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February 22, 1965

Thoracic-Disk Protrusions

JAMA. 1965;191(8):627-631. doi:10.1001/jama.1965.03080080017004

Sixty-one cases of surgically verified thoracic-disk protrusions (0.5% incidence) revealed that this condition affected both sexes equally, and that it was most common in patients in the fourth to sixth decade and at the lower four thoracic interspaces. The most common symptoms were pain, motor weakness, numbness, and visceral disturbances. Physical examination often revealed sensory loss, spastic paraparesis, hyperreflexia, and Babinski reflexes. Myelography was the most useful diagnostic aid, giving positive results for an intraspinal mass in 49 of 50 patients. The diagnosis is difficult to make clinically because thoracic-disk protrusion mimics many diseases. The surgical procedure most frequently used was complete laminectomy, and when possible the disk was removed extradurally. Postoperative results in patients with minimal neurological deficit have been gratifying, but in those with severe deficits they have been rather discouraging.