Thoracic Disc Herniation Presenting As Visceral Pain: A Case Report

Thoracic Disc Herniation and Abdominal Pain

Abstract

Thoracic disc herniation (TDH) is a rare clinical entity, accounting for less than 1% of all intervertebral disc herniations. Although it most commonly presents with axial back pain, myelopathy, or radiculopathy, TDH can occasionally manifest with atypical and misleading symptoms such as visceral or abdominal pain, significantly complicating diagnosis and potentially delaying appropriate neurosurgical intervention. We report the case of a 48-year-old woman who presented with chronic abdominal and back pain, accompanied by intermittent numbness in the lower extremities. Despite extensive prior investigations, no definitive diagnosis was established. Thoracic spine magnetic resonance imaging demonstrated a right paracentral disc herniation at the T9–10 level, causing compression of the spinal cord and adjacent nerve roots. The patient underwent a right transfacet discectomy, which resulted in complete resolution of symptoms without postoperative complications. This case highlights the diagnostic challenge of TDH presenting with atypical abdominal symptoms. Spinal imaging should be considered in patients with unexplained visceral pain, especially when neurological findings are present. Early detection can prevent unnecessary interventions and allow timely surgical treatment.