T4–S1 Spinal Fusion: Indications, Surgical Complexity & Outcomes

A T4–S1 instrumented fusion spans the thoracic, lumbar, and sacral spine. It is reserved for complex, multi-level deformities or instabilities (e.g., severe scoliosis, kyphosis, trauma, tumor, revision cases).

Challenges

• Prolonged operative time, significant blood loss.
• High risk of infection, hardware failure, nonunion.
• Adjacent segment disease, pulmonary compromise.

Outcomes

Can achieve substantial deformity correction and stability, but complication rates are higher than shorter fusions. Requires experienced surgical team and careful patient selection.