Procedures Dr. Joshua Landa Specializes In
The goal of the surgery is to remove all or part of the herniated disc pressing on a nerve root or spinal cord and is called discectomy. Thoracic discectomy can be performed either through the anterior approach (front side) or posterolateral approach (behind and the side).
Anterior approach: This approach usually involves open thoracotomy in which the herniated disc is accessed through the chest cavity. An alternative to open thoracotomy is Video Assisted Thoracic Surgery (VATS). VATS is a minimally invasive surgery that is done through several small incisions and involves the use of thoracoscope, a surgical tool with a tiny camera. Thoracoscope is inserted into the side of the thorax through a small incision to provide real images of the surgical area on a TV screen. These images guide the surgeon to remove the herniated disc using instruments inserted through other small incisions. VATS is minimally invasive and results in quicker recovery than open thoracotomy.
Posterolateral approach: This approach is also called as costotransversectomy. The herniated disc is accessed through the incision on the back of the spine. A window through the bones that cover the herniated disc is created by removing a small part of rib where it connects to the spine (Costo means rib) and transverse process (a small bone attached to the spine). The disectomy is then performed with the small instruments.