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Back Hernia (Thoracic Disc Hernia)

What is Back Hernia (Thoracic Disc Hernia)?

Back herniation occurs with the surge of the gelatine-like material between the vertebral bones from the disc. While the formation mechanisms of the neck, loins and back hernia are similar, back hernia’s giving symptoms are rarer.

What are the Symptoms of Back Hernia (Thoracic Disc Hernia)?

The clinical symptoms of thoracic disc hernia have a wide variety and may differ from case to case. The most frequent symptoms of the disease are wide back pains whose area cannot be described, and sensory disorders in which numbness is the case. The most dangerous finding of it is weakness and losses in bladder/intestine sphincter functions. The pain is generally described as in type of burning or stabbing. It is a consistent or periodical back or flank pain. The pain may also be described in type of a belt. The back hernia of thoracic region may cause risky clinical results because the canal in the vertebral bones in which the spinal cord passes is narrow. Because it advances insidiously, that is, may advance as asymptomatic without reflecting any clinical issues, there is a chance of an already developed impairment in the spinal cord when it is detected. Therefore, patients with similar complaints should consult a brain and nerve surgery clinic as soon as possible.

How the diagnosis of Back Hernia (Thoracic Disc Hernia) is made?

The most important method of diagnosis is an examination of a doctor who is a specialist in spinal surgery. Direct graphy which is one of the supportive imaging methods for the diagnosis gives information about the array of the structures of bones and joints. Tomography guides on the calcification of the hernia in this area. The most important imaging method which helps diagnosis is MR. Thanks to MR, which is consulted for the best assessment of the soft tissues named as connective and muscular tissues, a detailed information about the existence, size and the pressure of the hernia on the spinal cord or nerve roots may be acquired. Besides, the electrophysiological tests named as MEP and SEP may be useful for the diagnosis. With these tests, it can be checked whether there is an impairment caused by these types of hernia which are detected by the imaging or they may give an idea if there is a need for surgery.

How is the treatment of Back Hernia (Thoracic Disc Hernia) done?

The most important step in thoracic discs is the detection of the pressure area of the hernia. If the hernia presses on the nerve root and causes no myelopathy (spinal cord injury), the treatment is planned as conservative. If no clinical healing occurs with medication, physical treatment is applied. Besides, an injection therapy for the disc and pain may be applied. If there is a neurological loss like progressive weakness with the pressure of the disc on the spinal cord, surgical intervention is planned. Differing from hernia of the loins, there are surgical options like frontal or lateral accession within thorax, or from behind with taking some of the ribs.

What should be noted after Back Hernia (Thoracic Disc Hernia) Treatment?

If the recovery is ensured with conservative treatments regarding pain, it is recommended to have an examination by a FTR specialist to arrange a suitable exercise and rehabilitation program. While duration of recovery is approximately 4 weeks after surgery in the cases which necessitate it, it is vital to abide the recommendations of the doctor who executed the operation regarding movement, walking and wound care. It is needed to consult the centre where the operation was executed when the situations like difficulty in breathing, discharge in the wound, back pain, severe pain or weakness occur after the surgery.

Why should I have the Treatment of Back Hernia (Thoracic Disc Hernia) in Memorial Health Group?

Memorial Health Group Centres for Orthopedics provide service with their experienced staff, modern technologies and understanding of multidisciplinary treatment. Team work is the principle in all diagnosis-treatment processes applied in Memorial Health Group. Regarding the treatment of Back Hernia; the departments of Brain and Nerve Surgery, Spinal Surgery, Physical Treatment & Rehabilitation and Neurology work in coordination. For the patients whose complaints continued with medical and physical treatments, or who need injection or surgery, our patients can have treatment in comfort and regain their health in our institution where the operation rooms and technical equipment are furnished with the latest technology.

Frequently Asked Questions about Back Hernia (Thoracic Disc Hernia) (FAQ)

What are the reasons of Back Hernia (Thoracic Disc Hernia)?

Among the formation mechanisms of back hernia, deterioration of the small pads of this area by losing their liquid because of aging is an important factor. Besides, deterioration or tearing of the ligaments which surround these small pads and prevent their discharge provide a basis for the formation of the herniated disc.

-What causes herniated disc?

The most important factor of disc herniation is the participation of the cumulative effect caused by physical compulsion named as minor trauma in the alterations of the aged spinal joints within years. This type of formation is a long process which develops in years. High energy traumas (like falling from upland, traffic accident etc.) and sports injuries which develop with sudden movements may also cause back herniation.

-What happens if back hernia is left untreated?

When back hernia is left untreated, an increase in pain in cases of physical compulsions is expected. Besides, the areas of hernia activity enlarge with the growth of hernia and severity of pain. When no treatment is applied in cases of chronical pain, calcification and neural pressure in vertebral joints, a permanent neural damage (lose in sense/strength, deterioration in hot/cold distinction, deep sensory impairment (vibration and body position feelings), loss in bladder/intestine sphincter functions, neuropathic pain) may occur.

-I have back pain and an MR result which reveals a herniated disc. Do I need an operation?

Decision of operation is taken by evaluating the history of disease, findings of back hernia and MR image together. According to clinical researches, need for surgical operation occurs less than 1 per cent of the back hernia cases. If there are no findings which necessitate a surgical operation, back hernia should be treated with medications.

-Why do I feel pain in my leg if I have back hernia?

Back hernia may cause different complaints depending on the vertebral level and the neural area on which hernia makes a pressure. In the hernia types with midline placement, pain may be felt in legs because of the irritation in sensory nerves which move into leg as a result of the pressure on the spinal cord. On the other hand, development of leg pain in back hernia is far less frequent than the complaint of pain caused by hernia of the loins.

-May back hernia heal on its own?

Like hernia in loins and neck, back hernia may heal with rest as well. It has been seen in the researches and radiological images of some patients that the entire or most of the back hernia has been cleared away (spontaneous resolution/regression). While the effective mechanisms on this context have not been proven yet clearly, it is recommended to consult the relevant specialist for monitoring and treatment of back hernia.

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