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BrittleBones 06-11-2007 09:34 AM

Fractures at T3 & T4 - How to treat?
:eek: Hi everyone. Over the past 8 months or so I've been experiencing increased pain at the area around and just below my right scapula or "wing bone" as I call it! (I'm very technical!! lol) Anyway, because I hadn't seen my surgeon in about 20 months for a checkup I decided to make an appointment to see what was causing the pain. I just got back and, I must say, I'm a bit dumbfounded! He took xrays and came in to talk to me and hubby. He said, "well, the good news is that nothing has changed since I last saw you." I said, "thats good...but can you tell me what this pain is coming from?" He said it was coming from the 2 vertabrae fractures at T3 and T4. These fractures were news to me...he's never mentioned them to me before. I asked him how come these fractures weren't considered a change and he said because I always had them but he never told me because he said I wasn't complaining about them at the time. What kind of answer is that?? You mean to tell me that I've been walking around with 2 broken vertabrae with increasing pain and thinking that everything was just fine and dandy? You have to know this surgeon to appreciate him. He has zero, zilch, nada bedside manner. He's the one I've mentioned before who has NEVER looked me in the eye to answer a question.....always addresses answers to my questions to my HUSBAND!! Cold fish doesn't begin to describe his personality!! Anyway, his answer to my new pain is that my muscles have become very, very weak and aren't supporting my "fractures" the way they once did and so now I have pain. I asked him if he couldn't fix the fractures surgically for a permanent solution. His answer is yes, although neither he nor I really want ANOTHER spine surgery. His advice is for me to strengthen my muscles by working out 4 days a week. OK, I'll buy that for now and I'm going to follow his instructions to the "t". But, how long will this take? He couldn't really give me an answer except to say, "a long, long time". Here's my question for you folks - the broken vertabrae are part of my spinal fusion - the very top two vertabrae to be exact. Has anyone had success in improving pain caused by fractures by just exercising? And, since the bones are broken, would it be considered a "failed fusion"? Any advice or similar experiences with exercising to improve fracture pain? Thanks - KathyMac

BrittleBones 06-13-2007 10:28 AM

Re: Fractures at T3 & T4 - How to treat?
Hi again - I'm bumping this up because I need some feedback. Shorline, do you have any advice for me?? Anybody else? C'mon folks - don't let me down! Thanks - KathyMac

mzpain 06-14-2007 03:14 AM

Re: Fractures at T3 & T4 - How to treat?
Hi Kathy, I do alot of research of the spine medically and legally. When it comes to doctors ( actually anyone or anything) I can be extremely suspicious especially when my intuition flags go up. The first thing I thought after reading your post is, that doctor lied to her! I feel that his flimsy excuse doesnt fly with me. I think he didnt tell you (he may have a legal obligation to have told you when he first became aware of it) because he may have of felt he had caused it, and that can mean a malpractice lawsuit. I highly suggest you get copies of all your records and get your MRI films etc... from before he worked on you and after. Dont call attention to doing this, they could end up missing or damaged (this could be your proof). I could just be paranoid and wrong but his excuse sounds so guilty of something. I would call a top notch malpractice attorney tell him/her the whole story and see if the attorney knows a professional that can determine, by reading your films, if these fractured vertebra are the result of your doctors negligence. Since I am sure you signed releases before your surgery stating the risks etc.... which would usually cover a doctor's butt, but there has to be a reason he didnt tell you previously and it could be because he thinks he did something he can be held accountable for. Please just talk to an attorney that specializes in these things.

Shoreline 06-14-2007 08:42 AM

Re: Fractures at T3 & T4 - How to treat?
Hey Kathy, Unless the area they fused fractured it wouldn't be considered a failed fusion.If a fusion is succesful, it should be harder to break the fused area than the vertabrea above or below a fused area. However if you have screws and the fractures radiate away from the screws, this is a sure sign the fusion failed because the screws shouldn't be bearing weight once a fusion grows and becomes solid. I have fractured several vertabrea and my sacrum this way and all they can do is put me back in a brace or revise a 6 level fusion and extend it up and run a bar from hip to hip , not to mention remove a rib from each side. The last surgery took 11 hours and I'm not ready to sign up for that monster surgery and roll the dice with such horriable odds it will do anything more than stabalize things where I'm at.

I would certainly get a second opinion though. not because I think there is a potential for a law suite, because you would have to prove the neglected area that caused no pain at the time is some how the cause of all your pain and disabilty now. Millions of people walk around with DDD and never know it, walking around with a fracture that isn't causing any symptoms is really no different. so I understand the reaon not to emphasize a problem that really isn't causing any synptoms.

My concern would be, Why haven't the fractures he saw 20 months ago healed yet?. As far as strengthening the muscles and needing to keep them strong, that is going to take an effort the rest of your life to add stability to an unstable area. If nothing surgically can be done, the only thing you can do is strengthen the sourounding muscles.

There are minimalluy invasive procedures called Vertebroplasty and kyphoplasty , where compression fractures where more than 1/3 of the vertebral hight has been lost can be performed to repair the fractures and rebuild the vertebral height. Personally I would still want another opinion from a doc that's going to shoot straight and explain why something can or can't be done. I just read about the osteoP Kathy and that really changes everything. If it's the area above or below a fusion that fractures, there is no reason to think the fusion failed other than poor odds of sucess with osteo P.

If nothing else can be done surgically or your not willing to risk ending up worse, There really is truth to building the muscles around the injured area. As crazy as excersing when you hurt [I]that bad [/I]sounds, if you come to the conclusion, your going to hurt whether you excercise or not, and it will only help in the long run, why not benefit from all it does for you. It took me 7 months of excercising once a day and then twice a day to get to the point I went back to work part time. I started at 8 minutes with no weight in my hands and that kicked my butt, however by the end I was excercising twice a day for 30 minutes with 5 lb weights in each hand. That also kicks my butt, however the benefit is so worth it.

My wife thought I was a maniac, no PT or doc would have ever pushed me that hard but it seemed like the only thing I really had control over as far as making a change in my life. Weight training, even light wieghts along with the right protocol for OP can be effective and hopefuly resolve the fracture problem. Have you already had vertebroplasty done?

I've been able to rebuild strength, loose 35 lbs and haven't had a fracture in over 2 years. It's a little easier to stabalize and strengthen the core muscles,"abs and lower back" but high thoracic will be core and upper body. I use an elyptical machine and instead of using the hand rails I use 5 pound dumbels and do hundreds of curls, over head presses,tricep extensions, anything to keep my arms moving with the weight in my hands. Not heavy weight, I started with l lb sand bags from an old ankle weight, but hundreds of repititions with light weights is just as good as trying to push heavy weight and muh safer as far as injury..

When I started, just holding my hands out in front of me with no weight and keeping my balance was tough. I'm proof it can be done, I still have bad days, pay for working, pay for excercising, but I'm not the same person I was before I started excercising and decided I couldn't live the next 30 years loosing more strength and getting fatter and lazier. The difference it's made in so many areas makes it so worth while, I just can't name them all without getting edited. ;) Going from sedentary to excercising has so many health benefits including psychological, it makes the increase in pain from excercising worth while.

Definitely get another surgical opinion.The docs have to do their part to allow you to do your part. The doc should be able to tell you why he thinks it hasn't healed if it hasn't, he should be able to discuss the options and show you what he's looking at on the films that make him think he could or couldn't fix things. Docs aren't gods and taking them of the pedestal was one of the best things I could do when it came to dealing with docs. Every doc has their opinion, That's it, just an opinion. They should be willing to explain it and justify it and if they can't, something isn't right.

The patient does need to know why or how, not just that He could operate if you wanted. What would he operate on? what is there that he's not telling you that leads him to think there is a reason to cut you open again.

Sorry to hear things aren't going well, Hang in there, Dave

BrittleBones 06-14-2007 08:50 AM

Re: Fractures at T3 & T4 - How to treat?
Thanks MZPain - I appreciate your input very much. I'm thinking that this probably isn't a case of malpractice, but more a case of his thinking, "What she doesn't know won't hurt her!" His explanation for not telling me at the time he discovered the breaks was, "Well, you weren't complaining about them so I didn't see any reason to get you all upset about it." I would have much rather he told me at the time so that I had a chance for some repair. I've heard from another doc that after fractures have been around for awhile, they can become impossible to fix. I have had about 10 spinal surgeries with this doctor and most of them were to fix collapsed vertabrae. My pattern was to have a fusion and then weeks to months later a vertabrae or two would break due to my severe osteoporosis. He would go in and stabalize the fracture(s) and then months later the next level down would break, he'd go in and stabalize, and on and on and on. Perhaps he just didn't want to expose me to another surgery until it was absolutely necessary. I am also hoping that Shoreline will read my post and put his 2 cents in. I haven't seen him posting on the board in a few days. Hope he's ok. Dave...are you out there? Anybody else? Thanks again! KathyMac

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