Professor MD Thomas Gösling
Thoracic spine is a middle region of the spinal column at chest level. It consists of 12 vertebras. Injuries in thoracic spine is rarer than in lumbar or cervical regions as it has protection of the ribs but there are many other condition that can cause pain and degenerative change of the spine. Among them are following:
In severe stage, when other treatments do not relieve symptoms of above diseases, some patients may be candidates for thoracic spine surgery.
The list of thoracic spine surgeries is nearly the same but surgery may be performed in slightly different way as thorax is covered with rib cage from the front and the vital organs as the heart and lung are in close proximity. Traditionally, the operations on the thoracic spine were done through posterior approach but results often were poor as some problematic areas could not be reached from the back.
The latest years, anterior (frontal) trans-thoracic approach, as well as posterolateral (both from the back and side) approach, has become more popular. Though more difficult anterior thoracic spine surgery it gives better outcomes for herniated disks and degenerative disk disease.
One of the most common spine problems is compression of the spinal cord and spinal nerves caused by various degenerative diseases as intervertebral disk herniation, spinal stenosis, spondyloarthritis and others. There are several surgical treatments for relieving conditions related to compression and pinched nerves.
Thoracic herniated disk surgery. Herniated disk procedures in thoracic spine is done is cases of severe myelopathy (spinal cord compression) followed with neurological symptoms as increasing weakness in legs and radicular pain untreatable with other means. When accessing a protruded disk, a surgeon cuts diseased portion of the disk to give more space to adjacent spinal nerves. In recent years, operation for disk herniation is more often done with progressive minimally invasive methods that allow surgery via smaller incision. This type of spine operation is called microdiscectomy.
Laminectomy or laminotomy. These two surgeries have the same purpose but different in technique. Laminotomy is MISS (minimally invasive spine surgery) procedure. During the surgeon removes a lamina which is back part of every vertebra to decrease compression on the spinal cord. Thoracic laminectomy/ laminotomy can be done together with the treatment for herniated disks or independently.
Transthoracic decompression is a technique when procedures intended to minimize pressure on the spinal cord are performed through the chest case. The entry port is done between ribs.
Among stabilizing surgical interventions thoracic spine fusion is the most demanded. In spinal fusion surgery the two or more vertebras are fused together to limit flexibility of the spine and provide stability. As a rule, after thoracic fusion procedure the surgeon places instrumentation including screws, hooks and rods to fix the spine before fusion process is finished. I may take 3-5 months for bones to fuse.
I case of injury of the spinal column in thoracic region you may need the surgery to repair damaged spine. The specialist of Trauma and Orthopedics Surgery Clinic together with Neurological Department are able to carry out complex reconstructive surgery to restore normal functioning of the spine.
Thanks to modern technologies, most of above procedures now available with minimally invasive method using thorascope, an optical device inserted through the skin. Thorascopy helps to decrease morbidity of the procedure, postoperative complications and shortening of recovery.
Patients stay in the hospital for 3-5 days depending on surgery complexity. Usual procedures after the thoracic spine surgery are:
Until complete recovery a patient should avoid some activities as:
Among the possible risks after thoracic procedure some risks are associated with any type of surgery but some are specific for spinal problems. The common complications are:
The complications related to the spine surgery are:
Surgeon’s skill helps to reduce some of above complications, especially related to the spine injuries and nerve damage.
Spine Center of Clinic of Braunschweig offers to patients comprehensive service of spinal surgery. If you have thoracic surgeon you will be in hands of the team of qualified surgeons including specialist in orthopedic surgery, neurosurgery, trauma surgery and thoracic surgery. Making your spine healthy is our job.