Currently, minimally invasive surgical treatments for Thoracic disc herniation (TDH) mainly include Thoracoscopic Surgery, Thoracic Microscopic Discectomy(TMD), Thoracic Microendoscopic Discectomy (TMED), Transforaminal Endoscopic Thoracic Discectomy (TETD), and Unilateral Biportal Endoscopic(UBE) for thoracic disc excision. Compared to traditional open surgery, minimally invasive surgeries offer advantages such as smaller incisions, less intraoperative blood loss, lighter postoperative pain, faster recovery, reduced hospital stay, and cost savings. Different minimally invasive surgical approaches for thoracic disc herniation have their own strengths and weaknesses. When patients have clear surgical indications, the optimal surgical treatment should be chosen based on the patient's specific symptoms and signs, as well as imaging findings, and tailored to their individual circumstances.

Rui Zhu, Hao Wu. Advances in Minimally Invasive Surgical Treatment of Thoracic Disc Herniation. Frontiers in Medical Science Research (2024), Vol. 6, Issue 10: 34-39. https://doi.org/10.25236/FMSR.2024.061005.

[1] Arce CA, Dohrmann GJ: Herniated thoracic disks. Neurol Clin 1985, 3(2):383-392.

[2] Ridenour TR, Haddad SF, Hitchon PW, Piper J, Traynelis VC, VanGilder JC: Herniated thoracic disks: treatment and outcome. Journal of spinal disorders 1993, 6(3):218-224.

[3] Whitmore RG, Williams BJ, Lega BC, Sanborn MR, Marcotte P: A patient with thoracic intradural disc herniation. Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia 2011, 18(12):1730-1732.

[4] Kasliwal MK: Evolution and current status of surgical management of thoracic disc herniation - A review. Clinical neurology and neurosurgery 2024, 236:108055.

[5] Le Roux PD, Haglund MM, Harris AB: Thoracic disc disease: experience with the transpedicular approach in twenty consecutive patients. Neurosurgery 1993, 33(1):58-66.

[6] Benson MK, Byrnes DP: The clinical syndromes and surgical treatment of thoracic intervertebral disc prolapse. The Journal of bone and joint surgery British volume 1975, 57(4):471-477.

[7] Perot PL, Jr., Munro DD: Transthoracic removal of midline thoracic disc protrusions causing spinal cord compression. Journal of neurosurgery 1969, 31(4):452-458.

[8] Farber SH, Xu DS, Walker CT, Godzik J, Turner JD, Uribe JS: Minimally Invasive Retropleural Thoracic Diskectomy: Step-by-Step Operative Planning, Execution, and Results. Operative neurosurgery (Hagerstown, Md) 2022, 23(4):e220-e227.

[9] Mathews HH, Long BH: Minimally invasive techniques for the treatment of intervertebral disk herniation. The Journal of the American Academy of Orthopaedic Surgeons 2002, 10(2):80-85.

[10] Srinivasan ES, Than KD: Commentary: Minimally Invasive Retropleural Thoracic Diskectomy: Step-by-Step Operative Planning, Execution, and Results. Operative neurosurgery (Hagerstown, Md) 2022, 23(4):e230-e231.

[11] Burke TG, Caputy AJ: Treatment of thoracic disc herniation: evolution toward the minimally invasive thoracoscopic technique. Neurosurgical focus 2000, 9(4):e9.

[12] Horowitz MB, Moossy JJ, Julian T, Ferson PF, Huneke K: Thoracic discectomy using video assisted thoracoscopy. Spine (Phila Pa 1976) 1994, 19(9):1082-1086.

[13] Karmakar MK, Ho AM: Postthoracotomy pain syndrome. Thoracic surgery clinics 2004, 14(3):345-352.

[14] Landreneau RJ, Hazelrigg SR, Mack MJ, Dowling RD, Burke D, Gavlick J, Perrino MK, Ritter PS, Bowers CM, DeFino J et al: Postoperative pain-related morbidity: video-assisted thoracic surgery versus thoracotomy. The Annals of thoracic surgery 1993, 56(6):1285-1289.

[15] Rosenthal D, Dickman CA: Thoracoscopic microsurgical excision of herniated thoracic discs. Journal of neurosurgery 1998, 89(2):224-235.

[16] Anand N, Regan JJ: Video-assisted thoracoscopic surgery for thoracic disc disease: Classification and outcome study of 100 consecutive cases with a 2-year minimum follow-up period. Spine (Phila Pa 1976) 2002, 27(8):871-879.

[17] Court C, Mansour E, Bouthors C: Thoracic disc herniation: Surgical treatment. Orthopaedics & traumatology, surgery & research : OTSR 2018, 104(1s):S31-s40.

[18] Kerezoudis P, Rajjoub KR, Goncalves S, Alvi MA, Elminawy M, Alamoudi A, Nassr A, Habermann EB, Bydon M: Anterior versus posterior approaches for thoracic disc herniation: Association with postoperative complications. Clinical neurology and neurosurgery 2018, 167:17-23.

[19] Bartels RH, Peul WC: Mini-thoracotomy or thoracoscopic treatment for medially located thoracic herniated disc? Spine (Phila Pa 1976) 2007, 32(20):E581-584.

[20] Chi JH, Dhall SS, Kanter AS, Mummaneni PV: The Mini-Open transpedicular thoracic discectomy: surgical technique and assessment. Neurosurgical focus 2008, 25(2):E5.

[21] Khoo LT, Smith ZA, Asgarzadie F, Barlas Y, Armin SS, Tashjian V, Zarate B: Minimally invasive extracavitary approach for thoracic discectomy and interbody fusion: 1-year clinical and radiographic outcomes in 13 patients compared with a cohort of traditional anterior transthoracic approaches. Journal of neurosurgery Spine 2011, 14(2):250-260.

[22] Kasliwal MK, Deutsch H: Minimally invasive retropleural approach for central thoracic disc herniation. Minimally invasive neurosurgery : MIN 2011, 54(4):167-171.

[23] Cerillo A, Carangelo B, Bruno MC, Panagiotopoulos K, Santangelo M, Vizioli L: Paravertebral retropleuric microsurgery approach to the treatment of thoracic disc herniation. Personal experience and consideration of unsatisfactory results. Journal of neurosurgical sciences 2002, 46(3-4):135-142.

[24] Cho JY, Lee SH, Jang SH, Lee HY: Oblique paraspinal approach for thoracic disc herniations using tubular retractor with robotic holder: a technical note. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society 2012, 21(12):2620-2625. 

[25] Regev GJ, Salame K, Behrbalk E, Keynan O, Lidar Z: Minimally invasive transforaminal, thoracic microscopic discectomy: technical report and preliminary results and complications. The spine journal : official journal of the North American Spine Society 2012, 12(7):570-576.

[26] Perez-Cruet MJ, Kim BS, Sandhu F, Samartzis D, Fessler RG: Thoracic microendoscopic discectomy. Journal of neurosurgery Spine 2004, 1(1):58-63.

[27] Isaacs RE, Podichetty VK, Sandhu FA, Santiago P, Spears JD, Aaronson O, Kelly K, Hrubes M, Fessler RG: Thoracic microendoscopic discectomy: a human cadaver study. Spine (Phila Pa 1976) 2005, 30(10):1226-1231.

[28] Smith JS, Eichholz KM, Shafizadeh S, Ogden AT, O'Toole JE, Fessler RG: Minimally invasive thoracic microendoscopic diskectomy: surgical technique and case series. World neurosurgery 2013, 80(3-4):421-427.

[29] Benzel EC, Perry TG: Minimally invasive thoracic microendoscopic diskectomy: a tool for all surgeons? World neurosurgery 2013, 80(3-4):319-321.

[30] Silva JDS, Carelli LE, de Oliveira JAA, de Araújo RML: Full-endoscopic discectomy for thoracic disc herniations: a single-arm meta-analysis of safety and efficacy outcomes. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society 2023, 32(4):1254-1264.

[31] Choi KY, Eun SS, Lee SH, Lee HY: Percutaneous endoscopic thoracic discectomy; transforaminal approach. Minimally invasive neurosurgery : MIN 2010, 53(1):25-28.

[32] Nie HF, Liu KX: Endoscopic transforaminal thoracic foraminotomy and discectomy for the treatment of thoracic disc herniation. Minimally invasive surgery 2013, 2013:264105.

[33] Bae J, Chachan S, Shin SH, Lee SH: Transforaminal endoscopic thoracic discectomy with foraminoplasty for the treatment of thoracic disc herniation. Journal of spine surgery (Hong Kong) 2020, 6(2):397-404.

[34] Bae J, Kim J, Lee SH, Kim JS: Comparative Analysis of Transforaminal Endoscopic Thoracic Discectomy and Microscopic Discectomy for Symptomatic Thoracic Disc Herniation. Neurospine 2022, 19(3):555-562.

[35] Telfeian AE, Wagner R: Transforaminal endoscopic thoracic discectomy: surgical technique. Journal of spine surgery (Hong Kong) 2023, 9(2):166-175.

[36] Gao, F., & Feng, H. Progress in the Application of Unilateral Biportal Endoscopic Technique in Degenerative Spinal Diseases. International Journal of Orthopedics 2023, 44(01), 44-48.

[37] Hu, Z., Yang, Y., Zhao, S., Zhang, Q., Zhang, T., & Liu, L. Clinical Application and Prospects of Unilateral Biportal Endoscopic Technique. Journal of Military Medicine 2024, 49(03), 349-354.