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Thoracic Disc Extrusion

A thoracic disc extrusion is a condition in which a disc of cartilage between two vertebrae in the thoracic (mid-back) region of the spine ruptures. During a disc rupture, the inner disc material breaches the outer wall and leaks into the spinal canal. This condition is rare in the thoracic region of the spine due to its relative stability and reinforcement from the surrounding rib cage.

Causes

Age is typically the reason intervertebral discs degenerate and become susceptible to bulging and herniation. The age-related weakening of disc cartilage in the spine is a condition commonly called degenerative disc disease. As a disc dehydrates and loses strength over time, the tough outer wall, called the annulus fibrosus, may structurally break down and tear due to stress from the surrounding vertebrae. This could cause the jelly-like core, known as the nucleus pulposus, to seep out of the crack. Additional factors such as obesity, cigarette smoking, and genetics can all contribute to degenerative disc disease. A thoracic disc extrusion may also be caused by a traumatic injury to the upper body. Playing full contact sports, being in a car accident, or sustaining a fall where the mid- to upper body absorbs most of the force could all set the stage for a disc extrusion.

Symptoms

Symptoms developing from a thoracic disc extrusion can depend on the direction toward which the disc material is expelled. A central extrusion occurs when the material is pushed straight back toward the spinal canal. The spinal canal is usually narrower in the thoracic region, which means the chances of the disc material directly compressing the spinal cord may be higher. Direct compression could cause upper back and chest pain. In severe cases of a thoracic central disc extrusion, paralysis from the waist down can occur. If the extrusion occurs laterally, or to the side of the disc, the disc material may impinge upon a nerve root as it exits one of the foramina, or the nerve canals on either side of a vertebra. This may cause radiating pain in the abdominals, chest, or inner arms.

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Treatment

Your physician may recommend a course of conservative treatments, including rest, pain medication, core muscle strengthening exercises, and low-impact activity such as walking and swimming. Conservative treatments often help alleviate pain over a period of several weeks or months. However, symptoms from a thoracic disc extrusion or other spinal condition may not subside with conservative options.

Please note: Laser Spine Institute currently does not perform endoscopic procedures on the thoracic spine.