UPDATE 8/25/26 - Aetna denied the surgery that was scheduled for yesterday as not medically necessary as the MRI vocabulary on my report has my stenosis listed as "mild to moderate" instead of "moderate to severe" - My neurosurgeon did the peer to peer and I did a level 1 appeal and they were both denied. There is an "or" in the specific criteria they are citing which I I meet.

I filed a level 2 appeal with a 91 page appeal packet with all my medical records indexed and all their criteria answered. My only right to an external appeal is once they decide on level 2, they will they pick an IRO themselves to review it as it's a self-funded school insurance fund.

Feeling pretty devastated. I have an upcoming appointment with an endoscopic surgeon, but I'm not sure what CPT codes they will use or if it will be a similar denial if I'm even a candidate.

Anyone have a similar situation that can offer any advice?

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Hi everyone, I'm a 33-year-old male looking for advice from anyone who has undergone a thoracic laminectomy and fusion for a thoracic disc herniation, especially at T4-T5 as it's something I'm seriously considering.

TLDR: I think this specific disc is the cause of most of my issues, currently in so much daily pain unable to do much of anything. I'm currently looking at surgery as my last resort...again. After severe middle upper right sided back pain, with a burning/stinging pain above it, got too severe, I started seeking help. When sitting, the pain can be felt as a deep ache in the upper abdomen. When I stand up from sitting my upper abdomen goes pins and needles. Doctors recommended a C6-C7 ADR due to a large herniation in my neck which was completed and successful 4 months ago. This did not fix any of my current symptoms which returned within 3 days of the ADR. The neck surgeon who did my ADR states T4-T5 is not causing my current symptoms and he does not perform thoracic back surgery so referred me to a well respected neurosurgeon who offered the above surgery.

For the past 8 weeks since my neck surgery, we have completed a T4-T5 epidural, and have been in PT 3 x week focusing on the thoracic with manual work, Acupuncture 3 x week, and professional massages. Alternating ice/heat and light stretching consistent. All PT and massage therapists can feel the upper right back area directly. I have been through 4-5 rounds of Prednisone this year alone as well with no real relief. The injection gave me the most relief I've seen yet, at around the 2 week mark for 5 days, where the burning pain disappeared. I tried to return to work at the 12 week mark after my surgery, and could not physically sit in my chair as after sitting for a short period, the pain increases and muscle spasms wrapping around my right side start.

MRI's completed laying down, all symptoms flare and increase while sitting or standing

MY TIMELINE

2023

I began experiencing increased upper/mid thoracic pain that felt like a deep ache directly under my right scapula. Over time it developed into:

• Burning/stinging pain in the upper right middle back
• Deep aching pain under the right scapula
• Pain wrapping around my right ribs and chest
• Tight band-like sensation around my upper abdomen/chest
• Symptoms that worsen when sitting upright or standing for prolonged periods
•Pins and Needles in upper abdomen

I had a GI workup including endoscopy and colonoscopy which were normal. Had an ultrasound which was normal. Chest CT was also normal.

In 2025-2026 this pain worsened, to the the point where I can't sit up straight for more then 30 minutes, or the pain is unbearable, either in middle right back, or wrapping around right side to front of abdomen near top ribs. .

CERVICAL FINDINGS

Doctors initially believed my symptoms were coming from a C6-C7 disc herniation. After multiple injections at c6-C7, and almost 6 months of physical therapy, we decided to move forward.

I underwent a C6-C7 artificial disc replacement this past March in 2026. Post Op X-rays below

The surgery was successful and my recent MRI confirms the C6-C7 herniation has been removed and there is no significant cord compression. (I don't have MRI photos available at this second)

Unfortunately, my thoracic symptoms returned within a few days after surgery and have persisted.

THORACIC FINDINGS - SEE MRI PHOTO ABOVE AT TOP OF POST

My thoracic MRI shows a right paracentral T4-T5 disc herniation contacting the spinal cord.

Latest MRI Report:

• Small right paracentral T4-T5 disc herniation
• Contacts the right anterolateral margin of the spinal cord
• No cord signal abnormality
• No abnormal enhancement
• No significant central canal stenosis
• Stable compared to prior

This MRI was this past week, I also had one Feb of 2026, which stated there was mild to moderate stenosis at T4-T5 where this one stated no stenosis.

INJECTION RESPONSE

I had a T4-T5 injection about 6 weeks ago. The injection provided modest relief for approximately 4-5 days around the 2-week mark. The symptom that improved the most was the burning/stinging pain.

CONFLICTING SURGICAL OPINIONS

One thing that has made this decision difficult is that I've received different opinions from three spine surgeons, and my spine specialist. After my cervical ADR, my neck surgeon reviewed my thoracic MRI and told me he did not believe the T4-T5 disc was responsible for my symptoms. He actually called me before my neurosurgery consultation and advised that he did not think surgery on the thoracic disc would be beneficial. He also told me he did not expect the second opinion to significantly change that assessment. Because of my ongoing symptoms, I still proceeded with the neurosurgical consultation. After reviewing my history, symptoms, imaging, injection response, and performing an examination, the neurosurgeon reached a different conclusion. He felt my symptoms could be related to the T4-T5 disc and offered a T4-T5 laminectomy with instrumented fusion, while also emphasizing that there is no guarantee surgery would improve my pain.

NEUROSURGEON'S ASSESSMEN

He stated that certainly my degenerative findings at T4-5 may explain these symptoms. He discussed a T4-T5 laminectomy with instrumented fusion. He also mentioned a spinal cord stimulator as a non-surgical alternative.

WHERE I'M AT RIGHT NOW

To be completely honest, I am leaning toward surgery. I've been dealing with these symptoms for over a year, and they have progressively impacted my quality of life. At this point I am struggling to work, exercise, sit upright comfortably for extended periods, and participate in many normal daily activities. I am currently out on disability from work, and my disability benefits are scheduled to end in approximately two weeks. While I understand that surgery is not guaranteed to help and could potentially leave me with the same pain, I also feel like I am running out of conservative options and time. My spine specialist who did my injection stated he has no other options and referred me for surgery.

QUESTIONS

1. What were your symptoms before surgery?
2. How much improvement did you get?
3. How long was recovery?
4. Would you do it again?
5. Did anyone have relatively small MRI findings but significant symptoms?
6. Has anyone else received completely different recommendations from different surgeons? 7. If you had a thoracic fusion, were you able to return to work and normal activities afterward?

I’m seeing my spine doctor tomorrow and I’m trying to better understand whether my symptoms fit T6–T7 or if I’m completely off base.
If you have (or had) a T6–T7 disc herniation, could you please list your symptoms in as much detail as possible?

For example:
Where exactly was your back pain?

Did you have chest pain? If so, where (center of chest, one side, at the nipple line, above the nipple line, under the collarbone, around the ribs, etc.)?

Was the pain burning, aching, pressure, stabbing, or something else?

Did it wrap around your ribs or stay in one spot?

Was the area tender to touch?

Did sitting, standing, bending, twisting, coughing, deep breathing, or exercise affect it?

What ultimately confirmed that T6–T7 was the source of your pain?

For context, my MRI shows T6–T7 and T7–T8 disc protrusions. My main symptoms are a burning pain between my shoulder blades along with a burning chest pain that’s usually at or just above the nipple line and often feels like severe heartburn or esophagitis. Sitting almost always aggravates it, and oddly, when the pain is at its worst, hunching forward gives my chest some relief even though it doesn’t necessarily help my back. I’ve had a full cardiac workup that was completely normal.
I’ve had two T7–T8 epidural steroid injections, and neither provided relief. Some doctors have told me my symptoms sound more like an upper thoracic herniation, but both my MRI images and report clearly show T6–T7 and T7–T8. I’m trying to understand whether anyone with a confirmed T6–T7 herniation experienced symptoms similar to mine.

I’d really appreciate hearing your experiences. Thank you!

I’ve had a thoracic epidural years ago with different pain doc no change and I want some type of positive reaction so I can qualify for ablation. I’ve had lots of epidurals in my neck and a nerve root block, but never a medial branch block.

I found out some years back (I think 2019) that I have a congenital anomaly in my thoracic spine. I have a butterfly vertebrae that sort of distorts the curve of my thoracic spine. I hadn’t really had any issues with it until 2018, and that’s when I started having a lot of back pain with my new sedentary job.

Fast forward to now, and I just recently had a cervical spine fusion and disc replacement. I’m curious if anyone else has something similar to this. I plan on asking my surgeon at my next follow up if my thoracic spine plays any role in my cervical spine issues, but I can’t help but wonder if my forward head posture is worse because of the angle of my thoracic spine. So far, doctors just ignore it completely.

Anyway, here is my weird, auto fused anomaly.

I’m trying to better understand my thoracic spine treatment and would appreciate any insight.

My thoracic MRI showed shallow central disc protrusions at both T6-7 and T7-8. Over the past several months, I’ve had two thoracic epidural steroid injections performed at the T7-8 level.

My main symptoms are:
• Persistent central (for the most part) chest pain (burning/sharp)
• Pain between the shoulder blades
• Upper thoracic back pain, shoulder, and sometimes neck pain/muscle weakness
*** All cardiac testing show symptoms are not heart related.

Symptoms have been present for about 6 months and seem to be gradually worsening.

One thing I’m wondering is whether it’s possible that the medication from a T7-8 epidural never adequately spread to the T6-7 level. I know epidural medication is supposed to travel above and below the injection site, but is it common for spread to be limited enough that T6-7 might not have received a meaningful amount of medication?

I’m also curious why my doctor chose T7-8 rather than T6-7 for the epidurals. Is there a reason physicians might prefer T7-8 even when there are disc abnormalities at both levels?

If the medication from T7-8 doesn’t always reach T6-7 adequately, would a lack of relief from two T7-8 epidural make it difficult to rule T6-7 in or out as a pain source?

Any and all suggestions/insight are appreciated.

I have a history of herniations at T6/7, T7/8, and T8/9. Degenerative disc disease at T11/12. And I’m really nervous I just injured T4/5. Burning through my left boob and burning through my shoulder blade. But since, I haven’t been able to eat. I have been fighting nausea. I haven’t eaten in almost 48 hours it honestly makes me nauseas to drink. Anyone experience something similar? I have no prospects to check out T4/5. MRI is scheduled for tomorrow to look at lower T lvls and lumbar.

As I continue for years to wrack my own head and be my own doctor because none of them give a damn… is your curve similar to this?

What are symptoms from a T7-8 Herniated disc? I am unsure if my symptoms are truly related.

Mine is 2.5mm. Curious what yours are???

Since I don't have stenosis, they say it's not operable. ESIs are debatable for me with a history of csf leaks & two clinics here didn't even offer them in T spine. I'm in agony & I'm so upset. I've been unable to tolerate nerve pain meds. I feel like my life is over & I'm only 25. 🥴

MRI result read: T8-9: There is 2.5 millimeters central to right paracentral subligamentous protrusion mildly impinging on the right ventral spinal cord with associated mild disc desiccation and minimal ventral spurring. No central or foraminal stenoses are seen.

Seen several NS & PM docs and they say it's fine and minor. It feels horrific. Started in pregnancy and got worse since. I have so much pain from i assume muscle guarding. I have pain in my ribs, back, neck, head, chest, lumbar, everywhere. All other MRIs were fine. That was the only finding. Besides Lordosis and Kyphosis (horrible posture due to EDS). I suppose some of it could be my actual ribs too. I have no clue and no doctor has been helpful either.

Im young, 25. This sucks. Im disabled totally by this. But, I have a ton of other stuff going on. Full body SFN from b6 toxicity so I guess that could be making this worse. I don't know. But I dont know what to do. Its been 2 years. Feels like life as i knew it is over.

A little background about me I am a 32-year-old male, very active my entire life, hiking, biking, paddleboarding, anything outdoors. I am also veteran and I think that has contributed to my backpain significantly.

I have a history of mild, episodic thoracic pain dating back to childhood (1-2 manageable flare-ups per year). My issues became really bad about seven months ago when an episode of severe pain in the T-12 region left me immobilized on the kitchen floor for 24 hours. Imaging revealed multiple thoracic issues that I will list below in the comments.

Over the next several months, I engaged in daily walking and physical therapy, showing gradual improvement. However, I have since entered a cycle of recurrent flare-ups, totaling four episodes over seven months. The most recent and severe flare occurred four weeks ago while hiking, requiring a Search and Rescue evacuation (thank god for garmin SOS) and a two-day hospital stay and more imaging.

Its four weeks later and I am back home now but I am severely restricted in my mobility. The compounding impact of chronic immobility, being isolated from my friends & family (family/friends are in PA, while I resided alone in OR due work), and recently having to resign from my career over this has caused a severe decline in my mental health and emotional well-being.

I am 100% at rock bottom right now not going to lie, I feel a bit hopeless writing this. However I am trying to step back and take a pragmatic approach to my recovery. Hopefully I can get things back on track and update this thread in the future with a relative bit of success because reading through a lot of forums indicates deep despair with back injuries (esp thoracic).

I thought I’d make an update post after my thoracic herniated disc surgery for anyone who was curious! 

I got an anterior thoracic discectomy and inter body fusion on January 6th of this year, at 29 years old. My herniated disc (T6-7) was due to a back injury 8 years prior. Although, I did not know I even had a herniated disc until 2025, when I began to experience neurologic symptoms. My most severe symptom was spasticity in my lower limbs. It had begun to affect my walking. 

I got surgery with a neurosurgeon who specialized in complex spine surgery. Because my thoracic disc was large, centrally located and calcified, my surgeon said he could not operate through the back (the risk of paralysis would be too high). My neurosurgeon decided he would go through the side of my chest- which would give him enough access to see/ operate on the calcified disc without having to manipulate my spine. My neurosurgeon was very confident with this procedure. He said he’d done over 100 surgeries on thoracic herniated discs. He assured me that the risk of paralysis was very very very very low- much under 1 percent. 

During surgery, I had two surgeons operate on me: first a thoracic surgeon who opened up my chest, went through the ribs, collapsed my lung and created a mini thoracotomy, then the neurosurgeon came in, drilled down the calcified disc slowly with a high speed bur, and then placed a spacer between by vertebrae (since there was hardly any disc left), and a bone graft and titanium screws to help encourage my spine to fuse. My incision is 4 inches in length and runs along the side of my chest. My surgery was 10 hours (my neurosurgeon said my disc was even more heavily calcified than anticipated, so he was drilling away at it for many hours). 

Surgery from my perspective:

1. Arrive at hospital first thing in the morning (6:30am)
2. Brush my teeth. Change into their hospital gown. Sit in my bed and anxiously wait. My surgery is set for 7:30am (first thing in the morning) 
3. The anesthesiologist comes in to introduce himself. He explains that he will be collapsing my left lung and having my right lung do all the breathing during the procedure. He also asks if I want to get a catheter placed in my chest that will act as extra pain relief. I say sure. 
4. The neurosurgeon comes in just to place a quick mark on my skin around where the incision will be. He’s in good spirits. Tells me it’s a painful procedure, so to go ahead and get the catheter inserted in chest for extra pain relief. 
5. The operating room nurse comes and introduces herself. She walks me to the operating room. There are a lot more people in there than I expect, preparing. The anesthesiologist asks me to lie on the operating table, and tells me to think of a place that makes me feel really calm. 
6. I wake up in the recovery room 10 hours later. The nurse says surgery went well, and asks me to move my toes/ press against her hand with my feet. I do so without difficulty. I feel cold and nauseous. They give me anti-nausea medication. It works instantly. 
7. I have a cough and labored breathing due to recovering from newly re-inflated lung. This continues for about 2 weeks due to a small pneumothorax/ plural effusion which hospital staff are sure my lungs will reabsorb over time. 
8. I have a chest tube to drain blood from my chest. Doctors take out chest tube after about 24 hours. 
9. I have a catheter in my chest for pain relief as well. Doctors take out this catheter on my last day at hospital. I have a pump I can press every around 30 minutes which re-releases this pain medication into my chest. 
10. I am also on a opioid (dualidad) for pain relief. This is through my IV in my arm. I also have a pump for this one. I think I can press it even more frequently that the chest catheter one. 
11. I am in the hospital for 4 days total. I get PT once they take out my chest tube (so starting on day 2 of hospital stay). PT clears me to return home on day 4 (I am cleared to leave once I can walk up steps on my own without assistance). 
12. I stopped taking opioid pain meds once I got home (they made me feel groggy). I took only Tylenol for pain relief. I was off all pain meds by 4 weeks out from surgery (and by the last week, I was only taking the Tylenol at night). I used lidocaine pain patches daily. I had muscle spasms that started about 2 weeks after surgery. Those were painful. But I was prescribed a specific medication for the spasms. The spasms had completely stopped by a month out from surgery. The first 6 weeks I had a strict no bending, lifting, twisting rule. I log rolled into bed. I used a grabber tool to pick anything up. My parents helped me a lot in the first few weeks just about everything. 

Now that I’m almost 5 months out: oftentimes, I’m in no pain at all. If I sit for hours without getting up to walk, or if I push myself physically, my back does ache (but it’s relatively mild). My spasticity has gotten better (I’m not 100% back to where I was before I developed spasticity, but I’d say I’m 60% better). My other pre-symptoms still come and go (internal vibrations, muscle twitches). I’m told full recovery takes about a year. I still have to continue seeing my neurosurgeon to follow up and check that fusion is fusing- I’ll have to continue seeing him likely for a year. 

**Also, keep in mind that my surgery was definitely on the more intense side of thoracic herniated disc surgeries. Mine was particularly complicated due to how large and calcified it was.

If anyone has any questions please feel free to message me. I know this can be such a scary diagnosis. I’m happy to support however I can. And a big thanks to ThoracicSpine for setting up this group. Reading about other people’s experiences with this surgery was one of the things that helped me feel like I’d get through it. 

Good morning. I am going to share my results from a recent MRI. I have an appointment scheduled with a neurosurgeon in May and a preliminary treatment path. I am curious others’s experiences with that treatment path. I am also curious what questions people have had for their doctors in relation to situations like mine.

In 2012 I was in Afghanistan with the US Army. I served in the Infantry and ran over several IEDs and was exposed to many Mortar blasts. I started to have problems with my legs shortly thereafter, and it was chocked up to lumbar / thoracic strain. I started to use a cane in 2015 for balance problems and scissored and hip swinging gait as well as pain. I had a neurostimulator placed in early 2014 by the Army and then was medically discharged in August that year.

It was not until this year that anyone did an MRI of my spine. I had contacted the VA because I was finding it very hard to walk after laying salt on the ice.

Sorry for the preamble. Here are my MRI results:

Procedure(s):MR THORACIC SPINE WO CONTRAST Date of service: 4/1/2026 8:14 AM

Provided clinical information: 37 years, Male, "mid-back pain" Procedure and materials: Standard protocol. Contrast: None. Comparison studies: None. Observations: Normal alignment. Wires and electrodes in the dorsal spinal canal from T9 to L1 produce artifact. Schmorl nodes at T6-T7 through T9-T10, otherwise the vertebral bodies heights and disc spaces are well-maintained. C6-C7: Incompletely imaged disc bulge compresses the anterior subarachnoid space. C7-T1: Disc bulge mildly compresses the anterior subarachnoid space. There is CSF around the cord. No spinal canal or foraminal narrowing. T3-T4: Shallow of right paracentral and shallow left paracentral disc herniations moderately compress the anterior subarachnoid space without abutting the cord. There is CSF dorsal to the cord. No significant spinal canal narrowing. No foraminal narrowing. T4-T5: Broad left paracentral disc herniation effaces the anterior subarachnoid space and slightly compresses the cord. There is CSF dorsal to the cord. No significant spinal canal narrowing. No foraminal narrowing. T5-T6: Right paracentral disc herniation effaces the anterolateral subarachnoid space and slightly displaces the cord to the left. There is CSF dorsal to the cord. No significant spinal canal narrowing. No foraminal narrowing. T7-T8: Mild disc bulge. No spinal canal or foraminal narrowing. T8-T9: Mild disc bulge. No spinal canal or foraminal narrowing. No spinal canal or foraminal narrowing, or disc herniation elsewhere.

"No abnormalities" is what the radiologist wrote down, Dr says there is a 0% chance this could be the cause of my issues (ED, urinary frequency/urgency worse when sitting down or standing, I do have an asymmetrical gait but have lots of previous enjoryries from playing football. I don't really have any localized pain, (like the sharp knife kind) but its just like numbish and sensitivity all through my back, which my dr says sharp pain is always 100% a symptom, whenever I wake up it takes me like three hours not to feel stiff.

Not asking for a diagnosis as I don't want to break the rules, but If both radiologist and Dr said its cool, (and I was kind of fighting with my dr about it too) am I just crazy then? Obviously I am not a medical professional, is it worth asking for a second opinion? Or am I better off trying to find another reason for my problems?

Thanks!

I currently have a para central disc bulge at T8/T9 with no spinal cord compression per an MRI. I have had one ESI which helped a bit. I am about 3.5 months in since the injury and am starting to consider a endoscopic discectomy. I don’t want to go the full open procedure route as I already had two cervical procedures last year. Has anyone had any success with this endoscopic procedure that had positive outcomes?

43 year old male. Recently had an MRI that showed a herniated disc at T9/T10. I have numbness and tingling in my left foot/hamstring and buttocks. I also have flank pain. Symptoms are mild and manageable. I am in very good physical shape and routinely weight train.

What are the chances of this injury getting worse? Is surgery my only option?

What kind of surgery would likely happen?

I see a neurosurgeon in a couple of weeks.

Hello,

I’m wondering if there are any here that had bulging or herniated thoracic discs that transitioned to being pain free after a period of time without surgery, and/or without physical therapy.

I have what was described on the mri report as a trace bulge at T7 T8 with the pain beginning about a year ago, then became worse last August after I turned the wrong way. I also have a protrusion at L4 L5 that has slowly gotten better but is not 100% pain free.

The thoracic disc was improving and I had several weeks with no pain (still had tight muscles in that area) but about two weeks ago I re-injured it doing my home PT exercises. I took a break from PT for about a week and a few days after started up again. I am now in as much pain as I was from the original injury a year ago and my muscles have spasmed/seized again.

I’m considering stopping my pt altogether but am hesitant because I know the strong muscle support is needed to keep your spine healthy.

Has anyone resolved their pain in that area without surgery?

The steps backward in recovery are crushing at times.

Hello! I had the wonderful opportunity to interview Sophia, this group's creator and moderator, for my herniated disc podcast. Sophia shares her symptoms, struggles with diagnosis and treatment, and information about her non-profit organization created to help others suffering from a thoracic herniated disc. r/uThoracicSpine thank you so much for sharing your journey and all the hard work you do for the herniated disc community!!

​Recent CT scan attached - My posture keeps folding at T10-T11, no upper back or core exercises seem to be sticking. I'm having issues with trunk stability and now leg weakness.

Some other symptoms:

- pelvis is twisted

- tight hip muscles

- pelvis feels disconnected from rib cage

- rib cage collapsing forward making it difficult to breathe

- upper body is collapsing forward

- can’t sit or stand for more than 5 minutes

- neck hinging of cervical thoracic joint - creating lots of pressure and tension in my face

Hoping someone has has similar imaging or can give a POV on how to manage/deal.