Name of the Procedure:

Arthrodesis, posterior or posterolateral technique, single level; thoracic (with lateral transverse technique, when performed)

Summary

Arthrodesis is a surgical procedure used to fuse two or more bones in the spine. When performed on the thoracic spine using a posterior or posterolateral technique, the surgeon approaches the spine from the back or side. This specific method may also involve a lateral transverse technique to further stabilize the fused area.

Purpose

Arthrodesis aims to stabilize the spine and relieve pain or deformity caused by conditions such as spinal instability, severe arthritis, or fractures. The fusion helps to eliminate motion between the affected vertebrae, which can reduce pain and prevent further damage.

Indications

• Severe chronic back pain unresponsive to other treatments
• Spinal instability or deformities (e.g., scoliosis, kyphosis)
• Degenerative disk disease or severe arthritis
• Spinal fractures or dislocations
• Spinal infections or tumors

Preparation

• Fasting for 8 hours before the procedure.
• Discontinuing certain medications (e.g., blood thinners) as advised by the doctor.
• Completing pre-operative imaging tests like X-rays or MRIs.
• Undergoing medical assessments, such as blood tests and a pre-operative physical examination.

Procedure Description

1. Patient receives general anesthesia to ensure they are asleep and pain-free.
2. The surgeon makes an incision in the back or side to access the thoracic spine.
3. Muscles and tissues are moved aside to expose the vertebrae.
4. Damaged disk material between the vertebrae is removed.
5. Bone grafts (from the patient or a donor) or synthetic materials are placed between the vertebrae to facilitate fusion.
6. Metal plates, screws, and rods may be used to hold the spine in place and promote stability during healing.
7. The incision is closed with sutures or staples, and a sterile bandage is applied.

Duration

The procedure typically takes 3-5 hours, depending on the complexity and specific techniques used.

Setting

Arthrodesis is performed in a hospital operating room.

Personnel

• Orthopedic or neurosurgeon
• Anesthesiologist
• Surgical nurses
• Surgical technologists

Risks and Complications

• Infection
• Bleeding
• Nerve damage
• Blood clots
• Failure of the bones to fuse (nonunion)
• Pain at the bone graft site
• Hardware malfunction or migration

Benefits

• Significant reduction in back pain
• Stabilized spine
• Improved spinal alignment
• Increased ability to perform daily activities

Recovery

• Initial hospital stay of 3-5 days.
• Pain management with medications.
• Avoid heavy lifting and bending for several weeks.
• Physical therapy to aid recovery and strengthen the back.
• Full recovery period can range from 6 months to a year.

Alternatives

• Conservative treatments (physical therapy, medication)
• Spinal decompression surgery
• Spinal instrumentation without fusion
• Benefits of alternatives may include less invasive options with shorter recovery times, but they may not provide the same level of long-term stability.

Patient Experience

During the procedure, the patient is under general anesthesia and feels no pain. Postoperatively, the patient may experience discomfort and pain managed by medications. It may take several months for the bones to fully fuse, during which the patient might need to wear a back brace and undergo physical therapy for optimal recovery.