Year: 2026
Type: article
Study design: Case Report
Abstract: Objective: Symptomatic thoracic disc herniations (TDH) account for approximately 0.1-3% of all spinal disc herniations and pose a particular surgical challenge due to the ventral location relative to the spinal cord, the narrow spinal canal, and the limited tolerance of the thoracic cord to compression.Traditional approaches include anterior transthoracic, lateral extrapleural, and posterolateral techniques.Full-endoscopic techniques have emerged as minimally invasive alternatives, potentially reducing surgical morbidity and improved perioperative outcomes.In this case series, to our knowledge the first reported from Switzerland, we evaluate the feasibility, safety, and efficacy of full-endoscopic transforaminal thoracic discectomy (FETD) highlighting technical nuances and demonstrating its potential as a reliable minimally invasive option for symptomatic TDH.Methods: This retrospective case series included five consecutive patients who underwent FETD at Sion Hospital, Switzerland, between April 2023 and December 2025.All procedures were performed using fluoroscopic or O-arm navigation.Clinical outcomes were assessed with the modified Japanese Orthopaedic Association (mJOA) score, Nurick grade, and Oswestry Disability Index (ODI).Perioperative data were recorded.Descriptive statistics were used.Results: Five patients (4 male, median age 61 years, IQR 58-69) underwent FETD at T7-T8 to T11-T12, including one central, three paramedian, and one extra-foraminal herniation.Four patients (80%) presented with myelopathy and one (20%) with radicular pain; three (60%) had sensorimotor deficits and gait impairment.Median operative time was 101 minutes (IQR 97-145), and median hospital stay was 1 night (IQR 1-2).At a median follow-up of 6.6 weeks (IQR 6.1-43.3),median mJOA improved from 14 to 16, and median Nurick grade improved from 3 to 2. One incidental durotomy occurred without sequelae, and one patient (20%) required revision surgery at 6 weeks for residual herniation.No infections, respiratory complications, or neurological deterioration were observed.Conclusion: FETD combines minimal invasiveness with effective neural decompression, achieving favorable neurological outcomes.Given its low complication rates and rapid recovery, this technique seems a valuable addition to the surgical armamentarium and may be considered for appropriately selected patients.
Source: Brain and Spine
Institution: Hôpital de Sion
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,950
OpenAlex ID: W7203727596