Endoscopic discectomy is a unique approach to the thoracic spine. It requires a small incision from the back without deflating the lung as in trans-thoracic approach. Spinal fusion is usually unnecessary. The thoracic spinal canal is relatively narrow, which gives a significant advantage for endoscopic surgery.

Hospitalization is usually for one day and recovery period is short.

Anatomy of the thoracic spine
The thoracic spine is composed of 12 vertebrae, between each two vertebrae there is a disc, like in the cervical and lumbar spine. The spinal cord passes through the spinal canal. Nerve roots, one on each side, leave the spinal canal on each intervertebral level.
The spinal cord transmits signals from the brain to the legs and body. It also transmits sensory signals of touch, pain and position sense from the body to the brain. The spinal cord is important for bladder and sexual function.

Pathology of the thoracic spine (degenerative)
When disc herniation occurs, it can cause either radiculopathy with radiating pain or myelopathy due to spinal cord compression.
Spinal stenosis occurs as part of spondyloarthrosis and is relatively rare in the thoracic spine. Rarely the cause can be tumor.

Symptoms
A) Radiculopathy – Pain or numbness “belt like” on either side of the back or chest.
B) Myelopathy – Weakness and spasticity in lower extremities, imbalance, bowel and bladder dysfunction as well as sexual dysfunction.

Indications for surgery
A) Radiculopathy which is intolerable.
B) Myelopathy due to spinal cord compression and neurological signs.
C) MRI of the thoracic spine that correlates with the symptoms.
D) Obligatory AP and lateral X-ray films of the lumbar spine before surgery.