The thoracic spine consists of 12 vertebrae levels. The are located at the middle of the spine, between the cervical and lumbar vertebrae. Thoracic vertebrae are considered as those that have a rib. These levels are classified as T1 - T12. Thoracic spinal cord injuries are severe, however rarely cause death. Thoracic spinal cord injuries may affect one or both sides of the body, and although the long-term prognosis is good, early treatment is still critical.
Patients with thoracic spinal cord injuries live very independent lives. T1 is the highest level in the spine where the damage will leave the patient with use of their hands. Thoracic spinal cord injuries are serious enough to require immediate medical treatment.
The expected prognosis for these patients is great as they are very likely to live normal lives with minimal modifications. The most limiting factor of a thoracic spinal cord injury is the inability to control bladder and bowel function, but the patient is able to adapt to this quickly.
Patients with thoracic spinal cord injuries will likely be paraplegic with the use of their arms, chest, and upper back. These patients may:
- Breathe normally with limited endurance
- Use a manual wheelchair
- Feed oneself
- Transfer themselves in and out of their wheelchair without assistance
- Drive a modified car with hand controls
- Able to use a standing frame and/or leg braces
Thoracic spinal cord injuries, although not as severe as cervical cord injuries, are treated promptly with one or all of the following treatments:
- Surgery to remove any disc or bone fragments which are pressing against the spinal cord
- Surgery to decompress the spinal cord and/or fuse the segments together surrounding the injury
- Stem cell therapies are in the early stages of use to aid in reducing inflammation around the injury and potentially regenerate the spinal cord
Physical therapy will be an important part of rehabilitation for thoracic spinal cord injury patient. Patients with injuries to the spinal cord between T6 - T12 have a good ability to control their torso while sitting, thus physical therapy will be a critical part of recovery. These patients will do gait training so they may learn to use walking devices, and retain the remaining function in their lower body.
Patients will also participate in occupational therapy to learn to use their hands; this may be difficult in the beginning, as well as learn to dress and bathe independently. Occasionally speech therapy is used for those patients with injuries to their spinal cord in the upper thoracic spine as they may have reduced abilities immediately after injury. Psychiatrists are helpful for spinal cord injury patients. Mental health is key to recovery, so these therapists are used to keep the patient in the best mind frame for recovery.