STUDY DESIGN: A case report of a 51-year-old man with acute myelopathy owing to T2/3 disc herniation that was treated with transvertebral herniotomy. OBJECTIVES: To report surgical advantages of the transvertebral approach in the upper thoracic spine. SUMMARY OF BACKGROUND DATA: Various surgical approaches to the upper thoracic spine have been reported because the approach is difficult owing to the specific anatomical structure. However, a lack of consensus still remains regarding the choice of operative procedure because of some problems for each approach. METHODS: A 51-year-old man presented acute paraparesis of lower extremities and bladder paralysis owing to T2/3 disc herniation. The herniated disc was removed microscopically by the anterior approach through a 10-mm-diameter hole made in the T2 vertebral body without sternum splitting. RESULTS: Satisfactory decompression was performed. After operation, the patient had full clinical motor and sensory recovery. CONCLUSIONS: Transvertebral approach, which has been recently performed for cervical disc lesion, was also less invasive and safer than the conventional approaches, such as sternum splitting, transthoracic or posterolateral approaches, for our patient with T2/3 disc herniation.
STUDY DESIGN: A case report of a 51-year-old man with acute myelopathy owing to T2/3 disc herniation that was treated with transvertebral herniotomy. OBJECTIVES: To report surgical advantages of the transvertebral approach in the upper thoracic spine. SUMMARY OF BACKGROUND DATA: Various surgical approaches to the upper thoracic spine have been reported because the approach is difficult owing to the specific anatomical structure. However, a lack of consensus still remains regarding the choice of operative procedure because of some problems for each approach. METHODS: A 51-year-old man presented acute paraparesis of lower extremities and bladder paralysis owing to T2/3 disc herniation. The herniated disc was removed microscopically by the anterior approach through a 10-mm-diameter hole made in the T2 vertebral body without sternum splitting. RESULTS: Satisfactory decompression was performed. After operation, the patient had full clinical motor and sensory recovery. CONCLUSIONS: Transvertebral approach, which has been recently performed for cervical disc lesion, was also less invasive and safer than the conventional approaches, such as sternum splitting, transthoracic or posterolateral approaches, for our patient with T2/3 disc herniation.