Indications for Surgery
Surgery is recommended when conservative treatments fail to address progressive neurological symptoms or when cord compression is severe.
Difficulty walking, balance issues, or a feeling of "heaviness" in the legs.
Band-like or electric sensations that wrap around the ribs or chest area.
Sudden loss of bladder or bowel control requires immediate surgical intervention.
Ossification of the Ligamentum Flavum (OLF) is a condition where ligaments in the back of the canal turn to bone, directly squeezing the spinal cord.
Common Surgical Techniques
The approach depends on whether compression originates from the front, back, or side of the spinal canal.
- L
Thoracic Laminectomy: Posterior approach removing the "bony roof" (lamina) to create space.
- D
Thoracic Discectomy: Removal of herniated discs via transthoracic (chest) or costotransversectomy (side/rib) approaches.
- T
Transpedicular Decompression: Accessing the canal by removing pedicle bone, avoiding spinal cord manipulation.
- C
Thoracic Corpectomy: Removal of an entire vertebral body, typically for tumors or severe trauma.
Recovery & Risks
| Category | Details |
|---|---|
| Hospital Stay | Typically 3 to 5 days, depending on whether fusion stabilization was performed. |
| Restrictions | Strict "No BLTs" rule (No Bending, Lifting, or Twisting) for 6 to 12 weeks. |
| Blood Supply | The thoracic cord has limited blood flow, making decompression highly delicate. |
There is an approximately 5% risk of worsening neurological symptoms or permanent injury due to the sensitive nature of the thoracic spinal cord.
