Combined intra-extradural approach for posterolateral thoracic disk herniations: how I do it

Background Thoracic disc herniation is a rare degenerative spine disease that can cause severe neurological deficits. Nowadays, controversies still stand on the most effective surgical route. Method Herein, we describe the combined intra-extradural approach for a posterolateral thoracic disk herniation. We divided the technique into four steps: bony, extradural, intradural and intra-extradural. We disclose perioperative shrewdness aimed at improving outcomes and reducing complications. Conclusion The combined intra-extradural approach represents an effective technique for posterolateral thoracic disk herniations, reducing both the risk of spinal cord damages and post-operative CSF leaks.