Thoracic Fusion Options

[JulieAnnaAK]

Hello, I am so glad I found this site. It appears that there are a few thoracic patients and I am excited to get to know your cases, surgeries & recoveries.

Brief history: L4-S1 PLIF for grade 3 retrololisthsis w/HNP 7/2008, C5-7 ACDF 3/2010 followed by a MVA (T-boned) about 8 weeks after the surgery. I was driving and was struck on the passenger side pushing my car about 10 ft.

After several weeks of agony I finally convinced my NS (pa) to send me for a nerve block & steroid injection. They injected C8-T1 and I felt a little better but not a success. Then a month later we did T3/4 (no success) a couple days later my ordered my first T-Spine MRI. It showed multiple protrusions from T4-L1 with 7/8 torn and 11/12 torn. I then had 2 more injections with the t7/8 TFESI working for a few hours. This is now about November. I met with my NS for follow up and he sent me for a CT scan with Myelogram and spinal fluid test (rule out MS). He then told me when I can't take it any longer he would perform a Thoracic fusion (thoracotomy/ big ugly surgery).

I started into PM for medication and even though I am tired from the meds I was managing well enough. Still working but not very hard. I have had to stop any lifting, carring, all around cut back the activity or I go into bad flares in pain. Recently I fell down (for no reason) and then things started going down hill. I started getting myelopathy in my left leg (this week into my right), extreme nerve pain into my ribs, under my arms (typical ring of fire). I called my ns and they got me in right away. I am always in pain where my bad spot is located. They ordered a new MRI w & wo contrast. My bad disc is worse and now I have end-plate edema on both the T7 & T8.

I had asked my PM to get me a referral for a second opinion. I see my old NS later this month but saw this new NS yesterday. The second opinion is suggesting a XLIF only at the T7/8 spot. I am not sure what my old NS is going to tell me (how many levels). I am doing a lot of thinking. I am pretty sure T4 is also a trouble maker due to the intermitten electric pain I get right in the center of my breast.

I really like the minimally invasive idea (hearing that the thoracotomy patients have a worse recovery than a PLIF patient makes me cringe with the thought of it). I worry that the cage will shift or break.

Any input is greatly appreciated.

Thank you,

Julie