LASER Spine Surgery Side Effects: Meet the Thoracodorsal Fascia

by Chris Centeno, MD /

Receive a Regenexx® Patient Info Packet by email and learn why it's a superior regenerative solution.

Have you seen those new compression garments athletes wear to try to improve performance? The idea is that by adding compression to the muscles, the ultratight shirts and pants will make the muscles contract better. This concept has been around for a while; it’s called fascia. Every muscle in your body is already surrounded by fascia that acts like these garments. One bit of “compression garment” that’s critical to the health of your low back is called the thoracodorsal fascia. Without this, you wouldn’t be able to transfer energy between your arms and legs. So let’s look, this morning, at what happens when this fascia gets injured by a LASER spine surgery procedure.

The Thoracodorsal Fascia

How are your legs and arms connected? One way is obvious—the spine connects the two. However, unlike the legs, for the arms, there is a limited connection through the bones (the shoulder blades float on the back of the rib cage and only connect to the sternum through the collarbone up front), so most of the connection is muscular and fascial. What does that mean?fascia

We all know that we have muscles, but these muscles are surrounded by and often connected to one another through fascia. This tough covering is necessary for the muscles to work. However, in medicine, very little attention is paid to this important structure. The picture to the left shows how this covering not only surrounds the muscle as a whole but also the individual muscle-fiber bundles.

thoracodorsal-fascia-connections

If there was one piece of fascia in your body that was critical for the normal function of your arms, legs, and spine, it would be the thoracodorsal fascia (TDF). This tough muscle covering surrounds your low-back muscles as well as connects your hamstring and butt muscles to the lat muscles. The image to the right shows how these connections happen.

thoracodorsal-fascia-and-low-back-ligamentsThe TDF also connects to important ligaments in the spine that are critical for providing stability to the individual vertebrae. The image to the left shows how tension through the TDF actually pulls and tightens stabilizing ligaments all the way down to the back of the spinal canal! So suffice it to say that the TDF is critical to normal low-back and arm/leg coordinated function.

There is, of course, no scientific reason why physicians treating low-back pain wouldn’t be very interested in knowing what’s going on with the TDF. However, most back-pain patients reading this blog (and many doctors) have never heard of this structure. Why? Up until now, fascia has been the redheaded stepchild of musculoskeletal medicine. However, I’d like to share a case with you, this morning, that hopefully will increase awareness of how the TDF can be injured by surgery.

A Thoracodorsal Fascia Injury Caused by Surgery?

I love to share interesting things that I find during my clinic day. A case in point is the patient I evaluated yesterday with one our fellows. This middle-aged guy had undergone two right-sided LASER spine surgeries to open the right L4–L5 foramen (the hole where the nerve comes out). The surgeries were ineffective and left him with a new pain right under the small surgical scar. As I examined him, he was very clear that most of his back pain lived at that spot. So is this new pain a result of LASER spine surgery side effects?

thoracodorsal-fascia-mriWhen I reviewed his MRI, something looked strange at the location of the surgical scar. In the MRI to the right, the course of the thoracodorsal fascia is outlined in red triangles. It’s normally a smooth black line at the back part of the muscles. However, this one has a “pooch,” or area where it’s bulging out, right at the location of the surgical site. On the sagittal and axial images to the right, I’ve noted this area with a yellow-dashed circle. However, this MRI is static without motion. If this patient really had a TDF injury as a result of LASER spine surgery side effects, it would show up on ultrasound imaging as well, as the fascia would fail to contain the muscle at that site.

The video above shows how the normal left and abnormal right TDF functioned as the patient contracted the low-back muscles by lifting one leg. Note that on the left, the muscle is contained by the TDF. However, on the right, the muscle easily bulges out past a portion of the TDF (inside the yellow-dashed circle). That bulge corresponds to the one seen on the MRI, and that was likely caused by the surgery.

The upshot? I hope you’ve been properly introduced to this critical piece of fascia that helps your back muscles function normally and allows the energy generated by your legs to be connected with the arms through the spine. In this case, it looks like the TDF injury was a result of LASER spine surgery side effects. For for this gentleman’s injury, we will use our advanced platelet rich plasma injected under precise ultrasound guidance into the damaged area. If that doesn’t work to heal this spot, we’ll use a precise stem cell injection procedure. The whole story in video format is at the top of the page.

Category: Back/lumbar

Leave a Reply

Your email address will not be published. Required fields are marked *

2 thoughts on “LASER Spine Surgery Side Effects: Meet the Thoracodorsal Fascia

  1. Lawrence G. King, Sr.

    I have been scheduled for Spinal surgery. Should I cancel this? The doctor has very good references. People come from what I hear from all over the country to him for treatment.

    1. Regenexx Team Post author

      Lawrence,

      Your surgery is something you’d need to discuss with your Doctor. We share information for the purpose of education. If you’d like to see if your case would be a Candidate for Regenexx treatment, please submit the Candidate form here: http://www.regenexx.com/the-regenexx-procedures/back-surgery-alternative/

Chris Centeno, MD

Regenexx Founder

Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications.
View Profile

Get Blog Updates by Email

Get fresh updates and insights from Regenexx delivered straight to your inbox.

Regenerative procedures are commonly used to treat musculoskelatal trauma, overuse injuries, and degenerative issues, including failed surgeries.
Select Your Problem Area
Shoulder

Shoulder

Many Shoulder and Rotator Cuff injuries are good candidates for regenerative treatments. Before considering shoulder arthroscopy or shoulder replacement, consider an evaluation of your condition with a regenerative treatment specialist.

  • Rotator Cuff Tears and Tendinitis
  • Shoulder Instability
  • SLAP Tear / Labral Tears
  • Shoulder Arthritis
  • Other Degenerative Conditions & Overuse Injuries
Learn More
Cervical Spine

Spine

Many spine injuries and degenerative conditions are good candidates for regenerative treatments and there are a number of studies showing promising results in treating a wide range of spine problems. Spine surgery should be a last resort for anyone, due to the cascade of negative effects it can have on the areas surrounding the surgery. And epidural steroid injections are problematic due to their long-term negative impact on bone density.

  • Herniated, Bulging, Protruding Discs
  • Degenerative Disc Disease
  • SI Joint Syndrome
  • Sciatica
  • Pinched Nerves and General Back Pain
  • And more
Learn More
Knee

Knees

Knees are the target of many common sports injuries. Sadly, they are also the target of a number of surgeries that research has frequently shown to be ineffective or minimally effective. Knee arthritis can also be a common cause for aging athletes to abandon the sports and activities they love. Regenerative procedures can be used to treat a wide range of knee injuries and conditions. They can even be used to reduce pain and delay knee replacement for more severe arthritis.

  • Knee Meniscus Tears
  • Knee ACL Tears
  • Knee Instability
  • Knee Osteoarthritis
  • Other Knee Ligaments / Tendons & Overuse Injuries
  • And more
Learn More
Lower Spine

Spine

Many spine injuries and degenerative conditions are good candidates for regenerative treatments and there are a number of studies showing promising results in treating a wide range of spine problems. Spine surgery should be a last resort for anyone, due to the cascade of negative effects it can have on the areas surrounding the surgery. And epidural steroid injections are problematic due to their long-term negative impact on bone density.

  • Herniated, Bulging, Protruding Discs
  • Degenerative Disc Disease
  • SI Joint Syndrome
  • Sciatica
  • Pinched Nerves and General Back Pain
  • And more
Learn More
Hand & Wrist

Hand & Wrist

Hand and wrist injuries and arthritis, carpal tunnel syndrome, and conditions relating to overuse of the thumb, are good candidates for regenerative treatments. Before considering surgery, consider an evaluation of your condition with a regenerative treatment specialist.
  • Hand and Wrist Arthritis
  • Carpal Tunnel Syndrome
  • Trigger Finger
  • Thumb Arthritis (Basal Joint, CMC, Gamer’s Thumb, Texting Thumb)
  • Other conditions that cause pain
Learn More
Elbow

Elbow

Most injuries of the elbow’s tendons and ligaments, as well as arthritis, can be treated non-surgically with regenerative procedures.

  • Golfer’s elbow & Tennis elbow
  • Arthritis
  • Ulnar collateral ligament wear (common in baseball pitchers)
  • And more
Learn More
Hip

Hip

Hip injuries and degenerative conditions become more common with age. Do to the nature of the joint, it’s not quite as easy to injure as a knee, but it can take a beating and pain often develops over time. Whether a hip condition is acute or degenerative, regenerative procedures can help reduce pain and may help heal injured tissue, without the complications of invasive surgical hip procedures.

  • Labral Tear
  • Hip Arthritis
  • Hip Bursitis
  • Hip Sprain, Tendonitis or Inflammation
  • Hip Instability
Learn More
Foot & Ankle

Foot & Ankle

Foot and ankle injuries are common in athletes. These injuries can often benefit from non-surgical regenerative treatments. Before considering surgery, consider an evaluation of your condition with a regenerative treatment specialist.
  • Ankle Arthritis
  • Plantar fasciitis
  • Ligament sprains or tears
  • Other conditions that cause pain
Learn More

Is Regenexx Right For You?

Request a free Regenexx Info Packet

REGENEXX WEBINARS

Learn about the #1 Stem Cell & Platelet Procedures for treating arthritis, common joint injuries & spine pain.

Join a Webinar

RECEIVE BLOG ARTICLES BY EMAIL

Get fresh updates and insights from Regenexx delivered straight to your inbox.

Subscribe to the Blog

FOLLOW US

Copyright © Regenexx 2019. All rights reserved. | Privacy Policy

*DISCLAIMER: Like all medical procedures, Regenexx® Procedures have a success and failure rate. Patient reviews and testimonials on this site should not be interpreted as a statement on the effectiveness of our treatments for anyone else.

Providers listed on the Regenexx website are for informational purposes only and are not a recommendation from Regenexx for a specific provider or a guarantee of the outcome of any treatment you receive.