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Possible surgery on T7-8

KimD592KKimD592 Posts: 435
edited 06/11/2012 - 8:55 AM in Upper Back Pain, Thoracic
So, I just had a thoracic discectomy done completely posteriorly on 7/6. It was on T8-9-10 and has helped the right-sided pain I was having. However, since the surgery I have now developed worsening problems with T7-8. It was herniated before, but it has gotten larger and is now compressing the nerve root causing severe pain once again, this time on the left side.

When I was in the hospital, immediately after the surgery, they had done a CT scan which showed T7-8 had gotten worse. However, I was asymptomatic at that time, so he said he was going to leave it alone. My husband was there with me so he remembers the conversation as well. The doctor said that if it came down to surgery, he could attempt it posteriorly but chances are he's have to convert to an anterior approach.

Well, today I had my 7-week post-op appt with my NS, and we talked about the surgery again. At this point we're waiting another month to see if it resolves itself, and I'm going to try some other treatments in the meantime. However, we briefly talked about surgery on this disc, and he said he could do it posteriorly and basically re-open the other incision at the top and extend it a little bit. He made no mention of having to convert to the anterior approach. If it comes down to needing the surgery, then I'll obviously ask him about it, but I'm curious if anyone knows what the likelihood of them being able to operate posteriorly at this level is?


  • Kim,

    The problem with a anterior approach at that level is it is major surgery, and can become life threatening. So I am thinking for a pinched nerve he wouldn't try such a approach for that condition. Now if it was a cord compression and you were risking everything below that level different story, but not for a pinched nerve. I am not sure any doctor would risk their license on that, as if something went wrong they most certainly would be questioned on the whys of that surgery, for a pinched nerve. They can get injections into the area, to aid with pain relief. Along with a hoist of medications to help with the pain. Also with a pinch nerve at that level your not risking paralysis of any limb. It already appears they have opened pandora's box, with the initial surgery, if your needing a surgery this close out of surgery. With starting a new job would you even be able to take off now? I would try every conservative treatment they have to offer at this point and time, before considering another surgery, If I was in your shoes.
  • If there is a choice between major surgery and minimally invasive surgery, of course any surgeon would choose the minimally invasive route if at all possible.

    The anterior approach involves cutting muscle and tendons,removing a rib or two and collapsing a lung.
    Two surgical teams are needed, a chest team to open and close the chest cavity and a neurosurgical team to work on the spine. In other words, lots of expensive people, expensive equipment and expensive time.

    For the patient, recovery is painful, extremely uncomfortable, takes a long time,leaves a big scar and you may not regain full movement of the shoulder/arm.

    There is no doubt that these days, thanks to the amount of heart surgery performed, risk to the patient of having surgery through the chest is minimal, but nevertheless this surgery is not something you would want to rush into unless you really had to.

    However cord compression in the thoracic spine has to be treated and I think surgeons will always have the anterior approach as the fall back position if the problem can't be resolved by minimally invasive surgery.


    I'm not young enough to know everything - Oscar Wilde
  • I'm definitely going to be trying to conservative treatments first. I'm on my third round of oral steroids in hopes that it may provide SOME relief. I'm meeting with my PM doc next week to discuss having an epidural injection done. I had two ESI's done on the other discs, and they didn't help, so I'm a little leery. However, I'm willing to give it a try. I also tried 3 months of PT with the other two discs, which were located directly below this one. It never did help. I asked my NS about possible PT for this, but he said because of where it's located, PT will not help. I need to talk to the NP at my doc's office today, so I'm going to ask her about a TENS unit today. When I went to PT in the past, they used to use the TENS unit and ice, and it provided some temporary relief, so it's certainly worth a shot. The problem is that I can't take any pain meds, other than Motrin 800, during the day because they make me too drowsy, and I have three children to take care of on my own. I've also started a new job and am currently in training three evenings a week, so I can't take my pain meds while I'm at work. So I'm thinking the TENS unit would be good because I can wear it during the day and while I'm at work. Then, when I get home at night, I can take my pain meds to help me sleep. Oh, and I'm also on Neurontin 300 mg three times a day, so we can hopefully play around with that dosage a little bit.

    We're going to wait a couple of more months before doing any type of surgical intervention, because he knows I'd rather avoid surgery. However, this pain is even worse than the initial pain I was having, and it's affecting every aspect of my life. I'm praying that I can find SOME relief in these conservative treatments. The thought of even living another 6 months in pain like this honestly makes me feel desperate and depressed. He said that in 85% of cases (although he was speaking of the lumbar region, since thoracic is as common), the disc will heal on it's on within 3 months. He said if herniated disc/pain persists past 3 to 6 months, it likely will not heal on it's own.

    As I said before, this pain is much more debilitating than the other was. I wasn't able to work before, but at least I could still do things such as take walks, cook dinner, wash dishes, etc. With this new pain, I can't be on my feet for more than a few minutes without the pain becoming excrutiating. Last night I was attempting to rock my daughter to sleep. She isn't very big...only weighs about 20 lbs at 18 months old. After a minute or two of rocking her (I was standing), I started feeling the pain. Within a minute or two of that, the pain was excrutiating and kept getting worse. She was almost asleep in my arms, so I was trying not to make any noises or sudden movements, but I was literally shaking and the tears started flowing. I finally couldn't take it anymore and ran to her bed and attempted to put her down, but she started crying. So I picked her back up and ran to my bed with her so that I could at least sit and try to get her to fall asleep that way. I feel like I have basically no life. I used to be able to at least take the kids outside to play, but I haven't left the house (except for doctor's appts) in 5 weeks, which is when this pain started. I really hope the doctor is right and that it goes away on it's own. I'm SO over this whole back pain/surgery thing.
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