Objective. Many surgical approaches have been defined and implemented in the last few decades for thoracic disc herniations. The endoscopic foraminal approach in foraminal, lateral, and far lateral disc hernias is a contemporary minimal invasive approach. This study was performed to show that the approach is possible using the microscope without an endoscope, and even the intervention on the discs within the spinal canal is possible by having access through the foramen. Methods. Forty-two cases with disc hernias in the medial of the pedicle were included in this study; surgeries were performed with transforaminal approach and microsurgically. Extraforaminal disc hernias were not included in the study. Access was made through the Kambin triangle, foramen was enlarged, and spinal canal was entered. Results. The procedure took 65 minutes in the average, and the mean bleeding amount was about 100cc. They were mobilized within the same day postoperatively. No complications were seen. Follow-up periods range between 5 and 84 months, and the mean follow-up period is 30.2 months. Conclusion. Transforaminal microdiscectomy is a method that can be performed in any clinic with standard spinal surgery equipment. It does not require additional equipment or high costs. 1. Introduction Symptomatic thoracic disc herniation is one of the rare degenerative diseases of the spine. Its share among other similar pathologies can be indicated as 0,25 to 1%. Studies conducted on the general population revealed its incidence rate as approximately 1/1000000 patient in one year [1–3]. This rate applies to both women and men, and it is usually observed at ages 30 to 50 [4]. The pathology usually localizes at the medial or mediolateral region and rarely can one see a real lateral localization of the pathology [3, 5]. The rate of incidence for calcified pathologies is 30 to 70% [6, 7]. Decision for the surgical indication is controversial, due to the limited amount of information obtained so far on the natural course of thoracic disc herniation [8, 9]. On the one hand, the necessity of surgical treatment is not a matter of debate in the presence of progressive myelopathy symptoms, but on the other, it is still not clear whether the surgery can fix the symptoms in patients presenting radicular pain. Wood et al. followed up 20 patients, who were randomly diagnosed with thoracic disc pathology, for an average duration of 26 months and reported that the patients were still asymptomatic at the end of this follow-up period [10]. Brown et al. assessed 55 symptomatic patients with thoracic
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