Thoracic Spinal Fusion
What is it?
Thoracic Spinal Fusion is a surgical procedure to permanently stabilize the thoracic spine. It’s typically indicated for conditions such as severe spinal deformities (like scoliosis or kyphosis), spinal instability due to trauma or tumors, degenerative disc disease leading to painful motion segments, and some instances of spinal infections or fractures. The primary goal is to provide stability, correct deformity, and alleviate pain.
The thoracic spine, with its rib attachments and proximity to vital organs, presents unique challenges for fusion surgery. One key consideration is preserving thoracic mobility and lung function, especially in multi-level fusions.
Postoperative care includes pain management, physical therapy, and monitoring for early and late complications. In cases of deformity correction, postoperative imaging is crucial to assess the correction and monitor for any progression.
Procedure
Several approaches can be utilized for thoracic spinal fusion, each with specific indications and technical nuances:
- Posterior Approach: The most common approach for thoracic fusion, especially for deformity correction. It involves placing pedicle screws and rods to stabilize the spine. This approach allows for extensive multi-level fixation and is conducive to deformity correction maneuvers.
- Anterior Approach: Used for directly accessing the thoracic vertebral bodies, often for tumor resection, infection debridement, or anterior column reconstruction.
- Lateral or Thoracoscopic Approaches: These minimally invasive approaches are utilized for specific indications, such as lateral column stabilization or interbody fusion, with the benefit of reduced postoperative pain and morbidity.
The fusion process involves using bone grafts, which may be autografts, allografts, or synthetic substitutes, to promote bone growth across the fused segments. The complexity of thoracic spinal fusion demands precise surgical planning and execution. Intraoperative imaging and neuromonitoring ensure accurate hardware placement and protect neural structures.