So, apart from this, there are thoracic spine, rarely the patients can have a thoracic spine problems, mostly they are fractures, which are treated conservatively.
Sometimes patients can have, rarely, can have thoracic myelopathy in which there is a bad disc, causing stenosis at single level. Those patients may need surgical management in the form of a decompression and fusion.
Again, it’s not the presence of disc only, it’s the symptoms that they are getting, myelopathic, they are having a neurological involvement, they are losing their muscle power, or bowel or bladder involvement or balance, then those are a candidate for spine surgery.
So what entails for our spine surgery set up in our OR, just a little description on what goes inside the room. So these are the primitive type OR’s, 50, 60 years back, simple rooms, now, but now things have become complex. We have a lot of tables like these. We have a C-arm there, we have the monitoring. This is a modular operating room with a C-arm, which is fixed in the room.
We use operating microscopes. We have the C-arm still set up here and we use O-arms now- Intraoperative CT scans, especially for longer cases, these help in precision, quicker surgery, less blood loss. And we also use neuromonitoring over this.
So we have a neurophysiologist who is offshore, he’s never in the operating room, but we have a technician who will put all these electrodes and all the diagnostics there. They will be online at the same time.
We will get a report every time, and we can check our screw placement, our decompression, that we are not doing any more harm to the patient, especially important for patients we are doing on cervical and thoracic level, because we are working on a cord level, which is less forgiving than lower level in the lumbar spine.