My t-spine

[mmglobal]

Continued improvement... almost too good to be true!

OMG - It hurts!!!!! so good...

Mark

[mmglobal]

It's been a while since I've posted. That is an indication of how things are going. Things did get better for January and February... good enough that mid-Feb, I took a trip to Germany with clients. The trip went relatively well and I even got some time off over there. I got to spend a few days in Maastrict and Bonn with Dr. Zeegers. I got to tour the wonderful BetaKlink in Bonn and observer some surgeries there. I got to spend several days in Heidelberg with Dr. Feil at the ATOS Klinik and see some surgeries there.

Upon returning, things went south again. It's been a tough few weeks since I've been back. I'm actually in Barcelona now, at the end of a long-planned trip for me and Diane to go visit with our son and daughter-in-law.

On the flight over, we connected in Philly. On approach, the plane made a rather steep bank; the kind that fills the window up with cars, houses, backyards, etc... While I have no fear of flying, like most people, these views occasionally come with the unpleasant, "what if the bank continues steeper and we went in" kind of thoughts. I was a bit surprised when my brain came back with the answer... "if we went in high speed, it would feel good because the pain would stop."

I'm not suicidal... not even close. But, it has been so very long that things have been so bad. When I report that I'm doing much, much better... things still aren't good. Times of relief are brief, then innocuous activities take it away.

This is the 8th day in Barcelona and there was one day that I was saying "things seem to be improving." Back to miserable the next day. The good news is that I am managing to see the sites, but I'm always right on the edge of not worth it.

More later... Diane can't see me at the computer or I'll be in trouble.

All the best,

Mark

[Maria]

Hey Mark,
It's been a long time since I've been there, in fact went after my first discectomy allowed me to feel good sitting/traveling/siteseeing.

Don't know what to say.. when I'm in substancial pain I just can't do anything much so that's what I do. I've found that while my low back seems to recover much quicker (unless prolonged sitting on cummulative basis is hapening which I don't allow) my cervical spine seems to want to be a royal pain too often. That can be a definate deal breaker when it gets bad enough to involve a horrendous migraine.

I am always amazed at what you are doing and still am. You seem to do so much that I'm sure your body is saying "what's this guy going to do next?" so remember to give yourself a real rest/break when able.

[Crystal33]

Regarding T spine, all I have been offered is a posterior lami and microD by one surgeon and a side approach fusion by another. I have stuck with the pain option instead.
This is a recent publication. Maybe too good to be true?


Minim Invasive Neurosurg. 2010 Feb;53(1):25-8. Epub 2010 Apr 7.
Percutaneous endoscopic thoracic discectomy; transforaminal approach.

Choi KY, Eun SS, Lee SH, Lee HY.

Department of Neurosurgery, Wooridul Spine Hospital, Seoul, Republic of Korea.
Abstract

INTRODUCTION: Because of the increasing use of magnetic resonance imaging (MRI), thoracic soft disc herniations are being easily detected in the early stages. To avoid a high morbidity rate and other complications that are associated with the conventional approach, the authors have applied a percutaneous endoscopic technique. METHODS: From May 2001 to July 2007, fourteen patients with soft lateral or central thoracic disc herniation (TDH) underwent percutaneous endoscopic thoracic discectomy. Under local anesthesia with intravenous sedation, the authors removed the herniated disc through the thoracic intervertebral foramen after performing a foraminoplasty, which is the enlargement of the foramen by cutting the lateral and inferior part of the superior facet with a round cutter. The clinical outcome was evaluated using the visual analogue scale (VAS) and Oswestry disability index (ODI). RESULTS Six patients were male and eight were female, aged 21-75 years (mean: 48.1 years). Mean follow-up period was 60.2 months (15-89 months), mean operative time was 61 min. The mean VAS improved from 6.5 to 3.0 for back pain and 5.8 to 2.5 for leg pain at the final follow-up. The mean ODI scores also improved from 58.1 before surgery to 24.5 at the final follow-up. Conversion to an open procedure was not required for any of the patients. DISCUSSION: As it has been proven to lessen the morbidity rate, this percutaneous endoscopic thoracic discectomy (PETD) technique for symptomatic soft TDH is a safe and effective method that provides a direct route to the lesion under local anesthesia. (c) Georg Thieme Verlag KG Stuttgart . New York.

PMID: 20376741 [PubMed - in process]

[Keano16]

Wooridul Spine Hospital? Then its not "too good to be true", its only - TRUE.

[mmglobal]

Crystal, thanks for the post. My problem is not the disc bulge. I have a ton of room in the canal area, so I 'should' not be bothered by such a small bulge.

An endoscopic thoracic discectomy sounds interesting. Note that they are performing a foraminoplasty where they actually cut clean through the lamina in order to enlarge the canal area. Not too minimally invasive, but maybe better than the alternatives. I'd love to hear more about what they are doing.

Mark

PS... Keano... are you saying that you've heard wonderful things about Wooridul.

[Keano16]

Yes Mark. I have a few Wooridul surgeons on my FB. Also, I discusses about Wooridul with my spine surgeon from Croatia. He is fascinated by concept of their work. Recently they have opened a center of excellence in Barcelona. They are using a lot of innovative techniques like X-MR. They utilize Hoogland's endoscopic system and all other traditional MISS techniques.

Indeed, their founder and leading neurosurgeon dr. Sang-Ho Lee is one of the world leading MISS surgeons. You can look at all of their work and studies at Wooridul Hospital-Human respect, World Top Quality..

[Keano16]

WCMISST 2 (World congress of minimally-invasive spine surgery and techniques) is coming in 2 weeks time and in "Opening remarks" dr. Sang-Ho Lee is having a lecture about "The Development of Wooridul Hospital". Interesting to talk about clinic advancements at the spine congress. This means they are really doing something special in Korea.

Dr. Yeung is executive director and past president at WCMISST.