Thoracic disc herniation is a relatively rare yet challenging-to-diagnose condition. Currently there is no universally accepted optimal surgical treatment for symptomatic thoracic disc herniation. Previously reported surgical approaches are often associated with high complication rates. Here we describe our minimally invasive technique of removing thoracic disc herniation, and report the primary results of a series of cases. Between January 2009 and March 2012, 13 patients with symptomatic thoracic disc herniation were treated with endoscopic thoracic foraminotomy and discectomy under local anesthesia. A bone shaver was used to undercut the facet and rib head for foraminotomy. Discectomy was achieved by using grasper, radiofrequency, and the Holmium-YAG laser. We analyzed the clinical outcomes of the patients using the visual analogue scale (VAS), MacNab classification, and Oswestry disability index (ODI). At the final follow up (mean: 17 months; range: 6–41 months), patient self-reported satisfactory rate was 76.9%. The mean VAS for mid back pain was improved from 9.1 to 4.2, and the mean ODI was improved from 61.0 to 43.8. One complication of postoperative spinal headache occurred during the surgery and the patient was successfully treated with epidural blood patch. No other complications were observed or reported during and after the surgery. 1. Introduction Thoracic disc herniation is an uncommon condition. Although conservative treatment works well for many patients with thoracic disc herniation, surgical treatment is needed for patients suffering from myelopathy and/or neurological deficit caused by thoracic disc herniation. In the past decade, quite a few surgical procedures have been reported in the literature, and each of them has its own advantages and disadvantages [1–14]. Currently there is no universally accepted optimal surgical treatment for symptomatic thoracic disc herniation. Minimally invasive spine surgery has proven safe and effective in treating lumbar and cervical herniations [15–24]. The advantages of minimally invasive techniques have compelled many physicians to explore the feasibility of using minimally invasive techniques in treating thoracic disc herniation, and a number of authors have reported encouraging primary results [14, 25–28]. Based on our extensive experience with treating lumbar and cervical disc herniation using minimally invasive techniques, we have developed an endoscopic transforaminal foraminotomy and discectomy technique for treating thoracic disc herniation. The purposes of this paper are to describe the
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