WHAT IS A THORACIC DISCECTOMY?
A thoracic discectomy occurs in the thoracic spine. This is the middle section of the spine that connects the cervical spine with the lumbar spine and attaches to the rib cage. There is a total of 12 vertebrae in the thoracic spine, numbered T1-T12. A discectomy in this area of the spine seeks to eliminate the pain being caused by one of the discs between the vertebrae. These problematic discs are either herniated, bulging, or otherwise pushing on adjacent nerve roots exiting the spine. This is causing pain that can be anywhere from the top of the shoulders down almost to the hips. It can also radiate outward.
Dr. Watson uses a Thulium laser to treat these discs. The laser energy can shrink where the disc has herniated or is bulging, and it turns off the nociceptors, pain nerves.
For these procedures, an anterior approach enters through a small incision in the chest cavity. A posterior approach enters through a small incision on the back.
WHAT ARE THE BENEFITS OF A THORACIC DISCECTOMY?
The benefits of these procedures with Dr. Watson is the pain relief experienced by the patient without the recovery time and pain required with a surgical discectomy. By using minimally invasive techniques, Dr. Watson can usually access the disc or discs in question without creating the disruption created in typical surgery. Also, by using a Thulium laser to turn off the pain nerves in the disc, to char the annulus, and to seal the blood vessels, this can often allow the patient to avoid the more involved surgical processes of removing a herniated disc and fusing the two vertebrae. Fusions require up to a year of recovery.
Some patients may eventually still require those types of invasive procedures, but Dr. Watson’s thoracic discectomies remove the pain in most patients.
WHAT ARE THE RISKS INVOLVED WITH A THORACIC DISCECTOMY?
Remember, these are minimally invasive methods of pain relief. They do not involve lengthy incisions, removing the herniated disc, removing pieces of bone (such as the lamina), or fusion. Because of this, despite being spinal surgery, these are very low-risk treatments. There is the possibility of damage to the spinal discs beyond the pain receptors, but this is rare. These methods, which evolved from Dr. Watson’s original focus as an anesthesiologist and then an interventional pain management expert, are effective for dealing with the pain caused by a herniated or bulging disc.
CAN A HERNIATED THORACIC DISC HEAL ON ITS OWN?
No. Once any disc has herniated, where the inner gel pushes through the outer annulus, it cannot heal. Similarly, bulging discs won’t return to their normal shape. Part of this is the fact that our discs become more solid and less gel-like as we age. The good news is that after the age of 55, many people don’t have problems with herniated discs because their discs have become too solid to herniate.
Ways that you can help deal with this type of pain from a bulging or herniated disc is to strengthen the support muscles of the area. If you’re overweight, losing weight will also help. The goal of home therapy should be to lessen the pressure being placed on the spine.
IS THORACIC DISCECTOMY PAINFUL?
These are not overly painful procedures. This is in stark contrast to the highly invasive other options of spinal surgical discectomy and fusion. The main pain is tenderness at the needle insertion locations. Most patients can return to work in as little as one week.
WHAT IS THE THORACIC DISCECTOMY PROCEDURE PROCESS?
After being comfortably positioned on the operating table in the face-down position, the patient is given oxygen, connected to appropriate monitors and administered intravenous sedation to induce sleep. If considered necessary for the safety of the individual patient, a breathing tube will be inserted into the trachea after the patient goes to sleep.
A Thulium laser is then used to treat the posterior annulus of each symptomatic herniated disc and potentially some bulging discs. This process can both shrink the disc bulge or herniation as well as relieve the pain caused by the injured disc(s). The procedure places sufficient energy into the annulus to turn off the nociceptors or pain nerves, char the annulus as well as seal the blood vessels extending into the annulus. These vessels bring compounds to the disc that cause further inflammation and pain in the area. Antibiotics are now injected into each disc that has been treated and the instruments are removed.
HOW LONG DOES A THORACIC DISCECTOMY PROCEDURE TAKE?
The Thoracic Discectomy and Neural Decompression Procedure is performed in a surgery center and typically is accomplished over the course of 1 to 2 1/2 hours depending on the anatomy of the patient, the complexity of the pathology and how many discs are problematic.
WHAT IS RECOVERY LIKE AFTER A THORACIC DISCECTOMY?
After the procedure is completed, the patient is awakened and moved to the recovery room until discharge. The average time spent in the recovery room after the procedure is about 1 hour. As mentioned above, these are minimally invasive procedures. They do not involve large incisions or fusion. You will have some tenderness at the needle insertion locations. Most patients can return to work in as little as one week. Overall final results should be realized within six weeks. Dr. Watson will discuss your recovery with you during your consultation.
WHAT KIND OF RESULTS CAN I EXPECT FROM A THORACIC DISCECTOMY?
Disc herniation in the thoracic spine is rare because this area of the spine is the least mobile. These herniations account for less than 1 percent of all herniated discs. But when a disc does herniate in the thoracic spine, because the area is more difficult to access due to the bones and organs many spine surgeons do not perform discectomies in this area.
That’s where Dr. Watson’s minimally invasive approach can really make a difference. By turning off the pain nerves with the Thulium laser energy, we can achieve a good deal of pain relief without invasive surgery. The laser energy is able to directly impact the pain that originates in the disc and the areas where the discs are pressing on nearby nerve roots. This reduces or removes the pressure on the nerve roots and relieves the corresponding pain. While every patient’s results can vary, Dr. Watson has been helping patients with these laser treatments for 13 years and can help you.