Indications
Thoracic Spine decompression is a procedure to relieve pressure on the spinal cord in the middle of your back. Your consultant will already have shown you on your MRI or CT scan, the levels where the ‘crowding ‘ or ‘squeezing ‘ are worst. It is this compression that is causing your leg symptoms (weakness, stiffness, lack of balance). During this surgery, your consultant may remove part of the bone, thickened ligaments or facet joints to decompress the area.
Procedure
This will be performed under General Anaesthetic, placed face down on a special padded frame. The surgeon will make the incision in the midline. Muscles overlying the vertebra are split and moved to the side to expose the lamina of the vertebra. A dedicated microscope will be used to improve illumination and magnification, thus reducing the risk of spinal cord damage during the removal of the bone and ligament that is compressing the spinal cord.
Complications
There is a 1-5% risk of total paralysis in the legs, loss of bladder, bowel and sexual function (Cauda Equina Syndrome), or leakage of the spinal fluid (CSF). Very occasionally a CSF leak may need another operation to seal the leak. The risk of wound infection is about 2%. The risk of infection in the disc, joint or bones (discitis/osteomyelitis) is about 1%. That will require 6-8 weeks of intravenous antibiotics.
Recovery
You will be in hospital for 3 days after surgery if all goes well. Some patients need a urinary catheter to help then to pass urine post operatively for a day or two. You are allowed to walk, sit and lie down. It is best to vary your activity and to keep on the move as much as possible. The physiotherapists will give you more detailed instructions re exercises prior to discharge. You are advised not to drive for a minimum of two weeks after surgery. (You must be safe to control the car, be able to do an emergency stop and not be on any heavy painkillers that make you drowsy). It may be longer than two weeks before you are fit to drive.
