What is Thoracolumbar Spinal Fusion?
Thoracolumbar spinal fusion is a surgical procedure where screws and rods are used to stabilize the spine. This type of surgery becomes necessary when:
The spine becomes unstable due to an injury.
The spine requires fixing because of a deformity.
Pain necessitates the immobilization of the spine.
The thoracolumbar region of the spine is a junction between the middle (thoracic) and lower (lumbar) parts of the spine. It is crucial to understand the anatomical and functional nuances of this region. The normal thoracolumbar spine is relatively straight in the sagittal plane but shows a double curve in the coronal plane. Specifically, the thoracic spine shows a kyphosis (posterior convexity), while the lumbar region demonstrates a lordosis (anterior convexity).
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Different Surgical Approaches
There are several ways to approach this surgery. Some patients with lumbar and thoracolumbar curves may undergo thoracoscopic or lateral access surgery. In this method, incisions are made from the side of the torso or flank. Whether it’s posterior, anterior, or lateral access, the main goal remains the same – to correct the curve and rotation of the spine. More on scoliosis in adults.
Diagnosis and Imaging
Before surgery, it’s imperative to use the right imaging modality to screen patients for thoraco-lumbar spine injuries. Knowing which patients need radiographic screening is crucial. Accurate numbering of vertebral segments is vital to pinpoint the exact location of radiographic abnormalities. Typically, there are five non-rib bearing lumbar type vertebral bodies. Learn about radiographic techniques.
Post-Operative Care
After undergoing thoracolumbar spinal fusion, patients should avoid lifting, bending, or twisting more than 20 lbs until 3 months post-operation. See OSUWMC’s post-operative guidelines.
Lumbar Spondylosis
Another common condition that might be related to the thoracolumbar region is lumbar spondylosis. It’s an age-related degeneration where vertebrae and disks of the lower back deteriorate. This condition, sometimes referred to as degenerative disk disease or osteoarthritis, leads to a breakdown of one or more disks separating the spine bones. Learn more about lumbar spondylosis.
Thoracolumbar Trauma
Given the delicate nature of the thoracolumbar region, high-velocity impacts, like motor vehicle collisions, can lead to severe injuries here. A retrospective review indicated a 25% incidence of spinal thoracolumbar fractures in a group of 151 trauma patients. Read more on thoracolumbar trauma.
In conclusion, the thoracolumbar region is of paramount importance in spinal health. Ensuring its stability, especially post-trauma or due to degenerative conditions, is crucial for overall spinal function and individual well-being.
