Name of the Procedure:

Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); thoracic

Summary

Arthrodesis, commonly known as spinal fusion, is a surgical procedure aimed at permanently connecting two or more vertebrae in the spine. The lateral extracavitary technique is a specific approach that accesses the thoracic spine from the side, allowing for minimal discectomy (removal of disc material) to prepare the intervertebral space for fusion.

Purpose

Arthrodesis is used to treat severe spinal conditions that cause pain, instability, or deformity. The goals are to alleviate pain, correct deformity, and stabilize the affected spinal segment by fusing vertebrae together, preventing motion in that segment.

Indications

This procedure is indicated for:

• Severe degenerative disc disease
• Spinal instability or spondylolisthesis
• Chronic thoracic pain not responsive to conservative treatment
• Spinal fractures or trauma
• Certain spinal deformities like scoliosis or kyphosis

Preparation

• Fasting for 8-12 hours before surgery
• Adjusting or stopping certain medications as instructed by the doctor
• Pre-operative imaging (e.g., MRI, CT scan) to plan the surgery
• Blood tests and medical clearance

Procedure Description

1. Anesthesia: The patient is administered general anesthesia.
2. Incision: A lateral incision is made on the side of the thoracic region.
3. Access: Muscles and tissues are carefully retracted to access the spine.
4. Discectomy: A minimal discectomy is performed, removing affected disc material to prepare the intervertebral space.
5. Fusion: Bone grafts or implants are placed between the vertebrae to promote fusion.
6. Stabilization: Screws, rods, or other hardware may be used to secure the fused vertebrae.
7. Closure: The incision is closed with sutures or staples, and a sterile dressing is applied.

Duration

The procedure typically takes 3 to 5 hours, depending on the complexity of the case.

Setting

The procedure is performed in a hospital's surgical suite.

Personnel

• Orthopedic or neurosurgeon
• Surgical nurses
• Anesthesiologist
• Radiologic technologist (if intraoperative imaging is used)

Risks and Complications

• Infection
• Bleeding
• Blood clots
• Nerve damage
• Nonunion or delayed fusion
• Hardware failure
• Pain at the surgical site

Benefits

• Pain relief
• Improved spinal stability
• Corrected spinal deformity
• Enhanced quality of life Expected benefits may be realized within several weeks to months after surgery.

Recovery

• Hospital stay of 3 to 7 days
• Pain management with medications
• Physical therapy to restore mobility and strength
• Avoiding heavy lifting and strenuous activities for several months
• Follow-up appointments to monitor healing and fusion

Alternatives

• Non-surgical treatments (physical therapy, medications, spinal injections)
• Less invasive surgical approaches (e.g., minimally invasive spinal fusion) Pros and cons vary, with non-surgical treatments often being less risky but potentially less effective for severe conditions.

Patient Experience

Patients will be under general anesthesia during the procedure, with no awareness or sensation. Post-operatively, they may experience pain and discomfort, managed with medications. Gradual improvement is expected with adherence to recovery protocols, including physical therapy and follow-up care.