Hi,
I imagine that the reason you had a hard time finding information on
this condition is that 'toracic disk erniation' is a phonetic spelling
of 'thoracic disc herniation'.
I know it might seem odd, but the best way for you to understand this
problem is to look at a turkey neck - the part you toss or make into
soup when you cook a turkey dinner.
The human spine looks very much like that. Each of the bones fits into
the one beneath it. The hole in the center is where your nerves run
through.
The thorax is the part of your spine located between the end of your
neck and just above your waistline - your upper back. Ok, so far?
The bones have a cushion between them, a piece of soft, spongy,
gelatinous material - to keep them from rubbing together and to allow
you to bend and stretch without damaging them. The cushions between
each of the 12 vertebrae (bones) in the thorax is called a thoracic
disc. These discs are the shock absorbers of the upper back. There are
other spinal areas and the discs are named for the vertebra that they
cushion. You can see a drawing of the different regions of the spine
at: http://www.informeddecision.com/anatomy/normal.htm
When everything is fine, the spinal cord with all of the nerves that
let your brain communicate with your body, is held in place and
protected by this structure. That's the purpose of your spine.
Because humans stand upright, the spine takes a lot of pressure during
our daily activities. There is constant pressure on the discs as you
move around. Sometimes, just through normal wear and tear, the disks
get weak. This is called degenerative disc disease.
Think of the disc as sort of small balloon filled with a mushy
material - like thickened jello. The jello balloon is kept in place by
a thick ring of fibrous material. When a contents of the disc ruptures
or bulges through its surrounding fibrous band, it is called a disc
herniation. The herniated disc can cause pressure on the nerve
bundlethat it is supposed to be protecting. If you've heard people
talk about a "pinched nerve," that's what they are describing.
http://www.informeddecision.com/anatomy/abnormal.htm
shows a herniated disc and gives the technical names of the parts of
the disc involved.
Disc herniations may heal spontaneously in four to six weeks - about
80% do.
The clinical symptoms of a herniated thoracic disc are usually easy to
spot. When you have a herniated disc in the thoracic region of your
spine it may limit movement of your upper back. Moving your upper back
may be painful and you may experience pain or tingling from the upper
back that radiates to your chest. You may have pain when you cough,
sneeze or take a deep breath because all of these require movement in
your back muscles that cause pressure to be placed on the disc. Other
symptoms may be numbness or weakness in your legs. Remember, your
spine encases your spinal cord - the bundle of nerves that allows your
body to send and recieve messages to the brain. A nerve that passes
through the thoracic area is responsible for sending messages to your
legs. If that nerve is "pinched" your legs will be affected.
For some doctors opinions see:
http://www.back.com/faq-symptomsherniated.html
For the same reason you may wind up with problems involving your
bowels or bladder. This condition is not usually associated with
thoracic disc herniation. The lower (lumbar) discs are usually the
culprits in this case. If you are having this symptom - see your
doctor immediately! It may be an indication of a serious complications
called cauda equina syndrome.
http://www.spinesolver.com/cauda_equina_syndrome.htm
The usual tests that are used to diagnose a herniated disc are:
CT scan or CAT scan (Computed Tomography Imaging) this is a series of
X-ray pictures of your upper back - http://imaginis.com/ct-scan/
MRI (magnetic resonance imaging) is a picture of your upper back
produced by a machine that uses magnets to create an image of specific
tissue in your body. A good, simple explanation of this procedure can
be found at: http://www.howstuffworks.com/mri.htm
Myelogram/CT
This test is not used very often, but may be necessary if the MRI does
not produce clear results. In the myelogram, a contrast medium,
usually water soluble dye is injected into the spinal space and a scan
is taken of the upper back. Patient directives that explain the
procedue are at: http://www.neurosurgeon.com/conditions/myelogram.htm
What can cause this condition?
There are chronic and acute causes. It may be a chronic degenerative
breakdown of the tissues. The cause of this may be a genetic
predisposition or it may be caused by smoking! Scoliosis, a curving of
the spine that often affects the thoracic area may be responsible for
putting pressure on these vertebrea. An injury in the past may have
weakened the area and the damage can be climaxed by a sudden movement
or an additional trauma to the area.
This condition can also be acute - that is appearing suddenly - the
cause of an acute episode is normally a severe injury or tumor growth.
Exercises to strengthen the muscles supporting the spine and backare
used to relieve the pressure on the area that is damaged.
Non-steroidal anti-inflammatory drugs (NSAIDs) are often used to
relieve pain. Surgery is not normally recommended unless the pain is
not manageable through use of pain killers.
When surgery is recommended there are several minimally invasive
techniques available:
- Percutaneous Endoscopic Laser Discectomy
- Microscopic Laser Discectomy
- Percutaneous Cervical Disc Surgery
- Spinal Surgery Through Thoracic Endoscope
- Ligamentoplasty
- ALIF(Anterior Lumbar Interbody Fusion)
- Laparoscopic Spinal Operation
A complete description of thoracic disc surgeries can be found at:
http://www.wooridulspine.com/english/surgical.html
If you have a strong stomach and want to see what the endoscopic
surgery looks like from the doctors viewpoint try:
http://www.spinecenter.com/Presentations/Berlin%202000/MEAD%20BERLIN/index_files/frame.htm
It is a presentation of a surgery close up. Very interesting, but a
bit graphic.
The search terms I used tofind this information were: thoraic disc
herniation
and a second search for: minimally invasive surgery thoracic disc
Most of the information on minimallyinvasive surgery id focused on the
lumbar region. Even adding in the thoracic disc terms resulted inmany
articles referring to lumbar or cervical surgeries. Be sure to check
when you look at the articles from your search.
Hope this helps,
bcguide-ga |
