Posterior thoracic fusion is a surgical technique where the surgeon is able fuse segments of the thoracic spine together.
This may be needed in cases of trauma, where the thoracic spine is fractured, and screws and rods are needed as a buttress to provide support as an internal cast while the fracture heals.
Thoracic fusions are also used to treat deformities, scoliosis, kyphosis, or spinal instability.
During posterior thoracic fusion surgery surgery, the patient is placed on a special bed in the face down position.
An incision is made either directly midline (in open surgery), or off to either side (in minimally invasive surgery).
Muscle is either dissected away (in open surgery), or serially pushed aside with expanding retractors in minimally invasive surgery. This gives access to the spine.
The surgeon then uses fluoroscopy to place probes in the pedicles of the segments that require fixation with screws. Once probed to ensure the spinal nerves and cord are protected, screws are placed.
The screws are then connected to rods to provide support and stability. Bone graft is placed over the instrumentation to help promote fusion.
Posterior Thoracic Fusion works through multiple mechanisms.
In patients with deformities, portions of the spine are removed to allow the spine to be manipulated into a more normal pattern. Once reconstructed, thoracic fusion holds the spine in place to allow for a fusion in normal alignment.
In patients with instability, thoracic fusions immediately afford stability while providing a scaffolding for fusion to occur.
In fractures, thoracic fusions help bridge the fracture by taking force away from the compromised spine, and provide immediate stability while a fusion occurs.
Posterior thoracic fusion allows surgeons to achieve immediate stability and provide excellent chance for fusion as the body heals.
Patients can expect to stay in the hospital for 1-3 days after the surgery, depending on how invasive it was.
Patients may be instructed to wear a back brace for up to 1 month.
Physical therapy is typically prescribed a month after surgery to work on flexibility, core strengthening, and range of motion to aid surgical healing.
Patients typically return to their baseline level of functioning in 4-6 months.
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