What Is Thoracic Stenosis Surgery?

• In simple terms: The surgery removes bone, ligament, or disc material pressing on the spinal cord in the thoracic spine (mid-back), creating more room.
  
  

• Scientifically: Thoracic stenosis decompression may involve laminectomy, laminotomy, foraminotomy, or discectomy, with or without fusion, to enlarge the spinal canal and relieve cord/nerve compression. Microsurgical and image-guided techniques are often used due to the tight canal and high stakes in the thoracic spine.
  
  

Conditions Treated

• Thoracic spinal stenosis (degenerative or congenital)
  
  

• Thoracic disc herniation
  
  

• Myelopathy from cord compression
  
  

• Radiculopathy (thoracic nerve root pain, numbness, or weakness)
  
  

• Stenosis from ossification of the ligamentum flavum (OLF) or ossification of the posterior longitudinal ligament (OPLL)
  
  

• Post-traumatic stenosis or deformity
  
  

Types of Thoracic Stenosis Surgery

1. Thoracic Laminectomy

• Removes the lamina to decompress the spinal cord.
  
  

• Used for multi-level stenosis.
  
  

2. Thoracic Laminotomy / Foraminotomy

• Removes part of the lamina or widens the foramen to relieve nerve root compression.
  
  

• Often performed minimally invasively.
  
  

3. Thoracic Discectomy

• Removal of herniated disc compressing the spinal cord or nerves.
  
  

• May require an anterior, lateral, or posterolateral approach depending on location.
  
  

4. Thoracic Fusion (when needed)

• Added if instability is present or created during decompression.
  
  

• Uses bone graft and screws/rods to stabilize the spine.
  
  

The Thoracic Stenosis Procedure: Step by Step

Plain-English Overview

1. Anesthesia & positioning: You’re asleep under general anesthesia.
   
   

2. Incision: A small incision is made in the mid-back (posterior approach most common).
   
   

3. Decompression: Bone, ligament, or disc material pressing on the cord is carefully removed.
   
   

4. Stabilization (if needed): Screws and rods may be added to prevent instability.
   
   

5. Closure: The incision is closed; recovery begins the same or next day.
   
   

Surgeon-Level Detail

• Approach: Posterior midline incision for laminectomy/laminotomy; lateral thoracotomy or MIS lateral access for disc herniations.
  
  

• Decompression: High-speed drill and Kerrisons used for lamina removal; ligamentum flavum or ossified ligament carefully resected; disc fragments excised under microscope.
  
  

• Fusion decision: Based on facet removal, deformity, or instability; pedicle screws/rods inserted if required.
  
  

• Closure: Meticulous hemostasis; layered closure; drain use varies.
  
  

Benefits of Thoracic Stenosis Surgery

• Protects the spinal cord from further damage
  
  

• Relieves mid-back pain, numbness, and weakness
  
  

• Improves walking tolerance and balance
  
  

• Prevents progression to paralysis in severe cases
  
  

• Minimally invasive options available in select cases
  
  

Risks & Limitations

• Thoracic spine surgery carries higher risk due to proximity of the spinal cord
  
  

• Infection, bleeding, dural tear/CSF leak
  
  

• Neurologic injury (weakness, paralysis—rare with neurosurgical precision)
  
  

• Instability requiring fusion
  
  

• Recovery slower than lumbar/cervical surgery in some patients
  
  

Recovery Timeline

• Day 0–1: Walking begins with assistance; hospital stay 1–3 days typical
  
  

• Weeks 1–2: Wound care, light walking daily
  
  

• Weeks 2–6: Gradual activity increase; desk work often resumed
  
  

• 6–12 weeks: Structured physical therapy; improved mobility and confidence
  
  

• 3–6 months: Steady functional recovery; many return to normal activity
  
  

• 6–12 months: Full healing and fusion (if performed) confirmed with imaging
  
  

Why Choose Desert Spine and Pain?

• Expert neurosurgeon: Dr. Greenwald is highly experienced with complex thoracic decompressions
  
  

• Advanced tools: Microsurgical, navigation, and minimally invasive approaches for safety
  
  

• Comprehensive care: Conservative options first, surgery only when needed
  
  

• Patient-first philosophy: We explain everything clearly to reduce fear and anxiety about surgery
  
  

Frequently Asked Questions

How is thoracic stenosis surgery different from lumbar or cervical surgery?

The thoracic canal is narrower and the cord more vulnerable, so surgery requires extreme precision. It’s less common but more delicate.

Will I need a fusion?

Fusion is only added if instability is present or created during decompression. Many thoracic decompressions don’t require fusion.

How soon will I see improvement?

Leg symptoms (weakness, numbness, walking ability) often improve within weeks to months. Recovery is slower if myelopathy has been present for a long time.

What are the risks?

Thoracic stenosis surgery carries higher risks than lumbar or cervical due to anatomy. With neurosurgical precision, outcomes are very good, but patients must understand the seriousness of the procedure.

How does Desert Spine and Pain perform thoracic stenosis surgery differently?

We use microscope-assisted precision, MIS techniques where appropriate, and neurosurgical expertise to maximize safety and recovery.