Decompression and Spinal Fixation of Thoracic Epidural

Post-operative care
Expected postoperative stay will total approximately a week and significantly varies depending on the neurologic status and comorbidities.

Possible complications
Damage to the great vessels is the most feared of all complications when providing circumferential decompression, prompting urgent cardiothoracic surgery consultation. Thoracic fixation should be measured with the consideration that malpositioned screws could potentially injure a vessel and cause fatal neurologic injury. Similarly, transgression of the neural foramina or spinal canal with a screw can cause neurologic deficit or persistent radiculopathy.

In the case of infection or neoplasm, the parietal pleura can lose its plane and provide a risk for pneumothorax or hemothorax. Repeated passing of surgical instruments through a narrow injury by the spinal cord and exiting thoracic nerve root make direct injury to the spinal cord one of the more common and feared complications, as they carry the potential for paralysis. Furthermore, durotomy may occur, even without neurologic injury. In this case, these dural injuries can be managed with a primary repair with or without lumbar drain placement.