Mr Ben Okafor FRCS (Orth.)

Consultant Orthopaedic and Spinal Surgeon

The spine is composed of 33 vertebrae, uniquely aligned to support the body and provide a passageway for the spinal cord and nerves. At the top of the spine are seven cervical (neck) vertebrae, followed by 12 thoracic vertebrae from which the 12 pairs of ribs originate. Next are 5 lumbar vertebrae, followed by the 5 fused sacral bones (the back of the pelvis) and 4 fused bones of the coccyx (tailbone).

What is thoracic disc herniation?

The cervical, thoracic and lumbar vertebrae are separated from each other by intervertebral discs which cushion and separate the vertebra, providing space for the nerves roots to exit the spinal canal. Discs are composed of cartilage that lies between the bony vertebral bodies of the spine. The disc and vertebral bodies are considered joints since there is motion. The discs are composed of an outer wall of tough fibrous tissue called the annulus fibrosus, and a softer, inner substance called the nucleus pulposus. The nucleus pulposa contains water, which like a water filled balloon, gives cushioning to the disc. If a disc degenerates (a herniated disc), it flattens and puts pressure on the spinal cord. Because the space between the vertebrae is shorter, the bones may put pressure on the nerves also. 

What causes thoracic disc herniation?

The natural curvature of the spine provides the skeleton strength and stability. The curves act like a coiled spring to distribute the mechanical stress as the body moves. As discs age, they lose their water content and begin to degenerate. The annulus fibrosis (outer ring), may also be damaged through general wear and tear or by injury in which the nucleus, under extreme pressure, bulges out through the annulus fibrosis ring.

Can thoracic disc herniation be prevented?

Like other discs in the spine, the thoracic discs are vulnerable to injury when the person practices poor posture. Sensible exercises, designed to strengthen the upper back, help to improve posture and prevent injury. Maintaining a healthy lifestyle with good nutrition is key, as well as preventing accidents. The spine, designed for flexibility, will perform best if cared for properly.

What treatment options are there for thoracic disc herniation?


A discectomy is a surgical procedure in which part or all of an intervertebral disc is removed from the spine. This is commonly done when a disc is herniated (slipped disc) and is causing symptoms of pain and nerve irritation or injury. In the thoracic area, discectomies are usually done through an incision on the side of the ribcage. A small window is created in the bone overlying the disc herniation. The nerve root is gently retracted to expose the disc herniation. The disc material is then removed using special instruments which snip it away.


Fusion is a surgically created solid bone bridge between two or more adjacent (usually freely mobile) bones. In the spine, this procedure is used to create a stability between vertebrae. In order to achieve a fusion, bone must grow across the desired area in a gradual and solid fashion. A number of techniques can increase the chance of this to occur. The basis principle is to place bone tissue (bone graft) into the area of desired fusion, ensure sufficient immobility across that area (brace, cast, spinal instrumentation) and then wait for the fusion to take place (6-9 months or more).

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MRI scan of thoracic disc prolapse

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