The thoracic spine is the area of your spine below your neck connected to your ribs. It is made up of 12 vertebral bodies with intervening discs. The disc is a cartilage, gristle like material that sits between your vertebral bodies in all parts of your spine. The disc acts like a cushion and also allows flexibility in your spine. The disc can wear over time as we age or earlier if it is injured. As it wears, or degenerates, the space between the vertebral bodies is reduced.
Thoracic disc degeneration can be a cause of upper or mid back pain. If the disc is severely degenerated, bone spurs can form and limit the mobility of the thoracic spine. The spurs may cause narrowing of the spinal canal and impinge on the spinal cord. If the compression on the spinal cord is severe, it can cause numbness and tingling and possible weakness in the legs.
Thoracic disc degeneration can be seen and diagnosed on x-rays, but an MRI gives a better picture of the extent of the degeneration. An MRI will also show if there is any pressure on the spinal cord from bone spurs or a herniated disc.
In most patients, thoracic disc degeneration is treated non-surgically. Non-impact aerobic exercise (walking, bicycling), back and core strengthening are typically recommended with a physical therapist. If large bone spurs have formed and caused compression on the spinal cord, then surgery may be indicated if there are neurologic symptoms like numbness , tingling, and weakness in the legs. The surgery can be performed anteriorly through the chest cavity, or posterior. The goal of surgery is to remove pressure on the spinal cord. The surgery usually involves a fusion, whereby bone graft is placed along the spine along with rods or a plate to stop motion of the spine in the area of the spine causing the symptoms. If the disc is completely removed, a graft or cage device may be inserted in its place to help the bone fuse or heal. There are no total disc replacements designed or utilized in the thoracic spine.
