Thoracic Patient-Please Help!

[Scared]

I am a female in my 20's who has been suffering from extreme pain in my thoracic spine. I found a surgeon that thinks he can help me by doing a fusion. I just wanted someone who understands to tell me if it's the right decision. How painful is it? Is it worth it? How was your experience? I'm absolutely terrified! Here is what has been found:





Findings: On the scout localizer there is reversal of the normal cervical lordosis with mild disc osteophytic ridging in the cervical spine with still mild spinal canal and neural foraminal stenosis. There is a mild dextroconvexity within the thoracic spine. There is no definite subluxation of vertebra and no compression fractures. At least mild to moderate degenerative space narrowing in the mid thoracic spine. There is mild associated degenerative endplate irregularity and mild associated endplate spurring anterior in the mid and lower thoracic spine. Overall the neural foramina in the thoracic spine appears mildly narrowed.
T4/5: Disc space narrowing on the left side with a left lateral disc osteophyte complex, this is foraminal and subarticular without significant spinal canal narrowing and no more than mild narrowing of the left neural foramen. T5/6: Disc space narrowing on the left side. Mild anterior and posterior disc osteophytic ridging with a slightly more focal left lateral, subarticular and foraminal disc hernia with mild mass effect on the left lateral recess. Only mild spinal canal narrowing is present. The left neural foramen is mildly narrowed. T8/9: Right central there is a disc herniation with mild extrusion of disc
material. The disc remains unchanged compared to the previous exam and measures approximately 5 mm from anterior to posterior and approximately 8-9 mm from superior to inferior. On the right side the spinal canal is mild to moderately narrowed with mild mass effect on the right ventral aspect of the thoracic
spinal cord. There is no frank spinal cord compression or spinal cord edema. This is still relatively small to medium sized right central disc herniation. This is unchanged compared to the previous exam. Minimal disc osteophytic ridging at other levels for example T6/7 and T7/8. Mild or subtle degenerative facet arthritis for example on the left side at T9/10. Mild degenerative endplate signal changes best seen at T8/9 representing a
combination of Modic Type-I and Type-II. Impression: 1. Mild scoliosis in the spine with mild degenerative disc and facet disease. Small left lateral disc herniations at T5 and T5/6 with only mild narrowing of the left neural foramina. 2. Right central disc herniation at T8/9 remains stable with mild to moderate spinal canal narrowing and minimal mass effect and displacement of the thoracic spinal cord. This appearance remains unchanged. No spinal cord edema and no frank spinal cord compression. 3. Mild degenerative changes in the cervical spine.

[John Galt]

Hi, I don't understand all of the details of the MRI findings but I can say that you should get more than one opinion before having surgery. Also, check with Doctors who treat backpain using non-surgical methods.
Finally, if you do get surgery you want to be confident and not scared. Find out all that you can, learn all that you can and your confidence will grow in your decision.

[jsewell]

Hi,
I agree with everything John said. I don't understand a lot of what your test reveals.
I did have a thoracic fusion a few years ago when i was in pretty bad pain as well. It didn't help at all. what did help, was removing a few of the painful thoracic discs. I can't recommend the surgeon who did it , unfortunately. Just get as many opinions as possible. find the surgeon you are confident in.
judy

[Scared]

Thanks guys! Well I basically have a herniation in the thoracic spine. Ive done everything. Im too young to be on pain meds for the rest of my life and I just want it to be fixed. Ive seen a couple of surgeons and finally found one that is willing to do it. I just dont know if its worth it?

[mmglobal]

Scared, welcome to the forum! I'm sorry that you find yourself here... not a good place to be in your life.

You have a lot of pathology mentioned, but they all seem to be small, mild, subtle, etc... All of this could be completely asymptomatic, or it could be highly symptomatic. Be very careful because the pathology that looks the worst may not be where the pain is coming from. Are they talking about fusiing from T4 to T9???

There are many different ways to accomplish thoracic fusion. They used to do open thorocotomies; opening your chest to get to the spine from the front. Posterior fusions with pedicle screws and rods are not nice to think about because of the damage done to the musculature and other supporting elements.

In the 90's, Video Assisted Thoracic Surgery (VATS) was developed, allowing much less invasive access to the thoracic spine through small portals on your side. Better than the other styles (if you are a candidate), but still not a great surgery.

Now, many surgeons can offer XLIF, (eXtreme Lateral Interbody Fusion). I believe that this is the least innvasive approach... especially for multi-level procedures. I'd only consider this from someone with GREAT experience in this technique... they know how to stay out of trouble (from learning on their early patients). You may not be a candidate for XLIF.

Again, identifying the pain generator; not guessing about it, is key. For thoracic spine surgery, consider looking for the scoliosis specialists because they will have more experience and will have been through the progression of technologies. That gives them an understanding that the younger surgeons will not have.

Good luck! Please keep us posted. I hope the end of this process is you finding some relief.

Mark

PS... what does your cervical MRI show? Can you describe your symptoms in detail?

[Scared]

Thank u so much! I think he just wants to fuse T8-9. It basically feels like a hot sword through my back right about where my bra strap is.