Arthroscopic-assisted uniportal spinal surgery for the treatment of rare T10/T11 thoracic disc herniation: a case report.

BACKGROUND: Thoracic disc herniation (TDH) is rare, with an estimated incidence of 1 per 1,000,000 individuals. Surgical treatment is indicated for those suffering from myelopathy and/or intractable neurological deficit. Open surgical approaches including transthoracic and retropleural access carry substantial perioperative risks. Contemporary minimally invasive endoscopic techniques reduce tissue dissection and manipulation of the thecal sac, yet they are associated with a steep learning curve and limited intraoperative maneuverability. This study reports the case of a 76-year-old male with TDH who underwent decompression using arthroscopic-assisted uniportal spinal surgery (AUSS) for the first time, achieving effective short-term therapeutic outcomes.

CASE PRESENTATION: A 76-year-old male presented with progressive numbness and weakness in both lower extremities persisting for over one month. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed T10/T11 disc herniation with severe compression of the thoracic spinal cord. The herniated nucleus pulposus was excised via AUSS, thereby achieving decompression of the thoracic spinal cord. The patient recovered uneventfully without complications, and postoperative CT and MRI confirmed complete spinal cord decompression.

CONCLUSION: The application of the AUSS technique for the treatment of TDH is feasible. The AUSS approach offers several advantages, including minimal invasiveness, reduced surgical trauma, less blood loss, faster recovery, and greater operational flexibility.