Minimally Invasive Thoracic Discectomy Instructional Video: 2-Dimensional Operative Video.

Thoracic degenerative disk disease and disk herniation can be associated with significant morbidity.(1,2) A minimally invasive approach for thoracic discectomy can be achieved through the costotransverse approach. This approach uses a microscope and a minimally invasive tubular portal system through a small horizontal or vertical paraspinal incision just lateral to the costotransverse junction. A high-speed drill is used to remove a portion of rib head, lateral facet, and superior margin of the pedicle to gain access to the foramen and disk space for decompression. This video demonstrates the operative technique for minimally invasive costotransverse approach thoracic discectomy. We performed this operation on a patient who presented with debilitating thoracic radicular pain. After discussing the risks and benefits of the procedure, the patient consented to the procedure, a minimally invasive thoracic discectomy was performed, and a satisfactory clinical outcome was achieved with no complications and complete resolution of pain at 2 months of follow-up.