The thoracic region of your spine lies in your mid to upper back with each of your thoracic vertebrae connected to a pair of ribs. Given this unique anatomical configuration, the thoracic vertebrae not only provide support for an upright posture but are also an integral part of your rib cage- protecting your lungs and heart. Degeneration of this segment of your spine can lead to thoracic spinal stenosis (a narrowing of the spinal canal). This, in turn, can cause compression of your spinal cord or the associated nerves and lead to a variety of signs and symptoms, including back/rib cage pain/numbness, leg numbness/weakness, unsteady gait, or compromise of bladder/bowel function.
What is a Thoracic Laminectomy?
A thoracic laminectomy is a surgery that is performed to relieve (decompress) pressure on the spinal cord in the thoracic region of your spine. This pressure is caused by a condition known as spinal stenosis (a narrowing of the canal through which the spinal cord travels). A thoracic laminectomy may also be required to access the spinal canal for more uncommon conditions, such as to remove a spine or spinal cord tumor or infection in the thoracic spine. To perform a spinal laminectomy, your surgeon may use one of two techniques performed under general anesthesia: an open laminectomy or a minimally invasive laminectomy.
An open laminectomy involves an incision over the involved spinal segments. Muscles are dissected off the spine and retracted off to the side to expose the lamina, the back of the vertebrae and roof of the spinal canal. The lamina is removed with a variety of instruments allowing access to the spinal canal and providing more space for the spinal cord. If the procedure is being done to remove a tumor or infection, additional steps will be performed to address these issues. The muscles are then moved back into place and closed to create a protective barrier for the spinal cord. The incision is closed with sutures or staples.
A minimally invasive thoracic laminectomy is performed through smaller incisions at intervals along your spine near the affected vertebrae. Using a surgical microscope and specialized surgical instruments, the lamina is cut and the offending bone removed, then the tiny incisions are closed. The advantage to minimally invasive thoracic laminectomy lies in the reduced trauma, potentially less pain, and recovery time.
Recovery After Thoracic Laminectomy
Regardless of what type of thoracic laminectomy you have undergone, you will be taken to the recovery area as soon as your surgeon has finished with your surgery. The nurses and staff in this area will observe you and will also adjust your pain medications as needed to decrease your post-operative pain.
When you are ready, you’ll be moved to a room for the remainder of your hospital stay. You can expect that you will be asked to get up and walk shortly after surgery – usually within the first several days depending on what type of procedure was performed. You will be able to eat if you’re not feeling nauseous, which can sometimes be associated with general anesthesia.
The typical hospital stay for thoracic laminectomy extends over several days. During this time, you’ll be transitioned to oral pain medication and encouraged to walk and get plenty of rest.
It is very likely you will need to make arrangements to have someone stay with you to help with tasks such and meal preparation, bathing, and dressing. The first week you can expect to feel more tired than usual. This is normal and you should rest as much as possible, but you should also take several short walks throughout the day to increase circulation and enhance your recovery.
As the days go by you will start to feel stronger and have more energy. You can increase your activity level as healing allows but be sure not to overdo it. You will have lifting restrictions in place for several weeks, depending on the extent of your surgery.
Between weeks four to six, you will be ready to go back in for your first follow-up evaluation. Your surgeon may order X-rays to check the progression of your healing. If bone grafts were used (as in fusion surgery), this will help ensure that the grafts are healing appropriately.
For more basic procedures, you can expect to return to the majority of your normal activities between 6-8 weeks. If you work in a strenuous or high-impact job you may be instructed to wait a while longer to return to full duty. It’s important to attend all follow-up visits.
Risks of Thoracic Laminectomy
Thoracic laminectomy comes with the risks as any major spine operation. Some of the potential risks of thoracic laminectomy are:
- Neurological injury
- Leaking CSF (cerebrospinal fluid)
Is a Thoracic Laminectomy Right for Me?
Deciding to have a thoracic laminectomy may seem like a daunting proposition. Luckily, if you are armed with enough information and ask your surgeon plenty of questions, you can find the answers you need.
Some reasons you may require a thoracic laminectomy include:
- You have numbness or tingling in your legs from compression of your spinal cord
- You have a damaged thoracic vertebra that is placing pressure on nerves or your spinal cord
- The spinal canal is narrowed due to a tumor or infection
Working closely with your surgeon, you can begin to unravel the pain and discomfort that has been compromising your lifestyle. You don’t have to live with thoracic spinal stenosis and its consequences.