title: Surgical treatment for thoracic disc herniation: an update.
abstract: METHODS
  Retrospective review of the literature.
  
  
  OBJECTIVE
  To update recent trends in the surgical treatment for thoracic disc herniation (TDH).
  
  
  BACKGROUND
  TDH is rare; however, it is usually accompanied by myelopathy and is indicated for surgical treatment. A variety of surgical approaches have been described to reach these anatomically challenging lesions.
  
  
  METHODS
  Review of the literature.
  
  
  RESULTS
  Recently, minimally invasive techniques for TDH have gained popularity. These include thoracoscopic and mini-open anterolateral retropleural approaches, as well as microscopic and endoscopic surgery. In addition, this article updates important aspects of surgical treatment for TDH such as definition of surgical level, treatment of calcified and/or giant disc, multilevel lesions, and fusion requirements.
  
  
  CONCLUSIONS
  Definition of surgical level is imperative in the surgical treatment for TDH. Outcomes of minimum invasive surgery are satisfactory. Type of disc herniation and biomechanical stability are the important factors for surgical planning.
authors.affiliation: *Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, NY; and †Department of Orthopaedic Surgery, SUNY Downstate Medical Center, Brooklyn, NY.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yoshihara
mesh_terms: D003952:Diagnostic Imaging / Q000379:methods; D006801:Humans; D007403:Intervertebral Disc / Q000473:pathology / Q000601:surgery*; D007405:Intervertebral Disc Displacement / Q000175:diagnosis / Q000601:surgery*; D019060:Minimally Invasive Surgical Procedures; D019637:Orthopedic Procedures / Q000009:adverse effects / Q000639:trends; D011237:Predictive Value of Tests; D013123:Spinal Fusion; D013904:Thoracic Vertebrae / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome