The human spine provides support to the body allowing you to stand upright, bend, and twist. The spine is made up of a series of 24 bones called vertebrae which are stacked on top of one another. Between two vertebrae there is a disc of cartilaginous tissue called intervertebral disc. Intervertebral discs act as shock absorbers and protect the spine from the strong forces of movement during activities such as jumping, running and lifting.
The spine can be broadly divided into cervical, thoracic and lumbar spine. Thoracic spine lies in the mid back region between the neck and lower back and is more rigid due to the presence of ribs. The middle 12 vertebrae make up the thoracic spine.
Thoracic spine fusion is a surgical procedure in which two or more bones (vertebrae) of the thoracic spine are joined together so as to eliminate the movement between them. This is done by placing bone grafts or bone graft substitutes in between the affected vertebrae to stimulate bone healing. This promotes bone growth and eventually fuses the vertebrae into a single solid bone, permanently. Instrumentation such as plates, screws and rods are also used to hold the vertebrae together while the bone graft heals and fuses them together.
Bone grafts can be taken from the patient’s own hip bone (auto graft) or from a cadaver bone (allograft) acquired through a bone bank.Several artificial bone grafts substitute such as demineralised bone matrices (DBMs) and bone morphogenetic proteins (BMPs) and ceramics are also available and may be used.
The surgery is done under general anaesthesia. The surgical cut to access the spine and perform the fusion may be made either on the back or front side of the body depending on the best possible surgical approach for your condition. The surgery usually takes about 3-4 hours. The patient is discharged to home 3 to 4 days after the surgery and pain medications will be prescribed to relieve pain. A back brace or a cast may also be recommended. The recovery period varies among patients and depends on bone healing ability in each patient. It also depends on the procedure as spinal fusion can now be performed through smaller surgical cuts or incisions using newer minimally invasive techniques leading to quicker recovery.
Spinal fusion surgery is mostly performed along with other surgical procedures, to stabilize the spine. These surgical procedures include foraminotomy or laminectomy for spinal stenosis or discectomy for degenerative disc disease. It may also be recommended for treatment of the following conditions when nonsurgical measures have failed to be effective:
- Injury or fracture of the vertebra
- Instability of the spine caused by infections, tumours or spondylolisthesis (a condition in which a bone (vertebra) in the spine slips out of position onto the bone below it.
- Correction of abnormal spinal curvature (kyphosis)
Risks and Complications
Some specific complications after thoracic spinal surgery includes infection in the spine, nerve damage, non-union (not enough bone formation) of the vertebrae fused and persistent pain at the fusion site.
Follow your doctor’s instructions and maintain a healthy lifestyle to achieve better outcomes.