Posterolateral endoscopic thoracic discectomy procedures are often performed on herniated thoracic discs. The thoracic spine is the area of the back or torso between the bottom of the neck and the lower back. An endoscopic approach to this procedure provides a minimally invasive approach to relieving pain caused by herniated discs or other abnormalities that create pressure against nerves and nerve root endings in the spinal area.

Who Benefits from PETD Procedures?
Individuals suffering from mid-back pain and disability may benefit from a PETD procedure. Minimally invasive surgical procedures like PETD require reduced manipulation of muscle and nerve tissues, specific targeted treatment areas, and result in less blood loss, infection, and healing time.

Posterolateral endoscopic discectomy surgery is often used to treat:

• Pinched nerve or nerve root compression
• Pain in the thoracic area of the spine that often radiates to the chest wall
• Lack of improvement and relief of symptoms following a minimum of three months of traditional and conservative pain and therapy management
• Peripheral nerve damage

Individuals who undergo a PETD procedure are usually discharged within 24 hours, don't require prolonged periods of bed rest, and can get back to work sooner.

PETD Procedure in Detail
Patients are placed face down on a table with the back slightly raised. Careful measurements and markings are made on the back area to offer precise placement of the needle portal for the endoscopic procedure. A needle with a stylette is inserted into the back at precise locations to the right or left of the thoracic vertebrae. Using guided imagery, the surgeon inserts advancements of the stylette in increments into the center of the damaged or herniated vertebral disc. 

A narrow wire guide is passed through the endoscope into the center of the disc. The needle is removed and a cannula is inserted through a very small incision over the vertebra, through which the cannula is then inserted. Several surgical tools including micro forceps may be utilized in a fan-shaped sweeping side-to-side motion that removes the damaged portion of the vertebral disc and creates an opened area within the disc space. Cutter forceps are used endoscopically to remove disc fragments, thereby relieving pressure against nerves and nerve root endings.

Some of the most common advantages of percutaneous endoscopic thoracic microdiscectomy include:

• Can be performed under local anesthesia
• Smaller incisions resulting in fewer scars and surrounding tissue damage
• Better avoidance of injury to nerves and blood vessels
• Reduced to chance of infection
• The procedure is a same date outpatient procedure

This surgical approach is not recommended for individuals diagnosed with severe thoracic disc extrusions or severe neurological deficits, or those with acquired stenosis of the spinal canal.

How Much does PETD Cost?
In the United States, percutaneous or posterolateral endoscopic thoracic discectomy may cost about $10,000, but costs may rise depending on geographical location, approach, and the severity of disk damage. Costs may also rise depending on diagnostics, imaging, medications, or therapies involved in treatment. Patients traveling to foreign destinations such as India, South Korea, or South Africa may save thousands of dollars on the same procedure.

Who Performs PETD Surgeries?
PETD surgical procedures rely on competent and knowledgeable surgeons with experience in the field. Specific surgical training along with hands on experience is important as well as certification in endoscopic surgical procedures. A PETD procedure is generally performed by an orthopedic surgeon specializing in spine care or neurosurgeon as well as a vascular or general surgeon. Surgeons should be chosen according to their expertise and experience in related fields. Physicians and surgeons should be certified in their field, and show membership in national or regional boards or associations in his or her country of origin.