Spine Archive: Thoracic Disk Herniations

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Thoracic Disk Herniations

Nonsurgical treatment should be considered for patients without long-tract signs or major neurologic deficits. A short trial regimen of bed rest with gradual mobilization and limitation of activities involving axial loading and repetitive flexion and extension can be beneficial. Thoracolumbosacral orthosis bracing may be effective. Pain can be managed symptomatically with nonsteroidal anti-inflammatories, acetaminophen, and/or judicious use of narcotics. Physical therapy involving postural training, hyperextension strengthening, back school, and cardiovascular conditioning should also be attempted.¹

¹Garfin MD, Steven. Orthopaedic Knowledge Update : Spine. Rosemont: American Academy of Orthopaedic Surgeons, 1997.

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Radicular Disk Herniation Pain

The pathways by which a disk herniation can lead to radicular pain likely involve both mechanical and chemical irritation of the nerve root. Mechanical compression can lead to nerve root deformation, local ischemia, and subsequent radiating neuritis. A compounding factor with a disk herniation is the chemical effect of nucleus pulposus material directly on the nerve root that leads to the release of several inflammatory cytokines.¹

¹Garfin MD, Steven. Orthopaedic Knowledge Update : Spine. Rosemont: American Academy of Orthopaedic Surgeons, 1997.