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Hello Doctor, I did have an epidural steroid injection May 28th. It did take the fairly normal time frame of a week to feel the pain relief benefit. This was done in to my thoracic 5-6 due to the forarmanal stenosis and my complaint of radiating to the front rib pain and down into my abdomen pain. Well, that pain relief only lasted two weeks for me. I have a follow up visit with my Lima OH ortho surgeon next week. This pain mid back and radiating never lets up and is limiting my daily activities. I’m not sure my surgeon operates in the thoracic spine or not. From everything I read, it’s like no one wants to operate in the thoracic region of the spine? Do you do mostly min invasive or posterior big open surgeries? I’ve read about VATS? Anterior entry and rib removal? I can’t imagine living my life with this pain so I’m actually wanting surgery if that will resolve what seems to be a pinched nerve root at T 5-6.The doctor who performed the ESI said the stenosis was severe. It was diagnostic also as I had been about a level 7 pain and because of the numbing he injected with the steroid I immediately went to no pain!
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!! CindyThank you for your reply Doctor. No I did not have scoliosis. My ortho surgeon took it that high due to stenosis and DDD. My pain management doctor performed one brachial block diagnostic on March 10th and I had another scheduled the following week as the doctor said insurance requires he does two of them and the Covid cancelled out that out patient. So with the new thoracic MRI, you don’t think that a minimally invasive surgery to clean up the T 5-6 which may be pinching a nerve thus my radiating to the front rib/abdomen pain?? I have noticed every time a MRI of my spine has the words stenosis that my ortho surgeon recommends surgery. Yes the ACDF 4 level got rid of my right arm pain and numbness. The cervical MRI had stated stenosis. May I ask you please. Since I have two fusions now. S1-T10 and C3-C7, can a thoracic fusion be added without having to remove that hardware and make it one continuous rod??? Can one be proactive here since new MRI said disc dessigrated so I assume as I age will only get more painful? No mention of kyphosis in the MRI???
Yes Doctor I will list my history:
2013 pain down left leg from buttocks to back of heal did not improve with PT or epidural shot. Surgery was a posterior decompressive lam I believe at L5/S1
2015 same pain returned. First posterior fusion of that area
2018 same pain returned. Revised fusion, old hardware removed, Posterior fusion now extended S1-T10
within the first 9 months post op of that I developed pain in my mid back where I never had pain. Back to ortho-surgeon which his PA ordered both lumbar and thoracic CT scans which showed nothing. I complained to ortho, he advised me to stop working asap or something was going to break and I would end up in a wheel chair and need a machine to breath! Scared me but not retirement age yet so got a second ortho-neuro opinion with MRI March 2019 of thoracic and he said I could work and if anything broke they would fix it. The original surgeon just said to take ibuproffin 600mg for the pain. which I did and still painful. Altered my work schedule, rested more by missing out on fun outing with family and friends. Finally this pain in my mid back was now radiating around my right side along my rib bottom into my sternum/chest wall and most painful into my abdomen! Back to ortho which means his PA sees me and she tells me to see a PM doctor. That’s where I am at and considering radio frequency nerve ablation at the two levels above the fusion end at T10. I knew my thoracic MRI was now a year old so I made the Ortho PA order a new one as the PA asked me what I wanted and I told him to be rid of the pain I have lived with for 1 1/2 years oh which I forgot to add that about Nov 2019 I started with waking up with both arms but mostly right numb from should to hand. Then severe aching in right arm. I saw my GP who thought pinched nerve in neck and GP ordered cervical MRI then said see ortho. So I return to the same ortho who had done the previous 3 surgeries and saw him on Jan 7th and he was doing the ACDF C3-C7 ten days later. That was a cake walk recovery compared to my previous fusions. I feel since my first diagnose of DDD and spinal stenosis at age 59 here I am 7 years late at now 66 and thoracic problems. I always did the bone density test when my GP advised to and last year was now given diagnose of osteoporosis and osteopenia which I have had one Prolio injection just in March and will do again in 6 months. Yes I’m not a small build 5ft2in about 170. I’m active. Walk everyday if the pain allows. Now retired since Jan and I had planned on working until 70 but the pain was too much! Can you give me an idea of what I need to do?? Thank you!!in reply to: MRI of thoracic spine #32519Hello again Doctor! I would like to paste below the MRI results of my Dec 2019 that led to my ACDF Jan 2020 as your mentioned something about the curvature of my spine. My question is if you often see where a cervical curve could also be part of a thoracic curve?
There is stable reversal of the normal cervical lordosis. There is stepwise anterolisthesis of C3 on C4 and C4 on C5. There is slight retrolisthesis of C5 on C6 and C6 on C7. There are degenerative marrow changes in the endplates at the C5-6 and C6-7
levels. No suspicious osseous lesions are present. The facet joints are normally aligned.The cervical spinal cord is of normal caliber and signal intensity. The visualized aspects of the posterior fossa are normal.
On the axial images, at C2-C3, there are right-sided facet degenerative changes. There is no spinal canal stenosis. There is moderate severity right foraminal stenosis.
At C3-C4, there is a posterior discussed effect complex. There are bilateral facet degenerative changes. There is mild spinal canal stenosis. There is severe left and moderate severity right foraminal stenosis.
At C4-C5, there are right-sided facet and uncovertebral joint degenerative changes. There is mild spinal canal stenosis. There is severe right foraminal stenosis.
At C5-C6, there is a posterior disc osteophyte complex. There are bilateral uncovertebral joint and facet degenerative changes. There is moderate severity spinal canal and bilateral foraminal stenosis.
At C6-C7, there is moderate severity spinal canal stenosis. There are mild bilateral uncovertebral joint degenerative changes. There is moderate severity bilateral foraminal stenosis.
At C7-T1, there is no spinal canal or foraminal stenosis.
There are no suspicious findings in the cervical soft tissues
in reply to: MRI of thoracic spine #32518Thank you doctor! Now to figure out how to get a doctor close to where I live to look for that. Or make a trip to see you!!
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