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Old 03-16-2009, 08:22 PM   #1
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thoracic spine problems

Does anyone have a similar problem with thoracic back pain radiating to ribs? Pain is incapaciting most of the time. I wish I knew how to ease the pain so I can do something active again. Doctors are telling me they cannot operate in the thoracic spine until I have paralysis of bladder or bowel. I've been to 5 or 6 top surgeons in D/FW area and they say the surgery is way to risky. The problem is a herniated disc that is cacified and broke off into the spinal canal and is deforming the spinal cord in the T8-9 area. If anyone could help my husband and I would really appreciate your input.

 
Old 03-17-2009, 01:00 PM   #2
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Re: thoracic spine problems

Renee I have similar problem, I understand how much pain you are in. I get a series of epidural injections every 3 months and they bring the pain down to more tolerable roar. I also have used lidocaine patches on the area of the disc, in the thoracic some of the nerves lie close to skin T8-9 are a little further down from where they are closest to surface but it would be worth a try. What meds do you take? Other than ice/heat there is no magic.

There is a top US Neuro thoracic surgeon at Barrow Neurological Institute in Phoenix Arizona named Curtis Dickman you might get a consult, if you send your MRI and info he will evaluate and he may have ideas or take your case.

Take care!

 
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Old 03-17-2009, 04:09 PM   #3
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Re: thoracic spine problems

There is a surgery - it's called XLIF. I had it done at T6-7. It's not easy, but it might be worth considering for your case. I had it done at UC San Diego. They do it at UC San Francisco and LA, I know for sure. Probably Stanford, too. Definitely look around. I know traveling is a pain, but it sounds like your husband needs someone who can really help.

Good luck.
- Margaret

 
Old 03-17-2009, 06:41 PM   #4
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Re: thoracic spine problems

I would also like to recommend my doctor, who is the Director of Clinical Neuroanatomy at Barrow Neurological Institute here in Arizona: Dr. Frederick Marciano. He did a miraculous surgery on my spine... all thoracic. The Barrow doctors have excellent reputations. I hope you can get a consultation. Take good care and best wishes to you.

 
Old 03-17-2009, 07:57 PM   #5
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Re: thoracic spine problems

I'm so sorry for your pain. Sounds like we had/have a similar injury, though mine had not calcified before surgery. The issue with NOT operating (though I know how scared you are, the risks are huge and I was positively terrified) is that if there is nerve damage which it sounds like there is, the damage will become permanent over time.
I had a herniated disc at T8/9 radiating around the right chest wall. Terrible terrible pain. Anyway, I didn't have it operated on for 12 months for the same reasons as you and now I have permanent right T8 nerve damage.
What sort of surgery do you need? Trans thoracic? This is the type of surgery that I was told I would need, the only safe way at that level because of your aorta, lungs etc etc but after a number of second opinions I finally found a neurosurgeon who was will to do a costotransversectomy to get in to the area. This type of surgery is not performed by many as there is a much greater risk of paralysis (but at least they're not cutting through 6 ribs!) but a good, experienced thoracic surgeon might. Something to note considering how risky it is to operate in the thoracic region, I would never have surgery by someone who wasn't a specialist in that area. I had to travel but I have no regrets.
The only problem with a costotransversectomy is that they can usually only do a bony fusion which may mean trans-throacic surgery later down the track for me (like 40 years) but possibly never.
I strongly urge you to get a second opinion asap, it sounds like you have nerve damage and I wouldn't like to see that become permanent like mine did. TTLC just had some pretty major thoracic surgery done and may be able to help you. T8/9 is a difficult level though and pretty rare.
Please let me know if I can help in any way, chest pain like this is terrible to deal with on a daily basis. Does it hurt more if you try to twist or when you breathe in? This is worst for me. Take care.

 
Old 03-18-2009, 09:07 PM   #6
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Re: thoracic spine problems

Quote:
Originally Posted by Juliet31 View Post
I'm so sorry for your pain. Sounds like we had/have a similar injury, though mine had not calcified before surgery. The issue with NOT operating (though I know how scared you are, the risks are huge and I was positively terrified) is that if there is nerve damage which it sounds like there is, the damage will become permanent over time.
I had a herniated disc at T8/9 radiating around the right chest wall. Terrible terrible pain. Anyway, I didn't have it operated on for 12 months for the same reasons as you and now I have permanent right T8 nerve damage.
What sort of surgery do you need? Trans thoracic? This is the type of surgery that I was told I would need, the only safe way at that level because of your aorta, lungs etc etc but after a number of second opinions I finally found a neurosurgeon who was will to do a costotransversectomy to get in to the area. This type of surgery is not performed by many as there is a much greater risk of paralysis (but at least they're not cutting through 6 ribs!) but a good, experienced thoracic surgeon might. Something to note considering how risky it is to operate in the thoracic region, I would never have surgery by someone who wasn't a specialist in that area. I had to travel but I have no regrets.
The only problem with a costotransversectomy is that they can usually only do a bony fusion which may mean trans-throacic surgery later down the track for me (like 40 years) but possibly never.
I strongly urge you to get a second opinion asap, it sounds like you have nerve damage and I wouldn't like to see that become permanent like mine did. TTLC just had some pretty major thoracic surgery done and may be able to help you. T8/9 is a difficult level though and pretty rare.
Please let me know if I can help in any way, chest pain like this is terrible to deal with on a daily basis. Does it hurt more if you try to twist or when you breathe in? This is worst for me. Take care.
Juliet, I am so thankful for you writing me about this issue! Yes it hurts to twist and I have tried swimming and was down for two days and could hardly move. I have just seen a pain management doctor today and he is going to try more epidurals in the base of my neck since he said the epidurals in the thoracic will iritate the nerves and I've tried 3 of them and he was right! He is suggesting that I get to another top neurosugeon in case I start going paralyzed in the future. He seems to think I will probably need surgery in the near future and wants me to get to know a good surgeon. It really is frustrating to keep doctor hopping, but maybe I will hit on someone who really knows that area. Thanks again!

 
Old 03-18-2009, 09:10 PM   #7
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Re: thoracic spine problems

Thanks for sending me the information and understanding how much pain I am in. I too am going for another set of epidurals next week and hope to get some relief. Thanks again

 
Old 03-18-2009, 09:18 PM   #8
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Re: thoracic spine problems

Quote:
Originally Posted by TTLC View Post
I would also like to recommend my doctor, who is the Director of Clinical Neuroanatomy at Barrow Neurological Institute here in Arizona: Dr. Frederick Marciano. He did a miraculous surgery on my spine... all thoracic. The Barrow doctors have excellent reputations. I hope you can get a consultation. Take good care and best wishes to you.
Hi Chatterboxsd, Thanks for sending me the info. on the doctors that can do this sort of surgery. We don't mind traveling to get this taken care of so we can get on with our lifes!Much appreciated!

 
Old 03-19-2009, 02:50 AM   #9
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Re: thoracic spine problems

I'm so lucky to have found this site! I also have degenerative disc disease. In 90 I had 2 lumbar fusions, 95 2 cervical, 2002 all cervical disc corrected. Now I have 2 new lumbar ruptures, and 5 thoracic with decompression-T4-5, T8-9. Has anyone else had this many? What have you done for pain? I've been in PT since early January, 1st. epidural scheduled for 3/24.

 
Old 03-19-2009, 06:29 AM   #10
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Re: thoracic spine problems

No worries at all, sometimes it just makes u feel better that there are others in the same boat - thoracic probs aren't common so it's hard 2 know what 2 think & who 2 trust.

2 be honest I really don't understand why drs in the US are so keen 2 use epidurals - my surgeons have all been dead against them in case of complications. Basically saying that the risks outweigh the benefits. Perhaps my case is different though, that's just what every neuro has told me. Nerve blocks can help, but honestly, they're not perfect. The things that help me most are keeping active (walking and lots of pilates because by the end of the day I can barely stand up straight) and careful use of the right medications.

As 4 surgery, well, you feel the same way as me but sometimes it can't be avoided. I found a thoracic neuro specialist (who was also a lovely man) & then just put my life in his hands. If u have 2 have surgery, well, u just got 2 do it. It's scary but my neuro was like urs - within months I could expect bladder problems, breathing issues. So I went 4 it. I did (& still do) suffer some breathing probs & pain but as I said NO regrets.

Good luck mate, pls keep in touch. It will be ok

 
Old 03-19-2009, 06:31 AM   #11
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Re: thoracic spine problems

Ps: on blackberry so hope my msg below made sense...wish I had my laptop

 
Old 03-19-2009, 06:47 AM   #12
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Re: thoracic spine problems

Quote:
Originally Posted by Juliet31 View Post
No worries at all, sometimes it just makes u feel better that there are others in the same boat - thoracic probs aren't common so it's hard 2 know what 2 think & who 2 trust.

2 be honest I really don't understand why drs in the US are so keen 2 use epidurals - my surgeons have all been dead against them in case of complications. Basically saying that the risks outweigh the benefits. Perhaps my case is different though, that's just what every neuro has told me. Nerve blocks can help, but honestly, they're not perfect. The things that help me most are keeping active (walking and lots of pilates because by the end of the day I can barely stand up straight) and careful use of the right medications.

As 4 surgery, well, you feel the same way as me but sometimes it can't be avoided. I found a thoracic neuro specialist (who was also a lovely man) & then just put my life in his hands. If u have 2 have surgery, well, u just got 2 do it. It's scary but my neuro was like urs - within months I could expect bladder problems, breathing issues. So I went 4 it. I did (& still do) suffer some breathing probs & pain but as I said NO regrets.

Good luck mate, pls keep in touch. It will be ok

 
Old 03-19-2009, 06:52 AM   #13
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Re: thoracic spine problems

How do the nerve blocks work? I can't do a lot of walking because of the lumbar problems but I do the stationary bike and PT 3x wk. Getting ready for epi, had to stop using the anti inflamatory and asprin and worried how my bodies going to react to that. Have not missed a dose since I began those, Jan.

 
Old 03-19-2009, 11:20 AM   #14
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Re: thoracic spine problems

Reading all your posts sounds very familiar.

I had an XLIF at T6-7 in 2007. It was a non-union (didn't fuse), so I had a posterior revision in Jan/08 that was successful fortunately. I had the hardware from the revision taken out in July 2008 because the spasms were just terrible.

Before, during and after I've had repeated injections: epidural, facet, nerve root, etc. None have helped me unfortunately. I've also had RFA without success. I've tried land and water PT, acupuncture, yoga, massage, chiropractic, ice, heat, exercise, and meds multiple times in multiple combinations. I'm one of those stubborn cases. I hate sharing my story because it's not too uplifting. Still, I have hope that I'll figure something out.

Right now, they're looking at taking out the original plate and screws from the XLIF and maybe something related to the costovertebral joint. I wonder if that joint wasn't part of the problem this whole time - Dr. Me talking here...

I'm really fortunate that I trust my doctor. I have an app't next Weds. 3/25 and I'm already anxious about it. The surgery is scheduled for April 9, but I'm not sure I'm going to go through with it. I have to be confident that there is reason to believe it will help my back pain &/or radicular pain.

Anyway, it's great to hear all your stories. I really do believe in positive thinking and keeping a sense of humor. It's either that or crying all day, right?

Please keep posting. It helps me to not feel so alone in this thoracic world!
Best to you all,
Margaret

 
Old 03-20-2009, 03:18 AM   #15
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Re: thoracic spine problems

You aren't alone and anyone going through thoracic spine problems can't be uplifting all the time--it hurts too bad. Sounds like you've had a terrifically hard time. My Dr. is not in a hurry to try surgery. He's very conservative and I appreciate that. Dr. did my last cervical surgery that finally took care of the horrible spasms and pain so I have a lot of faith in him. Did epidurals give you any relief at all? My 1st is Tuesday and I'm worried just because I've never had 1 before.

 
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