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  • Avatarcindy2836
    Participant
    Post count: 8

    Hello Doctor,
    We have recently shared some messages here. I just had a thoracic MRI last Friday that I’m waiting to see the results posted or may have to get those at appointment at Orthopedic Institute of Ohio in Lima OH.
    I saw the PA there Tuesday. Since my MRI is now 14 months old, he did order a new one. He looked at the thoracic side view xray taken that day and explained my leaning forward in it just as you had thought the hyperkyphosis as I have a S1-T10 fusion placed in Jan 2018 as a revision of a small lumbar fusion. My diagnose since 2013 with leg pain has been DDD and stenosis. To add to my hardware Jan 2020 I had ACDF surgery C3-C7 for stenosis and arm pain. My question is if my hyperkyphosis can be surgically corrected (I have severe back pain that radiates around my right side along my rib and into my abdomen for well over a year now) What kind of surgery would that possibly be?? Is another separate fusion added above the ending at the current T10 and go up to meet my C7? or is all the hardware I have now removed and it has to be one continuous long rods???

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 7481

    If you have a hyperkyphosis and you have severe debilitating pain and you have failed all other treatments, you might consider a thoracic corrective fusion but I say that with great reluctance. The instrumentation necessary to allow a fusion can be adjusted to fit your current hardware which is not generally hard to do.

    You however would have a spine that was fused essentially from your mid neck all the way to the sacrum which is something I don’t recommend. You can try extension exercises and stretching over a Swiss ball as well as facet blocks. Try to stay away from a thoracic fusion if you can.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
    Avatarcindy2836
    Participant
    Post count: 8

    Thank you very much for your expertise doctor. I have a very high pain tolerance and yet this pain is now too much for too long for me. If at my ortho surgeon appointment tomorrow (and I continue with the same surgeon who has done all my spine work) if he offers surgery for my thoracic I will say yes. So I am more prepared in comparing things, do you see my thoracic spinal fusion being done by entering through the back, front, side or a combination of? Traditional open surgery or endoscopic? Plus since the MRI states all discs are showing breakdown, that the fusion be all the levels which would be meeting my current T10 up to T1 or possibly meeting my current C7? Basically the only non-fusion levels would be C1 and C2.
    Thank you!! Cindy

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 7481

    The surgery would depend upon the deformity (degree of your thoracic increased curve) and the pain generator. A sagittal standing scoliogram X-ray would be one of the keys for the need to treat. If you are talking about one or two levels only, then there is “dealer’s choice” in surgical approach. If you need a long construct, then the posterior approach is the one to choose.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
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