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Thoracic Fusion Surgery

What is a “Thoracic Fusion with Instrumentation”?

Here is the meaning of each word:

  1. Thoracic: the area of the spine located in the mid-back
  2. Fusion: to grow bones together into one large bone piece
  3. Instrumentation: to use metal implants in the spine to help complete a fusion

Altogether “Thoracic Fusion with Instrumentation” means to use metal and bone to mend bones together in the mid-spine.

What is a Thoracic Fusion with Instrumentation?

A Thoracic Fusion with Instrumentation is a spine surgery which uses metal implants in the spine to stabilize and straighten it.

Why is a Thoracic Fusion with Instrumentation done?                                              

Here are some reasons for the surgery:

  1. To straighten a scoliosis (abnormal curvature of the spine).
  2. To straighten an abnormal forward-bend (Kyphosis).
  3. To stabilize the spine after severe spine trauma.
  4. To stabilize the spine after cancer surgery where parts of the Vertebrae have to be removed.
  5. To provide stability in the spine after part of the vertebrae or discs had to be removed.
  6. To provide pain relief for severe spine degeneration (uncommon).

How is a Thoracic Fusion with Instrumentation done?

Here are some of the steps of how this surgery is performed:

  1. An intravenous catheter (IV) is started and antibiotics are given.
  2. The patient is taken to the Operating Room and initially placed on the back (supine).
  3. A General Anesthetic is given and the patient is carefully turned on the stomach (prone).
  4. The mid-back (thoracic spine) is cleaned with sterile surgical soap and clean plastic sheets (drapes) are placed around the site of the surgery.
  5. An X-Ray machine is used to find the correct discs and vertebrae of the spine. This machine is used throughout the surgery. Some surgeons use a monitoring device (neuromonitoring) during surgery to evaluate the function of the spinal cord.
  6. A cut (incision) is made over the spine.
  7. The tissue and muscles are freed up and moved to the side with retractors (metal device used to hold tissue out of the way).
  8. If there is a compression of the spinal cord or spinal nerves, part of the back of the vertebra such as the spinous process and lamina would be removed.
  9. With the help of the X-Ray machine, the pedicles (bone bridge between the front and the back of the vertebra) of the vertebrae are found.
  10. Small titanium screws are placed through the pedicles and into the vertebrae. This is done on each side of the spine.
  11. If the spine has an abnormal curvature (scoliosis), specialized instruments are used to straighten the spine.
  12. Titanium rods are hooked up to the screws.
  13. Bone or bone substitute material is placed next to the screws and rods to help form a bone fusion in the future.
  14. The tissue and skin are then closed.
  15. A bandage is placed over the surgical site.
  16. The patient is turned on the back and awoken from Anesthesia.
  17. The patient is brought to the Recovery Area.

How long does it take to complete a Thoracic Fusion?

This surgery can take 2-8 hours or more to complete depending on how many segments in the spine are fused. For instance, scoliosis surgeries take longer since often many segments of the spine have to be straightened and fused.

What is the recovery from a Thoracic Fusion like?

Here are some of the steps in the recovery:

  1. The patient is admitted to the hospital for 2-5 days or longer.
  2. A brace for the mid-back and chest is sometimes used.
  3. After discharge, the patient’s activities such as bending, lifting, and twisting will be restricted for a period of time.
  4. The patient is often discouraged from taking Non-Steroidal Anti-inflammatory medications since they can interfere with the fusion.
  5. The patient is usually asked to refrain from smoking since Nicotine interferes with the fusion.
  6. The incisions will often take 4-6 weeks to completely heal.
  7. The surgeon will usually reevaluate the patient within 1 week after surgery and take more X-Rays.
  8. The process of developing a full spine fusion can take 6 months to 1 year to complete. This does not mean that the patient will have symptoms such as pain during that time.

What kind of benefit can patients gain from this type of surgery?

The benefit depends on why the surgery was done. Done for scoliosis, the benefit is that the spine is straightened. If the surgery is done for degenerative disease or trauma, the patient can experience less pain and more stability.