Despite the successful application of percutaneous endoscopic thoracic discectomy (PETD), its technical feasibility and outcomes for symptomatic upper and midthoracic disc herniation have not been reported yet. The purpose of this article was to evaluate the feasibility of the percutaneous transforaminal endoscopic approach to remove disc herniations in the upper and midthoracic spine. Fourteen consecutive patients (mean age, 42.4 years; 12 males, 2 females) who underwent PETD were included in the analysis. The procedure was performed under local anesthesia and intravenous sedation using the standard endoscopy instrument set. The transforaminal approach combined with foraminoplasty was used to access the herniated areas. Treatment outcomes were evaluated using visual analogue scale (VAS) scores, Oswestry Disability Index (ODI) scores, and the modified MacNab criteria. Four discectomies were performed at T2–3, 5 at T3–4, and 5 at T5–6. The mean follow-up period was 43.4 months, and all patients showed statistically significant postoperative improvement (VAS: 7.3 to 2.3, ODI: 53.5 to 16.9, p<0.05 for all). No serious complications were reported during follow-up. PETD for upper and midthoracic disc herniation is a feasible and effective minimally invasive treatment option with favorable clinical results.
Citations
Citations to this article as recorded by
Safety and Efficacy of Real-Time Intraoperative Ultrasound-Guided Posterolateral Thoracic Diskectomy: Using Technology to Minimize Complication and Improve Surgical Outcome Weiye Zhang, Marc Prablek, Ashel Chelsea Dsouza, Lee A. Tan Operative Neurosurgery.2026; 31(1): 20. CrossRef
Complications in Thoracic Minimally Invasive Spine Surgery (2013–2024): A Systematic Review Sean Inzerillo, Chibuikem A. Ikwuegbuenyi, Eesha Gurav, Noah Willett, Mousa Hamad, Ibrahim Hussain, Alan Hernández-Hernández, Galal Elsayed, Osama Kashlan, Roger Härtl Journal of Clinical Medicine.2026; 15(1): 363. CrossRef
Early efficacy and safety of spinal endoscopy assisted anterior cervical discectomy and fusion in the treatment of cervical spondylotic myelopathy Haijun Ma, Lijuan Zhan, Mingkui Shen, Zhongxin Tang, Jun Tan Frontiers in Oncology.2026;[Epub] CrossRef
Interventional radiology management of disc herniation: a narrative review Salvatore Alessio Angileri, Carolina Lanza, Serena Carriero, Marianna Platì, Chiara Perazzo, Maria Francesca Girlando, Donatello Berloco, Maria Luisa Franzone, Chloe Yeabin Jung, Giovanni Maria Rodà, Pasquale Grillo, Pierluca Torcia, Pierpaolo Biondetti, La radiologia medica.2026;[Epub] CrossRef
Strategies for Optimizing Clinical Outcomes in Minimally Invasive Spine Surgery Chibuikem A. Ikwuegbuenyi, Sean Inzerillo, Evan Wang, Ibrahim Hussain Neurosurgery.2025; 96(3S): S139. CrossRef
Transforaminal Endoscopic Thoracic Discectomy Is More Cost-Effective Than Microdiscectomy for Symptomatic Disc Herniations Junseok Bae, Pratyush Shahi, Sang-Ho Lee, Han-Joong Keum, Ju-Wan Seok, Yong-Soo Choi, Jin-Sung Kim Neurospine.2025; 22(1): 118. CrossRef
UBE Therapy for Dual‐Segment Thoracic Disc Herniation Shiwei Ren, Zhengqi Chang, Junling Pan, Poulami Jha Case Reports in Medicine.2025;[Epub] CrossRef
Thoracic spine endoscopic techniques Jian Shen, Daniel K. Park, Albert E. Telfeian Seminars in Spine Surgery.2024; 36(1): 101085. CrossRef
The Transaxillary Approach as a Direct Route in the Management of Upper Thoracic Spine Pathology: A Technical Note with Case Series Syed Ifthekar, Ju-Wan Seuk, Ui Dong Hwang, Hyung Chang Lee, Sang-Ho Lee, Junseok Bae Asian Spine Journal.2024; 18(2): 265. CrossRef
Evolution, Current Trends, and Latest Advances of Endoscopic Spine Surgery Sharvari Gunjotikar, Malcolm Pestonji, Masato Tanaka, Tadashi Komatsubara, Shashank J. Ekade, Ahmed Majid Heydar, Huynh Kim Hieu Journal of Clinical Medicine.2024; 13(11): 3208. CrossRef
Uniportal, Transforaminal Endoscopic Thoracic Discectomy: Review and Technical Note Sang Hun Lee, Farah N. Musharbash Neurospine.2023; 20(1): 19. CrossRef
A modified percutaneous transforaminal endoscopic surgery for central calcified thoracic disc herniation at the T11/T12 level using foraminoplasty and decompression: A case report Hou Lisheng, Tian Suhuai, Zhang Dong, Zhou Qing Frontiers in Surgery.2023;[Epub] CrossRef
The Growing Popularity of MISS: A Focus on Endoscopic Surgery for the Cervical and Thoracic Spine Junseok W Hur, Subum Lee, Bum-Joon Kim, Se-Hoon Kim Journal of Minimally Invasive Spine Surgery and Technique.2023; 8(1): 5. CrossRef
Thoracic endoscopic surgery: advantages and limitations Mohamed Ragab Nagy Egyptian Journal of Neurosurgery.2023;[Epub] CrossRef
Development of an Endoscopic Spine Surgery Program Benjamin K. Stone, Ria Paradkar, George M. Anderson, Alan Daniels, Sravisht Iyer, Peter B. Derman, Albert E. Telfeian, Bryce Basques JBJS Open Access.2023;[Epub] CrossRef
T3-T4 Disc Herniations: Clinical Presentation, Imaging, and Transaxillary Approach Erwin M.J. Cornips, Bart Maesen, Gijs Geskes, Jos G. Maessen, Emile A.M. Beuls, Tomas Menovsky World Neurosurgery.2022; 158: e984. CrossRef
Full Endoscopic Surgery for Thoracic Pathology: Next Step after Mastering Lumbar and Cervical Endoscopic Spine Surgery? Junseok Bae, Sang-Ho Lee, Ralf Wagner, Jian Shen, Albert E. Telfeian, Kai Uwe Lewandrowski BioMed Research International.2022;[Epub] CrossRef
Full endoscopic surgery for thoracic pathology: an assessment of supportive evidence Rory D. S. Gibson, Ralf Wagner, J. N. Alastair Gibson EFORT Open Reviews.2021; 6(1): 50. CrossRef
Per Pedicel‐Ligament Flavum Tunnel Outside‐In Foraminoplasty for T10–T12 Discectomy under a Percutaneous Endoscope Wei Lin, Wei Liu, Wen‐ting Ma, Yuan Xue Orthopaedic Surgery.2021; 13(1): 253. CrossRef
Expanded Indications of Full Endoscopic Spine Sugery Ajay Krishnan, Hyeun Sung Kim, Aditya Raj, Bharat R Dave Journal of Minimally Invasive Spine Surgery and Technique.2021; 6(Suppl 1): S130. CrossRef
Thoracic vertebra interbody fusion surgery with robotic assisted system in a swine model Abuzer Güngör, Gürkan Berikol, Mehmet Berke Göztepe, Baris Ozoner, Murat Şakir Ekşi Journal of Clinical Neuroscience.2021; 92: 85. CrossRef
Safe Extraforaminal Docking and Floating Technique in Transforaminal Endoscopic Discectomy for Thoracolumbar Junction for Calcified Disc Herniation: A Case Report and Technical Review Junction for Calcified Disc Herniation Pang Hung Wu, Hyeun Sung Kim, Harshavardhan D Raorane, Dong Hwa Heo, Yeon Jin Yi, Kyung-Hoon Yang, Il-Tae Jang Journal of Minimally Invasive Spine Surgery and Technique.2020; 5(1): 26. CrossRef
Current and Future of Endoscopic Spine Surgery: What are the Common Procedures we Have Now and What Lies Ahead? Hyeun Sung Kim, Pang Hung Wu, Il-Tae Jang World Neurosurgery.2020; 140: 642. CrossRef
Transforaminal Endoscopic Discectomy for Hard or Calcified Lumbar Disc Herniation: A New Surgical Technique and Clinical Outcomes Sang-Ha Shin, Jun-Seok Bae, Sang-Ho Lee, Han-Joong Keum, Won-Seok Jang World Neurosurgery.2020; 143: e224. CrossRef
Overview of Minimally Invasive Spine Surgery Parthik D. Patel, Jose A. Canseco, Nathan Houlihan, Alyssa Gabay, Giovanni Grasso, Alexander R. Vaccaro World Neurosurgery.2020; 142: 43. CrossRef
Transforaminal Endoscopic Thoracic Discectomy: Technical Review to Prevent Complications Gun Choi, Diego Munoz-Suarez Neurospine.2020; 17(Suppl 1): S58. CrossRef
Transforaminal Endoscopic Discectomy for Large, Two Level Calcified, Thoracic Disc Herniations With 5-Year Follow-up Karlo Houra, Robert Saftic Neurospine.2020; 17(4): 954. CrossRef
First
Prev
