Thoracic Disc Herniation

WHAT YOU SHOULD KNOW:

• A thoracic disc, or intervertebral disc, is a sac filled with a gel-like material found between your vertebrae. Your vertebrae are the bones in your back that are linked together to form your spine. Your thoracic discs and vertebrae are found at the base of your neck down to just below your ribs. Your vertebrae and discs help your spine and body support your weight. Your spine surrounds your spinal cord that contains your nerves. Thoracic disc herniation occurs when the gel-like material bulges or leaks out from between your vertebrae. A weak disc, injury, cracked vertebrae, or scar tissue may cause your disc to herniate. The herniated disc may press on your nerves or spinal cord. A herniated thoracic disc may be painful and decrease your movement.
  
  
• You may feel pain in your back, shoulders, chest, or pelvic area. Your legs may be numb, or they may have a burning or tingling feeling. You may leak urine or stool (bowel movements). You may have trouble walking or moving your legs. You caregiver may check your spine and feel for areas that cause you pain. Imaging tests such as a computed tomography (CT) scan, magnetic resonance imaging (MRI), and a myelogram may be needed. Treatment may include medicines, injections, physical therapy, and surgery. Having your thoracic disc herniation treated may decrease your pain. You may be able to move and function in your daily life better. Treatment may also prevent your nerves or spinal cord from being permanently damaged.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

• You may have an allergic reaction to medicines used for treatment or surgery. Shots into your spine may bruise your back, cause an infection or damage your spinal cord. With surgery, you may bleed more than expected or get an infection. Fluid may build up in your lungs and your lungs may be damaged during surgery. Severe lung damage may lead to death. The covering of you spinal cord may be damaged and cerebrospinal fluid (CSF) may leak out. Your spinal cord may be injured and you may not be able to walk. Even with treatment, you may still feel pain.
  
  
• If your thoracic disc herniation is not treated, your symptoms may worsen. Your bulging disc may continue to press on your spinal cord or nerves causing permanent damage. Your back pain may spread to other areas of your body. Your legs may become numb (unable to feel) or paralyzed (unable to move). Ask your caregiver if you have questions or concerns about your condition, treatment, or care.

WHILE YOU ARE HERE:

Informed consent

is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

An IV (intravenous)

is a small tube placed in your vein that is used to give you medicine or liquids.

Medicines:

• Muscle relaxers: This medicine helps relax your muscles. It is also given to decrease pain and muscle spasms.
  
  
• Pain medicine: Caregivers may give you medicine to take away or decrease your pain.
  
  
  • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.
    
    
  • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.
  
  
• Steroids: Steroid medicine may be given to decrease inflammation, which is pain and swelling.

Treatment options:

• Injection treatments:
  
  
  • Chemonucleolysis: During chemonucleolysis, your caregiver will give you a shot of medicine into your herniated disc. The medicine used for this treatment works by shrinking your bulging disc.
    
    
  • Epidural injections: An epidural injection is medicine given as a shot into the area of your disc herniation. The injection may numb the area and decrease your pain.
    
    
  • Nerve blocks: A nerve block is a shot of medicine into a nerve near the area of your disc herniation. The injection may help to decrease pain and inflammation.
  
  
• Physical therapy: A physical therapist works with you to make your back muscles stronger and decrease your pain. A physical therapist may teach you exercises and stretches that help your back. They may also use massage and other treatments to improve your functioning. With physical therapy, your muscles may be better able to support your spine.
  
  
• Surgery: Surgery may be done to remove your herniated disc and make your spine stronger. Surgery may also be done to decrease pressure on your nerves and spinal cord. You may need an x-ray to help your caregiver plan your surgery. An x-ray is a picture taken of your spine and the areas around it. Ask your caregiver for more information about the different surgeries for herniated discs.
  
  
  • Chest tubes: You may need chest tubes if you have surgery to fix your herniated disc. Chest tubes are tubes inserted around your surgery site to remove extra blood and fluid.
    
    

Tests:

• Imaging tests: These tests may use a dye to help your caregiver see the pictures better. People who are allergic to iodine or shellfish (crab, lobster, or shrimp) may be allergic to some dyes. Tell your caregiver if you are allergic to shellfish or have other allergies.
  
  
  • Computed tomography scan: A computed tomography (CT) scan uses a special machine to take pictures of your spine. You may need a CT scan after surgery to check if the pressure on your spinal cord was relieved.
    
    
  • Magnetic resonance imaging: During magnetic resonance imaging (MRI), pictures are taken of your spine. An MRI may be done to show if your surgery corrected your disc herniation. Never enter the MRI room with any metal objects. This can cause serious injury.
  
  

Learn more about Thoracic Disc Herniation (Inpatient Care)