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'Thoracic Discectomy and Fusion'
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DeniceT posted:
Looking for advice on Thoracic T10 Discectomy with Fusion surgery and recovery. I am 51 and was very active until I was rear ended a year and a half ago. I went through months of chiro and phys. therapy and thought I was doing much better but then back in Sept. things just spiraled and after a trip to the emergency room and a missed diagnoses of a torn ligament on floating rib they finally did an MRI. I have 3 herniated disks in my thoracic with nerve impingement at T10/T11 and spinal stenosis throughout thoracic.

It's the Nerve pain that is giving me the most trouble. Feels like a hot poker in my side/back with spasms around my side and chest area, like someone has me in a vice. I have had two recent epidural injections as a last ditch effort to avoid surgery ...they have not helped but did lesson the leg weakness I was experiencing. Neuro has now suggested a discectomy with fusion to take pressure off the nerve but can do nothing about the other herniations or stenosis at this time. I am waiting on a call back from his nurse as I forgot to ask what approach he would take if I elect to have the surgery.

I can not lay down on my side, tummy or back without strong spasms, hot poker and a weird nerve sensations running along my side so I try to sleep sort of propped up on three pillows. Recently I have resorted to sleeping pills but still awaken several times uncomfortable, needing to readjust position. I am scared to death of the surgery but the pain is unbearable at times even medicated, especially in the morning upon waking and at night after a long day. My days are ruled by what ever I might have done the day before that may have aggravated it and whether or not I got good sleep which is hard to do setting up.

After reading posts of others and their outcomes I am even more hesitant for the surgery, as it seems no matter what I will still be in pain. My other concern of course is my quality of life with or without the surgery.

Right now I am on Hydrocodone 7.5mg 3 times a day, flexeril as needed for the spasms ( I rarely ever take it), Celebrex for the inflammation and Gabapintin for nerve pain (300mg morning, 600mg at bedtime). It may sound as if the meds aren't working but I certainly couldn't do without them, they definitely take the edge off.

I would appreciate hearing from anyone out there with advice on the surgery proposed or any other advice for that matter.

(MRI results - focal disc protrusion to the right at T10-T11 with nerve impingement. Disc bulge eccentric to the left at T9-T10, disc material has migrated cephalad along the vertebral body of T9 and does indent the ventral aspect of the thecal sac. Disc bulges centrally at T6-T7, T7-T8, and T8-T9, The discs at these levels indent the ventral aspect of thecal sac. ) Sorry for the long post!
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TRS1960 responded:
Have you tried Facet anesthetic injections? They are a test procedure for a more permanent nerve burning procedure. The Facet block is not that painful. If the nerve pain goes away for a few hours then the more permanent nerve block is likely worth persuing.

I'll post up more tomorrow...it's night night time for me now.

Wishing everyone a good peaceful night's sleep.
 
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DeniceT responded:
I did have a laser nerve oblation in a cervical disc back in 08 that was very successful, it also was a two step process. it sounds like the same thing, is it? I asked the surgeon if that could be performed in the T10-T11 and he said no.
 
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Dot40324 responded:
Hi Denice and welcome. I am sorry you are in so much pain. Most of my problems are in the lumbar area and I'm afraid I won't be much help in your area of pain.

Please remember too that this is a pain board and we are the unfortunate ones. There are many people out there leading normal lives after their surgeries.

It's good that you are researching all your options before having the surgery. Once it's done there is no going back but there come a point where something has to be done too. It's a hard decision to make.

I am posting a link that shows how each disc affects different areas of the body. This might help you understand your pain a bit better.

Please keep us informed. This is a great place to come for support. It really does help to talk to others who understand what kind of pain you are in.................Dot '

mississaugachiro.com/interactive_flash_spinal_nerve_chart.php
 
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TRS1960 responded:
OK, I finally have a few minutes to add to this.

The good news: thoracic fusions are not nearly as problomatic as lumbar or cervical. By nature your thoracic vertabrae barely move. They are the back of the box created by your ribcage to protect your internal organs. So you can live with thoracic fusions and have very little side effects. If such procedures can help mitigate the pain you may end up kissing you surgeon. You've got stenosis issues too tat may not be that easy to fix, but if they could go in and open up some of the spinal canal and remove the nerve impingment even if it required fusions I'd be willing to listen. My problem with my thoracic injury is that I was crushed by a tree and my spine was shortened 3 inches in the thoracic region. This caused much damage to spinus process and the muscles that attach to them. So along with disc pain I had/have much muscular pain too. I'd recommend advice from a neurosurgeon and an orthopedic surgeon.

Back to work, I'll add more as I think about it.
 
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beachgirl47; responded:
Although I have been told that I am not a candidate for sugery I have long suffered Thoracic pain. Started out of the blue 5-6 years ago. I am in my mid 40's and taking Oxycontin, Soma, Klonopin, Skelaxin just to be somewhat comfortable. Pain is worse at night and travels from the back into my ribs around front. Along with muscle spasms. Upper shoulder area also very painful. Have tried every Dr. and none can find an answer. I am have been under the care of a Pain Management Dr. and have a spinal nerve stimulator implanted in my upper back. Still in pain everyday!
 
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Janemarie55 responded:
Hi Denice, Thoracic surgeries are sometimes more difficult than disk surgeries because they have to go in from the front instead of the back. I have a T12 fracture that I had a procedure for and it failed, so I may be looking at surgery. Be sure you have a good Neurosurgeon that can explore all the options with you.I am in constant pain that I get some relief from pain meds and bracing, but since surgery is a major decision I'm not going to rush into it.
 
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TRS1960 responded:
That's not true. Posterior vs. anterior surgucal sites depends on the actual surgery/injury. You can have posterior thoracic fusions or anterior fusions through the entire thoracic region.

Regardless, you need an ortho or nuero that you can trust.

Harrington rods are the classice hardware used to attach (fuse) thoracic (and lumbar/cervical) vertabre from the posterior (back) side. I have 12 fused vertabrae and have harvest sites from my hip bone. The only anterior (frontal) incision I have is from a lung tube that was installed to re-inflate my right lung the trauma triage.
 
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Mallardman responded:
I will say one thing my back surgeon said to me and that the Thoracic is a no mans land.

I asked what he meant and he said they don`t like to work on them except in a trauma situation .

They just don`t have much success there.

Good Luck
 
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Denice_T responded:
I wasn't going to rush into it either but the last three days have been just terrible. I have been in bed for three days, can't get comfortable even in the recliner, just shaking my head makes the pain unreal in my side. My dr. has sugested Posterior access. What procedure did you have that failed if you did not have surgery?
 
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Denice_T responded:
Hey Tim,

My Dr, has suggested Posterior but why I don't know, I see him again on the 10th. He said laminectomy/discectomy with peticle screws and fusion. I don't recall anything about plates or rods though. All I can do is hope it's the way to go. I guess you didn't have much choice since yours was from trauma. I've read about microdiscectomies, and he does specializes in them but did not suggest it in my case, maybe that's because of the stenosis, I was so shocked I didn't know what to ask at the time...still just learning here.

My daughter is having a C-section May 31st and needs help, as she also has a 4 yr old. I had planned to be with her for the whole month of June (before all this got bad) and when the Dr. said he'd probably do surgery in March, if this last EDI didn't work, I just lost it when he said there would be no way I could help take care of a new born by that time. That's when I really got scared about recovery.
 
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pkings responded:
I am sorry about your situation. I have trouble in the t-5 t-6 area and was told that is a real tough area to repair. Had to go home today because of the pain. I, like you, are trying to weigh options on what treatment is best.I wish there was a clear cut direction but unfortunately there is not. From what I've heard and read from other people's experiences no 2 are alike and no 2 doctors opinions are the same. terribly frustrating. All I can do try to take it as long as I can, but my time is starting to run out. This is the 1st time I've gone home or called in sick with this problem and have been dealing with it for quite a while. Try to keep positive. I know that can be difficult just ask my wife and kids. Sometimes I can be a real bear. I'm lucky that they understand, to a point. It is good that you are asking advice and we are lucky that there is a forum that we can reach out to for help. Good luck with your situation and keep posting.perry k.
 
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TRS1960 responded:
Perry, I absolutely agree with you. Every doctor has different opinions. Every doctors will look at things their own way and every one of us deals with pain differently, heals differently and thinks differently. Everyone of us metabolizes drugs drugs differently too.

That's why the main them to this group is support. We don't tell you what to do or how to do it, we tell you to keep your chin up and hang in there; to listen to your doctor and with all of our ecperiance we sometimes tell you what your doctor should be saying to or asking of you.

Denise, if your pain wasn't so bad maybe you could put the surgery off until after you've helped your duaghter? Make sure you're scheduling surgery because it's right for you, not because it's right for the doctor's vacation schedule.

As for plates and rods, there's a ton of ways docs can mix and match. Typically rods go posterior (on the back) of the spine and plates cages etc go anterrior (front). But nothing is writen in stone, especially when it comes to truama versus degeneration.

Good luck to you and we'll keep praying for you.

Tim
 
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patb49 responded:
Denise, I am fused from T8 to S1, I really need to go back in & have it all redone as my spine did not heal straight. I am beginning to be bent over, but.... as my surgeon said, to do that type of operation would be very painful besides very dangerous. So.. I will not be doing it. My rods have broken twice and have had to have them repaired both times. The Dr. said to go any higher in the Thorasic section of my spine is not a good idea. All of my problems stemmed from birth and all was degenerative. He tried to straighten me as much as he could but I have such a problem with walking that it did not heal straight. I am thinking of calling him and being refit for a hard cover brace to help me straighten up. Of course gaining the weight I have gained has not helped any. Good luck & please keep us posted as to what you decide to do.

LOVE LUCK & LAUGHTER

Pat
 
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pkings responded:
Tim, I see that you have had quite a bit of trauma in your life. You give excellent insight to people in need. My question to you is what is your take on pain meds. I was on a board with some other people earlier today, but I forgot what page and website. I'm new to this game and my inexperience shows. Anyway the topic was how people on pain meds are perceived. Are you on any pain meds and how do you deal with pain med issues. perry k.


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