Chest X-ray showing that T1T2 disc space is far enough above biclavicular line. 17: 418-30, 4. Protrusions of thoracic intervertebral disks. Pain can radiate in the upper 2nd and 3rd ribs , just below the shoulder joint. At 9 months postoperatively, the patient continued to be pain free with full strength and intact sensation. (b) The disc space is a little bit above the manubrium line and cervicothoracic (CT) angle is 27. Intervertebral thoracic disk herniation is rare. Asian Spine Journal, 2012 (evidence level 3A) T2 radiculopathy: A differential screen for upper extremity radicular pain. 1. If youve been having intolerable pain that fails to respond to conservative treatments and or causes neurological deficits. There is no charge to read or download any SNI content, but registering for a free membership will provide you with additional special features. We focused on the clinical presentation, e.g. After confirming the diagnosis with MRI, the patient was treated with standard posterior approach with laminoforaminotomy and diskectomy. Horner's syndrome secondary to intervertebral disc herniation at the level of T1-2. 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. Careful radiographic analysis is needed preoperatively to identify the upper limit of the sternum. All but five intrinsic hand muscles are innervated by the ulnar nerve; abductor pollicus brevis, flexor pollicis brevis, opponens pollicis, and lateral lumbricals. Clin Neurol Neurosurg. Turbo spin-echo T1 and T2-weighted sagittal and turbo spin-echo T2 axial 4 mm sections parallel to the disc spaces were taken. 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. The third patient undergoing a transfacet pedicle-sparing left-sided approach had a postoperative three-dimensional computed tomography scans showing adequate root decompression and screw placement screws [Figures 3e and d ]. The details of 36 cases with T1T2 disc herniation. Correspondence to Dr. Luczak: [emailprotected]. Rev Chir Orthop Reparatrice Appar Mot. (a) T2-weighted sagittal image demonstrating a disc herniation at T1T2 level with considerable cord compression. An accurate diagnosis and timely surgical intervention may provide the patient the best chance for regression of symptoms and a satisfactory outcome. Nakahara S, Sato T. First thoracic disc herniation with myelopathy. A cervical herniated disc may cause a number of symptoms in different parts of the body. doi: 10.1136/bcr-2014-204820. Neurology. Proc Staff Meet Mayo Clin 1954;29:375-378. He is an M.D. 6. Report of four cases and literature review. 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. 1998 Jan;88(1):148-50. doi: 10.3171/jns.1998.88.1.0148. (e) Showing removal of the sequestrated disc fragment. These all symptoms always confuse before the proper diagnosis of slip disc in D1-D2. 1960. 1968. However, it is most common in men between the ages of 40 and 60. The T-1 radiculopathy usually involves weakness of the intrinsic muscles of the hand. 1955. J Neurosurg 1998;88:148-150. Sitting in chairs with a firm back to support the spine will help alleviate back pain. Vaidya Dr. Pardeep does it according to the scientific principles of Ayurveda. 49: 599-606, 23. Herniated thoracic disc at T1-2 level associated with horner's syndrome. Thoracic back pain may be exacerbated when coughing or sneezing. Love JG, Schorn VG: Thoracic-disk protrusions. Patients with upper extremity radicular pain/paresthesias are often sent for radiographs and MRI. (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. The tough outer layer (annulus fibrosus) loses elasticity with age, increasing the risk of tears that can result in herniation. 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. (b) Sagittal, (a) T2-weighted sagittal magnetic resonance imaging shows a T1T2 extruded disc migrated up., MeSH 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). Report of four cases and literature review. (d) Axial T2-weighted axial view also confirms disappearance of the disc. J Neurosurg Spine. Thoracic disc herniations are rare conditions compared with other disc herniations seen at cervical and lumbar spine levels. 2016 May;25 Suppl 1:204-8. doi: 10.1007/s00586-016-4402-y. When there is a change in the consistency of the jelly of disc, this falls under condition of slip disc or disc protrusion. J Neurosurg. Federal government websites often end in .gov or .mil. 2016. Some error has occurred while processing your request. . You May Like: Parvo Symptoms In Older Dogs. Unable to load your collection due to an error, Unable to load your delegates due to an error. Approximately 75% of all thoracic disc herniations are seen below T8. J Neurosurg 1978;48:128-130. T2 sagittal and axial MR images with T1-T2 disk herniation (arrows). The symptoms are limited, as observed in both patients, to a T1 radiculopathy, to be distinguished from C8 radicopathy. 6: s-0036, 28. Nonsurgical treatments are usually tried first to treat CTJ injuries. [ 3 , 6 , 19 , 28 , 30 , 34 ] Most thoracic disc herniations occur below the T8 level, and the majority are found at T11T12. Vaidya Dr. Pardeep Sharma is Chief Ayurvedic Physician at Sukhayu Ayurved Jaipur. Follow-up magnetic resonance studies documented full resolution for the patient with radiculopathy and a posterolateral disc. (f) After placement of peek cage, note brachiocephalic vein at lower border of the scene. Objective: To present the unique case of a collegiate wrestler with C7 neurologic symptoms due to T1-T2 disc herniation. 2005. If the disc is severely degenerated, bone spurs can form and limit the mobility of the thoracic spine. The most common areas to have a herniated disc are the cervical and lumbar areas of the spine. Bransford R, Zhang F, Bellabarba C, Konodi M, Chapman JR. Surgery was done 8 days from the onset of symptoms. Disc herniation can occur in the cervical, thoracic, or lumbar spine. Bransford RJ, Zhang F, Bellabarba C, Lee MJ. Kuzma SA, Doberstein ST, Rushlow DR. Postfixed brachial plexus radiculopathy due to thoracic disc herniation in a collegiate wrestler:A case report. 24-Apr-2019;10:56. (c) T2-weighted sagittal image shows complete resolution of the disc at 5-month follow-up. 1986. (d) Three-dimensional cervical computed tomography (CT) scan shows T1T2 and T3 screw rod fixation on the left side. Pain just below the spine of the scapula. Thoracic herniated discs are less common than herniated discs in the neck or low back, but they do happen. 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 PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Specially in case of T1-T2 disc problem, age plays an important role. Possley, Daniel DO; Luczak, S. Brandon MD; Angus, Andrew MD; Montgomery, David MD. Herniated thoracic discs can cause paralysis. Epub 2016 Jan 28. Background: The authors conducted a 2-year retrospective follow-up to investigate the efficiency of an extraforaminal full-endoscopic approach with foraminoplasty used to treat lateral compressive diseases of the lumbar spine in 247 patients. Along with this when we work with pronated shoulders and fixed neck- chances of problem with D1-D2 disc increases in same frequency. i have a t1-2 herniated disc pinching a nerve, possible thoracic outlet. A disc bulge is not a disc herniation. Calcific discitis with giant thoracic disc herniations in adults. Because thoracic disc herniation can be caused by an injury, it can affect anyone. Epub 2021 Nov 26. 2. Conclusions: 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. There might be some other reasons like- some addiction or something like this, that causes the desiccation of the T1-T2 disc. 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. Federal government websites often end in .gov or .mil. doi: 10.1097/00007632-200111150-00021. 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. Back, Lower Limb, and Upper Limb Pain among U.S. Two females aged 67 and 48 years presented with acute cord infarction and paraparesis, respectively; the modified Japanese Orthopaedic Association (JOA) score for thoracic myelopathy (maximum 11) was 6 and the second patient was 7 [ Table 1 ]. J Neurosurg Spine. Medications, traction, dry needling, and epidural spinal injections can be used with physical therapy to help manage pain and allow the body to heal on its own, says Dr. Good. 35: 329-31, 11. 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. While the anterior approach tends to be a more familiar approach to most spine surgeons, certain anatomic restrictions may limit its use for T1-T2. She also works as an Adult and Pediatric Sexual Assault Nurse Examiner. Cervical radiculopathy is a disease process marked by nerve compression from herniated disk material or arthritic bone spurs. eCollection 2021. A, Right parasagittal T1-, T2-, and STIR-weighted images that demonstrate a discrete fracture line through the pedicles of L4 bilaterally without pedicle marrow signal intensity changes (long arrow) and a less obvious fracture line on T1 images through the L5 pedicle with concomitant type 1 pedicle marrow changes (short arrows). Conclusion: Adjacent-segment degeneration after cervical spine fusion may rarely occur even at T1-T2, and the unusual symptoms of a T1 . BMJ Case Rep. 2014. People who have a herniated disk often have radiating numbness or tingling in the body part served by the affected nerves. 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. If the lower thoracic region is involved, a patient may encounter pain radiating to one or both lower extremities. (e) Showing removal of the sequestrated disc fragment. (g) Post-operative CT AP X-ray: shows the cage in T1T2 disc space. Disc herniation at T1-2. This was excised utilizing a transfacet pedicle-sparing left-sided approach with left-sided T1T3 pedicle screw fixation to avoid instability [ Figure 3 ]. The further down the spine the injury occurs, the greater chance for at least partial recovery. 1 Cervical pathologies causing these radiculopathies include herniated nucleus pulposus and cervical spondylosis. The pain may be centered over the injured disc but may spread to one or both sides of the mid-back. The number one prevention is not smoking. FOIA (a) T2-weighted sagittal magnetic resonance imaging (MRI) shows T1T2 disc herniation. 1998 Jan;88(1):148-50. doi: 10.3171/jns.1998.88.1.0148. First thoracic disc protrusion. Background:Symptomatic T1T2 disc herniations are rare and, in most cases, are located posterolaterally. Thoracic region is the first segment of the thoracic or dorsal spine. 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). 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. Rossitti S, Stephensen H, Ekholm S, von Essen C. The anterior approach to high thoracic (T1-T2) disc herniation. This site needs JavaScript to work properly. J Neurosurg 1998;88:623-633. Anterior surgery can be achieved without sternotomy. [ 1 , 2 , 4 , 5 , 7 - 9 , 11 - 15 , 17 , 18 , 21 , 24 - 26 , 29 , 31 - 33 , 35 - 37 ]. Disc Herniation - Statpearls - NCBI Bookshelf. National Library of Medicine, January 18, 2022. Bookshelf Ruptured thoracic discs. 2017. Also Check: Symptoms Of Heartworm In Dogs. MRI best documents soft T1T2 thoracic discs, while computed tomography is typically optimal for calcified herniations. There was a decreased sensation noted along the left medial forearm and hypothenar region. 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.