The T4 vertebra

The fourth thoracic vertebra, otherwise known as the T4 vertebra, is located in the upper region of the middle back and is an important support structure for the rib cage.

This vertebra is similar to the other 11 vertebrae in the thoracic spine in that it is designed for strength and support more than for flexibility. This stability means that, not surprisingly, middle back pain is less common than neck or lower back pain because of the limited mobility, which leads to a reduced risk of developing a degenerative spine condition.


The thoracic spine has one main role: provide support for the rib cage. While the lumbar and cervical spine segments also support significant weight, they additionally are required to provide a wider range of motion, exponentially increasing the likelihood of wear and tear.

Conversely, the thoracic spine needs only to be marginally flexible, so the T4 vertebra and other vertebrae in the thoracic segment are instead built to bear the burden of supporting the ribs with a stable foundation. This stability is accomplished two ways:

  • First, the T4 vertebra, like most vertebrae, has two sets of matching facet joints. These cartilage-coated facet joints connect to the adjacent vertebrae, in this case T3 and T5, and are covered with a thick lubricating fluid. This allows the joints to move and provide limited motion but also ensures an extremely strong bond by limiting the degree of flexibility.
  • Second, the first 10 thoracic vertebrae (T1 through T10) also connect to individual ribs, bonding the backbone to the rib cage. This stabilizes the rib cage and protects the vital internal organs in the torso.


Over time, however, the facet joints in the thoracic spine, like all joints in the body, are prone to arthritis and other forms of deterioration, which can lead to painful symptoms. If these symptoms occur, you may experience pain and discomfort in the middle of the back or along the rib cage and chest.

For many patients, several weeks or months of conservative treatment like pain medication and physical therapy can reduce these symptoms. Your doctor can help you find the right treatment regimen for your needs. However, if you require spine surgery, you should contact Laser Spine Institute to learn about our safer, effective alternative to traditional open back surgery.

Our minimally invasive spine surgery is designed to help treat degenerative spine conditions without the lengthy recovery time^ and increased risk of infection associated with traditional open back surgery. To find out if one of our minimally invasive decompression or minimally invasive stabilization surgeries can help you, contact Laser Spine Institute today and ask for a review of your MRI report or CT scan.