{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:38:12Z","timestamp":1787755092725,"version":"build-2784847793"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JBJS Case Connector"],"published-print":{"date-parts":[[2017,1,25]]},"abstract":"<jats:sec>\n                    <jats:title>Case:<\/jats:title>\n                    <jats:p>A 29-year-old man presented with right medial arm pain with paresthesia, as well as right-sided ptosis, miosis, and anhidrosis. Magnetic resonance imaging revealed a right paracentral disc herniation at the T1-T2 level. The patient underwent a hemilaminectomy with a medial facetectomy through a posterolateral approach to the T1-T2 disc space, followed by a discectomy. Intraoperative findings were notable for a conjoined nerve root.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Although high thoracic disc herniation is rare, its diagnosis should be considered when patients present with radicular arm pain and Horner syndrome. A high index of suspicion should be maintained for nerve root anomalies to limit iatrogenic injury and to ensure successful decompression.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.cc.16.00106","type":"journal-article","created":{"date-parts":[[2017,1,12]],"date-time":"2017-01-12T12:39:49Z","timestamp":1484224789000},"page":"e4","source":"Crossref","is-referenced-by-count":3,"title":["High Thoracic Disc Herniation Causing Horner Syndrome with the Intraoperative Finding of Conjoined Nerve Root Compression"],"prefix":"10.2106","volume":"7","author":[{"given":"Amit K.","family":"Bhandutia","sequence":"first","affiliation":[{"name":"Departments of Orthopaedic Surgery (A.K.B., M.J.S., and D.T.A.) and Neurosurgery (N.D.T.), Allegheny General Hospital, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary","family":"Zuzek","sequence":"additional","affiliation":[{"name":"Drexel University College of Medicine, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J.","family":"Schessler","sequence":"additional","affiliation":[{"name":"Departments of Orthopaedic Surgery (A.K.B., M.J.S., and D.T.A.) and Neurosurgery (N.D.T.), Allegheny General Hospital, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nestor D.","family":"Tomycz","sequence":"additional","affiliation":[{"name":"Departments of Orthopaedic Surgery (A.K.B., M.J.S., and D.T.A.) and Neurosurgery (N.D.T.), Allegheny General Hospital, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel T.","family":"Altman","sequence":"additional","affiliation":[{"name":"Departments of Orthopaedic Surgery (A.K.B., M.J.S., and D.T.A.) and Neurosurgery (N.D.T.), Allegheny General Hospital, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"bib1-20230712","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1097\/00003086-199403000-00009","article-title":"Surgical treatment of the symptomatic herniated thoracic disk","volume":"300","author":"Rogers","year":"1994","journal-title":"Clin Orthop Relat Res."},{"issue":"3","key":"bib2-20230712","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1097\/00002517-199306030-00006","article-title":"Herniated thoracic disks: treatment and outcome","volume":"6","author":"Ridenour","year":"1993","journal-title":"J Spinal Disord."},{"issue":"19","key":"bib3-20230712","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/00029679-199618190-00001","article-title":"Current management of thoracic disc herniation","volume":"18","author":"Theodore","year":"1996","journal-title":"Contemp Neurosurg."},{"issue":"5","key":"bib4-20230712","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1097\/00007632-198606000-00023","article-title":"First thoracic disc protrusion","volume":"11","author":"Kumar","year":"1986","journal-title":"Spine (Phila Pa 1976)."},{"issue":"3","key":"bib5-20230712","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1227\/00006123-198609000-00020","article-title":"High thoracic disc herniation","volume":"19","author":"Alberico","year":"1986","journal-title":"Neurosurgery."},{"issue":"1","key":"bib6-20230712","doi-asserted-by":"crossref","first-page":"128","DOI":"10.3171\/jns.1978.48.1.0128","article-title":"Herniated thoracic disc at T1-2 level associated with Horner\u2019s syndrome. 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