Laminectomy is a commonly performed procedure to treat spinal stenosis. These type of thoracic procedures involve resection of the spinous process, lamina, and mesial (most midline portion) facet joints. In addition, foraminotomy is also performed. If required, a diskectomy can be simultaneously done to treat a disk herniation. Laminectomy can also be done when spine tumors need to be removed. Although an excellent procedure to treatment of certain disorders, Laminectomy does carry the risk of facet injury and spinal instability.
Foraminal stenosis in the cervical spine can be treated with an incision in the back of the neck then removing the bone spur compressing the nerve. A diskectomy (removing the herniated portion of the disk) can also be performed. Typically a fusion is not performed. However, a fusion also can be done in selected circumstances.
Fusion of the thoracic can be performed posteriorly (i.e. pedicle screws) or laterally through the chest.
Corpectomy involves resection of the vertebral body. Usually a thoractomy (opening the chest cavity) is required to perform a corpectomy. Rarely, a corpectomy can be performed via a posterior approach.
Certain disk herniations in the thoracic spine (especially those herniations that are centrally located) can be removed through an endoscopic approach. Typically, three endoscopic ports are inserted into the chest to remove the disk herniation. A camera is placed through of the three ports in order to visualize into the chest.
Thoracic disk herniations that are located laterally can be removed from a posterior approach. Posterior discetomy is commonly performed for lumbar disk herniations.
These thoracic procedures are performed through 2 small incisions in the armpit. One port contains the camera while the other is the working port that holds the scalpel and/or forceps and/or coagulator. The sympathetic chain is located in the upper chest cavity and then resected.