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Help with post-op mri

renee swanzyrrenee swanzy Posts: 20
edited 06/11/2012 - 8:37 AM in Upper Back Pain, Thoracic
Having severe pain post-op fusion t8-9 3 months ago and my MRI says spinal cord edema and slight cord enlargement but not the size of a shrinx 2mmx2.2cm. I had none of this before the fusion and pain is way more now than before the surgery. they had to put me on pain patches and oxycodone to keep me more comfortable. Doctor thinks it's just post=op pain, but he always says that and come back in 2 months. I'm very worried it could be spinal cord trauma because when I look up edema and cord enlargement it always comes up spinal cord trauma and emergency steroid IV to get the swelling down. Have any of you heard of this after fusions?


  • Where is your pain? Is it around the surgical incision site or is it in other places?

    The emergency IV steroid protocol I am familiar with is for folks with spinal cord compression and have nerve symptoms, or have C spine cord swelling and the team is afraid of ascending swelling. These all are for acute trauma. These are MAJOR doses of steroids and then a continuous steroid drip. This is just what I am familiar with.

    Again, where exactly is your pain? I guess I would not be happy to just be poo-poo'd off by the doc and told it was normal postop pain. I'd want to have him explain exactly what the cord swelling means. When did this pain develop? Did it just develop sometime AFTER surgery? That would send up a little red flag to me if you were fine immediate postop and then a month later this started.

    What all hardware was used during the fusion and what graft material was used-hip, cadaver, lamina with BMP? It's difficult to read any films when metal is in your back due to artifact. In my personal opinion, symptoms are most important and should drive the type of diagnostic measures.

    I'd call up the nurse/NP/PA and have a chat. You are paying big bucks for this surgery, your surgeon or his staff should be explaining this all to you. If he's not worried, great, but sounds like you want to know exactly why you have cord swelling.

    Please post an update!
  • My pain has been serious from day 1 and I mean doubled over in pain went to er because a few days after surgery for pluerisey of the lung they deflated and wore a fentynal patch 50 and oxycodone so I was pretty
    doped up and still had alot of pain from the fusion. I cried the first month and a half or more and they said they only wanted to see people when they heal up (joking I think). The pain I am describing is where the fusion is and all around my ribs, they feel like there on fire and deep ache in my t8-9 area all of the time. My neck gets so stiff it's hard to move and my low abdomen aches all the time, not to mention my legs and arms go numb and lots of leg cramps all the way up and down.Even my pubic area goes numb sometimes. I think I need IV steroids and a mylogram because he only did a MRI without contrast and even the nurse that did the MRI said it was wrong to not do it with contrast after surgery, but that's what my doctor ordered.
    I am pretty nervous because I am still hurting through the strong meds quite a bit. What do you think? This all developed after surgery.
  • I would be tempted to find another spinal specialist and go for a second opinion. I would definitely keep pestering the surgeon -- if possible I would just make an appointment and go in to see him. Ask your questions and make it clear you need answers...that your pain is such that you cannot live this way.

    Is the pain different from what you experienced prior to surgery? Did it develop immediately after surgery or did it gradually build up?

    It seems to me that you need to get someone to take your complaints seriously and take a good look at what is going on.


  • Hi and thanks for your help!
    This all started about 3 weeks after surgery and he ordered a MRI but his partner said sometimes they tell us more than we want to know right after surgery so I got on stronger meds and the pain was so bad I was doubled over crying saying I just wanted to be put out of my misery! I had 3 daughters natural and the pain compared to that in my back and ribs. I decided to have the MRI and a steroid shot which made me feel better but only a couple of weeks.
    The surgery was a extreme interbody fusion with my left lung collapsed so they could go in minamly invasive and put in a cage with donor type bone I guess and maybe a plastic cage, I'm not sure about all the hardware stuff.
    My doctor joked and said we only want to see people when there well, which upset me because I felt like I was bothering him after that, so now when I call they never call me back.
    My pain is the worst in my back, feel like a very deep ache and my ribs are so bad they have a very tight and achy feeling and very sharp pains that take my breath away, so needless to say I'm not wanting to even drive. I have been having major cramping in my legs and even numbness in my pubic area. The other night I was trying to sleep and the pain hit me hard from the surgery area and paralyzed my neck for 5 minutes and the next day I couldn't hardly hold my head up, my arms are almost useless since the surgery very tingly and weak. I'm scared needless to say and I'm about to go to another doctor, I feel like that's just fine with him if I move on to someone else. Sorry so long! I promise it want be this long ever again.
  • Dear Renee,

    I can sure empathize with you... :(

    What you are describing, is exactly how I felt for several months post-op.

    I am still in a lot of pain, but it's not as excrutiating as the first few months.

    The swelling is typical with thoracic fusion and I have never been given any kind of steriod, yet. I was confined to the TLSO hardshell brace for 3 1/2 months after surgery and my abdomnial muscles didn't balloon out, until I started weaning myself off the brace. I wore the brace due to the multiple fractures I had and also because I dislocated my spine at T11 and T12. Are you in a brace? Hopefully you aren't, as it takes longer to strengthen the core muscles.

    I would be happy to compare notes with you, during your recovery.

    Please keep in mind that it is a long and very painful recovery when they go into the thoracic area. It does get better, but it's a very slow process. Pain control is vital, so keep speaking up.

    I wish you less pain each day... hang in there, sweety.

  • Thanks for your help, and sorry for your pain. That's a long fall! I had a collapsed disc that had been painful for a few years again around the ribs. I couldn't use the arms much before surgery and sure can't use them now.
    What's got me bothered is the constant pain now and not nearly as well as I thought I would be at this point. The doctor told me I would be able to do most things at the 6-8 week point and it's now 3 months. After all he did a minamal
    invasive interbody fusion just a 1 inch incision on my left side. How was yours performed? He said mine was a new surgery with a very fast recovery. Now he's saying could be a year!
    I'm seeing a neurologist this week about all the leg cramps and arms going numb.
    I am already taking percocet and pain patch, neurontin, so my P.M. doctor is trying to help. No P.T. as of yet and that would surely put me in the hospital as I am close to going to the emergency room every day.
    Did you have a MRI? Mine has got me worried about the cyst inside the spinal cord and swelling around it. I am afraid he may have very well damaged my spinal cord. Maybe my neurologists can shed some light on that this week.
    I didn't have to wear a tlso brace but 6 weeks, again because it was supposed to be a fast recovery and my spine was not nearly as damaged as yours was. Thanks for your help!
  • Thanks for your input! I am going to see my neurologist thurs.
    My husband left a message for someone to call us last friday at my surgeon's off. and we didn't even get a response back. I will definetly be getting someone else. This has happened before with them. My surgeon did send me to a P.M. and we let them know on the message that I did not need them for pain medicine, as I have plenty meds. we just needed help in knowing what to do about my extreme pain. I really don't think that is the way they should treat patients.
    I will be asking the new doctor for a new MRI or Mylegram to give more details of what might be going on. I'll keep you posted. Thanks for your help!
  • Even if this is all supposed to be normal according to your surgeon, YOU are not satisfied. Get another opinion. I don't know that I would seek a neurologist, unless you have a previous relationship with one. Personally, I would go for a spine specialist surgeon.

    I know with my dad's T spine surgery it took a long time to heal-chest tube for lung, had to cut diaphragm to access T12, but I don't recall symptoms getting so much worse after surgery, though everyone is different.

    With my 1st lumbar surgery, I remember 3 weeks suddenly feeling much better and have heard many others say the same thing, 3 weeks is a turning point for them. Course, that's lumbar.

    Saddle anesthesia, pain out of control, I'd run(or scooter) my butt as soon as I could to a 2nd opinion.
  • Dear Renee,

    How did your appointment go with your Neurologist today?

    I hope he/she was able to answer the questions you have regarding your pain and the results from your last MRI.

    Please let us know, when you get a chance.

  • Dear Renee,

    It's good to hear you have an appointment today with your Neurologist. I hope it goes well.

    I wanted to mention that Neurosurgeons do not take thoracic surgeries lightly. Surgeons are very hesitant to do any kind of thoracic surgery, as it is considered very risky. The thoracic area is not easily accessible.

    I agree with ernurse... a second opinion with a reputable spinal surgeon is a good idea. It's terrible to read that you never received a call back from your doctor. If your "gut feeling" is telling you something just isn't right with this doctor... chances are you're correct.

    My surgery was performed by the posterior approach. The incision is straight down the crease of my back... approximately 4 1/2 inches long.

    I had a lot of leg cramps, tingling and numbing sensations throughout both legs, both feet, both arms and both hands. These sensations lasted a good 6 months for me. The arms take quite a bit longer to work through the many odd sensations, swelling and stiffness. I was diagnosed with arthritis throughout my spine during my 6th month of recovery, so I know this contributes to a lot of my joint pain, stiffness and swelling in certain areas.

    It has helped me to ask questions and exchange recovery battles with a few people I have been introduced to in person. Each have suffered thoracic injuries either through skiing accidents or automobile racing accidents. One had to have two scheduled thoracic surgeries (like you) and is doing very well. The person who had the skiing accident years ago...is back to being a ski instructor and has his own landscaping business. The professional race car driver has an artificial leg, he works full-time and is happily married to a professional dancer. Please feel free to ask me any questions, as I would love to be of help to you.

    I started PT during my 3rd month post-op and thought I was doing okay. After my eleventh session, my surgeon pulled me out due to the extra pain I was having. I had the mentality of "no pain, no gain" for the longest time. It took me quite a while to recondition my thought process on that. It doesn't work that way with us. I started doing aqua therapy at home over the summer in our pool. I was ready for the aqua therapy at that time and it was wonderful. Please, don't push yourself when you start PT. Take it real easy.

    Regarding my last MRI... I am in the process now of reviewing my full hospital report. (I chose to wait on reading the horror story). There are several MRI's, CT scans, etc. One thing I can tell you, is that MRI's are not pretty to read at all... during your recovery. Xrays are necessary to show our surgeons how we are fusing and in my situation, how my fractures were healing and how my spine was attempting to realign itself. My spine re-evaluation MRI is set for next June. Unless I require another visit to the ER, I'm hoping next June will be the only MRI I will need. I'd really like to take a break from tests... lol.

    Hang in there and please know you are in my thoughts. I take morning, afternoon and evening walks... but unless I have a scheduled outing... I am laying down or stretching. I can't stand still for longer than 3 minutes and I can share what my days are like, if you wish. I would be curious to hear where you are at, as far as being able to dress yourself yet, etc.

    Ta ta for now,

  • Hi Tammy,
    Thanks for asking! My appt. with my neurologist was pretty much a waist of money I guess. He just confirmed that my pain should not be this bad this long, but also said this surgery is very different from others. I paid him 175.00 to tell me what I've already heard from every doctor I've seen. He was out of network too. He suggested another surgeon, but who wants this kind of surgery again? I still have a piece of bone indenting the spinal cord and he thinks the surgeon should have shaved that off, but he wasn't sure what I should do.
    I guess I'm stuck with this pain and pain management for now,
    at least I'm getting some relief since p.m. put me on pain patch and percocet. I can at least quit talking about going to the emergency room and give more poor husband a break from my constant belly-aching about it. Boy if they only new how bad this is.
    I'm so happy I found someone who can relate! What is Platinum Infrared heating pad? Sounds like it would feel good on the back.
    I just hope I get better for the birth of my first grandchild. I read you have 3 children, I have 3 daughters and am having a granddaughter in Janurary.
    I hope we both will heal someday and not have to have so many test like you mentioned,they are a pain!
    Hope to hear back from you soon! Robin
  • Why are you stuck with this pain? If the doctor clearly identified a piece of bone indenting the spinal cord and thinks you should have surgery, there's your answer. You were looking for an answer, you know that your pain is not the norm and a good reason why you have pain and spinal cord swelling. I'm just kinda confused: Why would you just take more meds and be "stuck with this pain" when you have been told you have a surgical issue? Yeah, surgery is not fun, but holy cow, you have bone against your cord and you were worried about cord swelling?

    I'm glad the neurologist gave you more pain meds, but aren't you worried that the bone indenting your cord will get worse and cause permanent damage??? I would worry that getting more pain meds(other than enough to last you till and upcoming surgery) might make you delay surgery(as recommended by the doctor) until you have permanent problems.

    Please be careful with this. What did the neurologist say about the risks of waiting? You said he told you things you already know-so are you going for another opinion then or did you just want pain control? I doubt IV steroids are going to "fix" you. It seems like you are saying that more than one doc has told you what the problem is so I don't understand why you are not having surgery? Please explain why, I'd really like to hear more.
  • I know this seems weird but it's in a really bad spot and that was the reason I had surgery in July. The doctor thought he could repair the collapsed disc and get the bone off the cord but wasn't successful. Now he is just saying he hopes that it backs off the spinal cord since he opened up the disc space with the fusion,or that it will absorb in the body someday. The Neurologist said yesterday that that isn't going to happen and wants me to go to another Surgeon Monday.
    I haven't found a Surgeon than wants to touch it. That's why I let the Orthopedist do it, and I can't even get a call back from him!
    I woke up this morning and could not move my neck and my whole leg went numb and my husband gave them a call and only got the receptionist again! Of course no call back from the doctor, so I am about to go the emergency room. It is getting better as the day goes, so I'm not sure what I'll do. What a freakin mess! Thanks you so much for your concern!
  • Dear Renee,

    I am very sorry to hear about your appointment yesterday. I was hoping you would get some concrete answers and/or help.

    Did the Orthopedist make an appointment for you to see another surgeon on Monday, or do you have to make the call yourself? I'm hoping his office made the appointment for you, as it's important that you get a second opinion from a spinal surgeon.

    I sent you a PM with my surgeons name and information. I don't know where you live, but he's the only surgeon who will EVER touch my back. You can look him up on the internet and see that he is highly accredited and very well-known. If there is any way you could see him, I feel he could help you. My back was a mess and he pulled me back together. It's highly possible that I will need additional surgery and he is the only person I will let touch me. He is often called out to treat our soldiers, but the majority of the time he is in the United States.

    Please don't hesitate to go to the emergency room, if your pain worsens or you develop any unusual symptoms.

    Keep us posted with how you are doing. I am very concerned and want you to get the best care possible. If you know the name of the surgeon you are to see on Monday, look up his credentials online.

    Take good care and please vent... anytime you need to.

  • Good morning Robin,

    How was your night and how are you feeling this morning?

    Please let us know, when you get a chance.

  • Hi Tammy,
    I slept for 13 hours, that's a record for me! I feel much better today. How are you doing today? It's beautiful here in Grapevine Tx. How is the weather where you live?
    I just got a Jury Duty summons in the mail and needless to say I'm not thrilled about that. I will have to try to get a doctors letter. I am in the process of changing Doctors since mine is no longer responding to my calls. Hopefully my P.M. doctor will write one but I have only had one appt. with him so we'll see what happens. I'm absolutely in no shape to sit on a Jury right now.Let me know how you are?
  • Hi,
    I am really sorry you are having so much trouble after your surgery in the thoracic area. I will be having surgery on T11-12 T12-L1 to L2. I see the Doctor on December 1st. to see when I will be ready to have it. Hopefully by next April or so. I still have to get over my Lumbar spine surgery first thought. I would very much like to keep in touch with all of you that has had this type of surgery, as the more I read, the scarier it sounds.

  • Hi, I saw my doctor on the 1st. of December. He told me a lot of my pain is still from my fusion on L5 S1 surgery that I had in July 2009.

    I ask him about my thoracic problems, the hurting that I am having in my left side and all the way up to my upper back, pain still in my right leg that goes all the way to my foot. I still have to get up a couple times during the night and walk. He said that is from several reasons. One was from the arthritis that I have in my back, one from my surgery back in July and the rest from my thoracic area.

    I ask him about the surgery for the T11-12, T12-L1, L1 - L2. He said that he will go in from the back. That the cut will be about 6" to 8" down the center of my back. But he wants me to wait at least until next May when I have to return to see him. I don't know if I can hold out that long, but will try.

    I am sorry that you are still having so much trouble and that your doctor will not even call you back. I agree with everyone else here, I would go to see someone else.

  • Just found this thread and read it.
    I was wondering how you are doing now.
    I hope that you are feeling better and healing now that more time has elapsed.

    Do you know what caused your thoracic problems?
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