Endoscopic Interlaminar Decompression for T1-T2 Thoracic Disc Herniation: A Case Report.

Symptomatic thoracic disc herniation (TDH) is a rare entity, accounting for less than 4% of all surgically treated disc herniations, yet it can produce devastating myelopathy because of the precarious vascular supply and limited anatomic reserve of the thoracic spinal cord. Traditional open approaches, such as transthoracic discectomy and costotransversectomy, are effective but carry substantial approach-related morbidity. Full-endoscopic Interlaminar thoracic discectomy has recently emerged as a minimally invasive alternative that allows ventral cord decompression through a small skin incision, with reduced blood loss, shorter hospital stay, and the option of awake surgery. We report the case of a 58-year-old man who presented with progressive mid-back pain, lower-extremity weakness, gait instability, and a sensory level at T10. Magnetic resonance imaging (MRI) and computed tomography (CT) demonstrated a right paracentral soft disc herniation at the T1-T2 level with significant ventral cord compression. The patient underwent a full-endoscopic interlaminar thoracic discectomy under general anesthesia. Postoperative imaging confirmed complete decompression of the spinal cord, and the patient experienced rapid neurological recovery with resolution of mid-back pain and substantial improvement in lower-extremity strength and gait at six-month follow-up. This case adds to the growing evidence supporting full-endoscopic discectomy as a safe and effective treatment option for selected patients with symptomatic TDH and highlights the technical feasibility of ventral cord decompression through an interlaminar endoscopic corridor.