Thoracic Vertebrectomy Abroad

Thoracic Vertebrectomy Cost Package:
{The surgery cost covers all medical & logistics costs at the destination}
International Destinations: India, Jordan, Mexico, South Korea, Turkey

Vertebrectomy refers to the surgical removal of the entire vertebra. When a thoracic vertebra is affected due to a fracture, a malignant metastatic tumor, or an infection (especially Pott’s spine), it progressively damages the vertebra and may result in deformity, pain, and neurological deficits, which causes the loss of its functional capacity.

In such cases the entire thoracic vertebra is removed and replaced by a bone graft, which subsequently restores the full strength and most of its functionality.

There are different techniques of conducting the surgical procedure which include the conventional open surgical technique or laparoscopic technique. In addition to the different techniques of conducting the procedure, the site can be accessed either from a posterior approach or an anterior approach.

The modalities depend upon the patient’s clinical condition, age, and other parameters. It’s a complex surgery requiring strong medical and surgical skills. Several destinations provide this spine surgery at costs lower than those in the United States.

These include India, South Korea, Jordan, Turkey and Mexico.

When is Thoracic Vertebrectomy Needed?

Thoracic Vertebrectomy is required for various pathological conditions in the thoracic vertebra:

Primary or secondary tumors of the spine which involve the thoracic vertebra
Trauma and injuries which result in total destruction of the vertebral bone. In such cases, the vertebral bone presses onto the underlying nerve root, and surgical removal is recommended to alleviate pain and compression
Infections of the vertebral spine, which cause significant degeneration of the bone tissue, resulting in structural deformity of the shape of the spine (i.e. kyphosis, scoliosis, lordosis, etc)

Thoracic Vertebrectomy: The Procedure

Surgical procedures on the upper portion of the back or thoracic region are highly complex and require surgeons with a special set of skills and techniques to work their way around the heart, lungs, and large blood vessels.

There are different approaches to the surgery of the thoracic vertebra, which include an anterior (or transthoracic approach), a posterior approach, or a combined approach.

The selection of the technique depends upon the patient’s condition, the underlying pathology and the level of emergency to execute the procedure. The procedure is conducted under general anesthesia and the length of the procedure depends upon the number of vertebrae involved and the extent of resection planned.

A brief insight into the various procedures is provided here,

Anterior thoracic vertebrectomy uses a minimally invasive surgical approach or a conventional open spinal approach (thoracotomy approach).
In the minimally invasive surgery approach, several small incisions are made in the intercostal space, which depends upon the level of the spine involved. Several flexible, narrow, workable portals are placed into the incisions made.
In the open surgical approach, a single large incision is made to gain access to the thoracic region.
One of the lungs is deflated temporarily using an endotracheal tube while the parietal pleura, vessels, and rib heads attached to the involved vertebra are dissected to provide a clear view of the involved region.
Subsequently, long dissection tools are used to perform decompression and reconstruction surgery. Reconstruction is carried out through the same approach, with the use of a titanium mesh cage filled with an autologous bone graft from resected ribs or the iliac crest.
Later, posterior instrumentation is required for stabilization of the spinal column at two levels above and below the resected vertebra.
In cancer patients in whom the ribs are involved, the ribs are dissected along with some of the surrounding area
The microsurgical technique has several benefits, namely reduced post-operative pain, reduced rate of complication (due to reduced dissection of soft tissue), and quicker return to physical activity (resulting in shorter length of stay).

The patient is placed in the lateral position. A posterolateral thoracotomy incision is made first, depending on the location of the concerned vertebra. A second incision is made in the midline.
Subsequently, the trapezius muscle is detached along with the latissimus dorsi muscle along the course of the rib
Once the access is gained, resection of the vertebra along with reconstruction surgery is performed, depending on the requirement

Surgical Outcome of Thoracic Vertebrectomy

Clinical studies have indicated that the various approaches had very similar outcomes with regard to post-operative pain relief, ambulatory ability, and other morbidities.
Certain differences were observed, however, in terms of blood loss (which was least in the anterior approach), the incidence of wound infection and deep vein thrombosis (higher in the posterior approach), and rate of complications like pneumothorax and pleural effusion (lowest in the posterior approach).

Preoperative Preparation for Thoracic Vertebrectomy

The preoperative preparation for thoracic vertebrectomy essentially depends on the underlying condition for which the procedure is being conducted.
Various radiation imaging techniques like Computed Tomography (CT), Magnetic Resonance Imaging (MRI), Radionuclide imaging are carried out to confirm the location of the involved vertebra, the spinal pathology, and the surgical approach best suited for the thoracic vertebrectomy
Surgical planning becomes essentially crucial in conditions involving primary or metastatic tumors to assess the extent of the surgical resection required

Postoperative Care After Thoracic Vertebrectomy

On average, the post-operative patients require intensive care monitoring for about 5 days after the procedure.
The patients may require custom-made braces for an average period of 30 days after the procedure. In case of delayed mobilization of critical patients, braces may not be required
Steroid therapy may be required for patients presenting with transient post-operative paresis, which will subsequently be resolved after the therapy

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Thoracic Vertebrectomy in South Korea

Thoracic Vertebrectomy requires highly trained surgeons with specialized skills to conduct a successful procedure and enhance the health outcomes for the patient. South Korea, with its rapidly emerging medical equipment technology market, has been at the forefront of imaging technology for medical services.

Further, the country has doctors and medical professionals who have been trained abroad with special skills to manage oncology patients.

Hence, even as seeking medical care and treatment in South Korea implies an extremely long travel time, more and more international patients prefer the destination thanks to its technological advantage.

Thoracic Vertebrectomy in India

India is the most preferred medical destination in the world, which provides medical care at one-eight the cost compared to the United States. This implies that to seek care in a JCI-accredited hospital in India, a US citizen will spend only 15-20%, which will include the travel fare, visa processing fees, and other miscellaneous expenses.

The quality of care in India remains comparable to that in the United States. This has given the Indian healthcare market a great advantage in the sector of medical tourism and has been attracting several international patients.

Thoracic Vertebrectomy in Mexico

As per the World Health Organization (WHO), Mexico has the 61st best healthcare infrastructure in the World. This speaks volumes about the quality of medical care, technology and skilled manpower, which is deployed in hospitals across the country.

Further, with several JCI-accredited hospitals, Mexico has reiterated its commitment to providing good quality medical care services to US citizens seeking medical care abroad.

Thoracic Vertebrectomy in Turkey

Turkey has several top-quality medical, spa, wellness, and thermal facilities and five-star hotel accommodations in Istanbul, Ankara, Izmir, Antalya, and other major cities, which has increased the inbound flow of medical tourists from abroad.

Some of the leading hospitals in Turkey have JCI accreditation and are affiliated with top-tier US providers such as Harvard Medical School, Johns Hopkins Medicine, etc. This has augmented international patient flow in recent years, with more and more US patients looking at Turkey as a destination for medical tourism.

Thoracic Vertebrectomy in Jordan

According to Deloitte, by 2017, over 16 million Americans could be traveling to other countries for treatment in search of better prices, better quality, better access, and better availability. This is due to the escalating cost of medical care in the United States and available options for lower cost of medical care abroad.

As per the World Bank, Jordan is ranked the fifth-best hub for medical tourism and the best in the West Asian Region. With the superior quality of care, the cost of seeking medical care in Turkey ranges from 10% to 25% compared to the costs in the United States.