Thoracic Spinal Stenosis Surgery

Spinal stenosis surgery in the thoracic region is a fairly rare procedure as narrowing of the spinal canal usually occurs in the lumbar or cervical regions of the spine. Where thoracic spinal stenosis does occur it can cause pain in the ribs and the back, radiating pain down the legs that can affect walking, and even breathing difficulties. Some patients experience pain in the internal organs and many find it difficult to move from side to side or rotate the body. Thoracic spinal stenosis may also be accompanied by cervical spinal stenosis and/or lumbar spinal stenosis which are the more common sites of spinal canal narrowing.

Thoracic Congenital and Degenerative Stenosis

A small number of patients will have congenital thoracic spinal stenosis that necessitates surgery such as a foraminotomy to open up the foramen and allow the spinal nerves more room. Symptoms may present at an early age or this condition may remain asymptomatic until the general wear and tear of age causes nerve or spinal cord compression. Degenerative disc disease can occur in the thoracic spine, although this is more likely in the more mobile sections of the spinal column. Herniated and bulging discs, along with bone spurs, can reduce the spaces in the spine and cause stenosis symptoms and there are a variety of procedures that can address such problems.

Procedures for Thoracic Spinal Stenosis Surgery

Laminectomy may be considered to decompress the thoracic spine, along with a corpectomy, discectomy, laminotomy, laminoplasty or other procedure. The thoracic spine is fused to the ribs and sternum however and any surgery is likely to be carried out from a posterior approach unless the surgeon is particularly skilled and experienced. Only around 1% of spinal stenosis cases involve the thoracic spine, meaning that many clinics do not offer thoracic spinal stenosis surgery, particularly as an endoscopic spine surgery or minimally invasive procedure. Thoracic spinal stenosis surgery involving the removal of supportive structures can have a knock-on effect on the cervical spine and lumbar spine. Spinal fusion may be required to restore stability in the area and is just one option for surgery in the thoracic spine. A number of patients investigate other, less invasive, options for thoracic spinal stenosis prior to giving consent for spine surgery. These can include the use of back braces, osteopathic manual therapy (OMT), and a range of pain medications, anti-inflammatory drugs, and physical therapy such as yoga, pilates, or acupressure.