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Costotransversectomy thoracic fusion

SheboSShebo Posts: 9
edited 06/11/2012 - 8:54 AM in Upper Back Pain, Thoracic
I have a ruptured disc T9/10 pressing on spinal cord and I am in constant pain. I finally had an appt with a doctor last week. He said he could help with a costotransversectomy and a fusion.

Does anyone know anything about this surgery?


  • This is a surgey being offered to me- when I can no longer take it. It is a very brutal surgery,recovery & rehab- since they usually remove some portion of the ribs and deflate the lung to reach the area that they need to work on. I was told to expect 6-12 months before I could go back to work.

    I just met with my NS today and we are still trying to put this off as long as possible. I am suppose to research Spinal Cord Stimulators options with my PM over the next few months to see if I can buy a few years more.

    Good luck.

  • My doctor said the this surgery would be a 4 month recovery and if he has to switch to a thoracotomy then it would be a 6-12 month recovery.

    I considered a stimulator but my new MRI showed the herniation has gotten worse in the past year (along with the pain). They said they can't do an MRI once the stimulator is in place. So I decided surgery was a good answer.

    Good luck, I know it is a hard decision.
  • Please keep us posted on your surgery and recovery.

    Good luck,

  • Wanted to say hi and welcome to the group. You have a lot on your plate on all levels. Glad that you joined, as there is a lot of support and answers here.

    Wishing you all the best in your decision, please keep us updated on how you are doing.

    >:D< Karen
    >:D< >:-D< : Karen
    L3-S1 herniation and bulges, stenosis, mod facet,ddd,impinged nerves,coccydinia
    discectomy/lami July 2011-unsuccessful
    adr L5-S1 Feb 2012
  • Thank all. I will let you know how it goes.
  • This is big and risky surgery,not usually considered until there is leg weakness or loss of bladder/bowel control.
    I'd certainly be looking for at least a second opinion before going ahead with this.

    I'm not young enough to know everything - Oscar Wilde
  • mickkr said:
    This is big and risky surgery,not usually considered until there is leg weakness or loss of bladder/bowel control.
    I'd certainly be looking for at least a second opinion before going ahead with this.

    i see you had a surgery in 2003...can you tell me how its now after 8 years ???
  • Mickkr, thank you for your suggestion. I have had 6 opinions. Four recommended surgery but they didn't do the surgery that I need. One said there wasn't anything wrong with me.

    It looks like you had a similar surgery. I would appreciate any insight.

  • I'm having thoracic spine surgery this coming wednesday, but it's being done all posteriorly. I'm just having a discectomy. Best of luck to you! My surgeon said that if I re-herniate, I'd have to have a fusion, because the thoracic spine cannot endure multiple discectomies the way the lumbar spine can. I'm praying I never have to have spine surgery again.
  • do u still check your form ?
  • would like to talk . just had mine done , 8 weeks in
  • would like to talk . just had mine done , 8 weeks in
  • and how is situation now???
  • Scott:

    Yes, I do check the forum but sometimes not every day. I would like to talk to you. If you don't want to post here, you can send me a private message.

  • KimD:
    I'm sorry I missed this post. I hope your surgery went well and it brings you relief. The laminectomy I had done last year was done posterior and I had no problems. I wish you fast healing and happy results.

  • One of the problems with thoracic spine injuries is that the symptoms often mimic other conditions.

    This is what happened in my case and it was almost too late by the time it was determined the herniation at t5/6 was the cause of all my problems.

    This meant I was an emergency and I only had a few days to contemplate the ensuiung surgery and I had no idea what was involved.

    No time to organise any fancy techniques, this was the traditional brutal surgery through the chest cavity. Rib removed, lung collapsed and 11 long hours of delicate surgery before I was wheeled off to the ICU.

    Needless to say there was a lot of pain and considerable discomfort when I woke up and this did not abate any time soon.

    MRSA slowed my recovery considerably but even without this unwelcome complication, you should expect a long gradual process.

    I had lost the use of my legs and become double incontinent prior to surgery (hence the emergency)
    and it took a long time and some tough physiotherapy to get things working properly.

    In all I spent 16 weeks in hospital (10 weeks surgical unit, 6 weeks rehab) then 6 months outpatient physiotherapy.

    It took about 2 years to regain full use of my legs and other functions, but the good news is my recovery is 99 percent complete and I am virtually pain free.

    Every case is different of course and if I had not contracted MRSA and if surgery had gone ahead much earlier my recovery would have been considerably quicker. But you should be prepared for a long slow
    and not entirely pleasant period before you reap the benefits of having this surgery.


    I'm not young enough to know everything - Oscar Wilde
  • Mick:

    I am so sorry for all of your pain. I know about the pain mimic. My internist refused to order an MRI after she had ordered every other test imaginable. She told me that there was no way my pain was coming from my back. The doctors she sent me to even told her that the pain was probably from my back. Needless to say, I fired her.

    I can't believe what you went through. How did you catch MRSA in the hospital? I am happy to hear that you are pain free now.

    I am not even close to having your symptoms. My only symptom is pain. If I get up from a laying position, I am in uncontrolable pain. At the moment, I've been awake for almost 48 hours from pain. The surgery scares me but being like this forever scares me more.

    I have had other doctors tell me they won't operate until it is an emergency. It seems like such a backwards recovery process at that point. I assume you had pain at first. How long did you have to wait until they discovered the thoracic was the problem? Hope I'm not being too personal - just curious.

    Thank you for your story.

  • shebo,
    sorry for the delay in replying.
    I had symptoms for about two years, getting progressively worse, before receiving a correct diagnosis.
    I put this down to my own doctor who seemed at first to believe I was faking to get off work, then, when it was obvious I was not ( Babinski sign, reflexes,etc) decided I had MS. Numerous tests followed, including an MRI of skull/neck (if only they had scannned a few inches lower!) and nothing conclusive was found. Still he persisted with his belief that MS was the cause and when I eventually became too weak to walk and I was losing control of my bladder/bowel, I was booked into my local hospital for 3 days IV steroids to "boost me up".
    Fortunately for me the hospital had a very good neurosurgical department and because of a series of flukes, or possibly divine intervention, I was moved
    to a neurosurgical ward when my original bed was required for an emergency admission.
    Initially I was to be sent home, but my wife, when contacted by the hospital to collect me, told them I had said "If I am sent home still unable to walk I will comit suicide". I never said any such thing.In fact she was having an affair with a man 18 years her junior and didn't want me messing up the three days of fun she had arranged in my absence.
    It was enough to panic the hospital into scouring the entire hospital for a spare bed for me and one was found in the neurosurgical unit.
    What followed was quite bizzarre. They forgot about me!
    I was fed, washed, bedding changed for a week. Each morning the doctors,nurses and physios did their rounds attending to their own patients, walking straight past me. I tried to find out from the nursing staff what was occurring but either they forgot my requests or decided to ignore them. Then I decided to go for a walk, collapsed in the corridor knocking another patient to the floor. Suddenly I was the focus of everybody's attention and after interigation by doctors, nurses, admin staff with clipboards a particular doctor, a surgeon (who later performed the surgery), sat down next to my bed and listened to my story. A day later and following an observation by a physio that my responses to excercises did not indicate M.S., I found myself "in the tube" having an MRI of the entire spine and the spine problem was discovered.
    It took ten days to organise the surgery because I had to have further scans to assess my preparedness for a long surgery and because two teams are required, one to open the chest cavity and another to perform the neurosurgery.
    Looking back there were so many things that conspired to get me in the right place and meeting the right person (surgeons who are able and willing to perform thoracic spine surgery are few and far between) and it happened just in time!
    Strange story I know, but lucky for me!


    P.S. The mrsa infection was in the chest drain incision. My surgeon became suspicious when levels into the drain did not reduce after a few days and berated the nurses when he saw how inflamed the wound was under the dressing. Tests revealed mrsa and blockbuster anti biotics injected direct to the abdomen for a week. In 2003 mrsa was endemic in hospitals.
    I'm not young enough to know everything - Oscar Wilde
  • There are now minimally invasive alternatives for thoracic disc herniations. I use MISS techniques with the Metrx system and can resect a thoracic disc herniation through a one inch incision as an outpatient procedure.
  • Dr Maliner,

    Can you qualify your answer more? Is it not true that minimally invasive discectomy will not work on all thoracic patients? It depends on the location and size of the herniation right?

    My PM seems to think I need to have the minimally invasive discectomy and my NS says I need a thoracic fusion....I have already been fused in the cervical and lumbar spine.

    I am confused,

    Thank you,

  • Julie, which discs does your PM doc want to perform the discectomies on? It is my understanding that the lower T-spine discs can be done completely posteriorly. The higher up you go, the more likely it is that they need to do the anterior approach. Also, based on your signature, it seems you've got a bunch of herniations throughout your t-spine, which may be why the NS is recommending a fusion.

    In my case, I had two discs that really needed fixing, T8-9 and T9-10. Being that they were further down, my NS was able to do a completely posterior approach with about a 2-inch incision. He did say, however, that if I were to re-herniate, I would have to have a fusion. It's not like the lumbar spine where you can go for a repeat discectomy. I can't remember his reasoning, I think it had to do with the stability of the t-spine, but it cannot tolerate repeat discectomies like the lumber spine.

    Not sure about this procedure that Dr. Maliner is talking about.
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