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Any help would be great

I am new to the group, so just a little background. I am a truck driver and was in an accident on 3/13. I was thrown from the sleeper into the dash...head first, and back into the sleeper, and was unconscious for a few minutes. I had 9 compression fractures from T-3 through T-12 and disk herniation from C-3 through C-7. I had C-4 to C-7 fused in May. My trapezius is in constant spasm and I have pain between my shoulder blades, right shoulder, and right arm. I have had trigger point injections that only lasted 3 days. I had RFA done three weeks ago, and not much improvement yet but the Dr. said it can take a few weeks. My question is in regards to my middle back pain, roughly around T-7. It hurts all day every day, and is worse when I try to sleep. Originally, the NS said they would heal on their own, and I have had no treatment for my back injuries at all. Everything to date has been done to treat my neck. I only have limited range of motion with my neck...35 degrees to the left and 33 to the right. I am still off work even though I was fully released by the NS last week as he said that is how long the neck surgery takes to heal and he has to be fair to the workmans comp ins. company! I am only being treated by a pain management doc and PT. Im not sure how to proceed because I have been telling the ins and the doc about my back pain, but they only seem concerned with my neck pain. I don't want this to get worse due to no treatment, if that's possible. Any advise? Thanks


  • LizLiz Posts: 7,832
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    Liz, Spine-health Moderator

    Spinal stenosis since 1995
    Lumber decompression surgery S1 L5-L3[1996]
    Cervical stenosis, so far avoided surgery
  • thoracic spine painthoracic spine pain Posts: 566
    edited 09/04/2013 - 5:22 PM
    You must be in agony. I only crushed T5 and know what it feels like. I believe the reason they look at cervical and not thoracic is because it is very dangerous to operate on thoracic - my specialist told me an 80% chance of paralysis, above T5 until cervical they cannot do minimally invasive surgery, in my case. When I was prescribed muscle relaxants as well as painkillers, it helped considerably. I think you need to combine them or your muscles go berserk.

    Try to get a standing or sitting MRI as they miss 20% of spine damage on prone MRI's. It's the only way to see the real damage.

    In my opinion they are just to scared to operate on thoracic, the spinal cord is narrower and closer to the vertebrae. My specialist wrote to my GP and I quote ' With regards to her spine unfortunately there is nothing that can be done. L's fracture has healed in a kyphotic position. It is not possible to perform a pedicle subtraction osteotomy through the spine at this level for this condition and get a good result.'

    They told me mine would heal too and it didn't heal in the right place. I think that why they ignored my injury instead of admitting they don't usually have good outcomes. Try and find a specialist with thoracic knowledge, they are hard to find. Ask them to explain why they can't fix your thoracic so that you can understand. It is only when you lose function, not for pain they have to operate. I believe only a standing or sitting, weight bearing MRI will show the extent of your damage.

    Take someone with you to the specialist to reinforce how much pain you are in. I spent 8 years without a proper diagnosis. Mine healed in a bad place, so I hope they have given you a thoracic brace, so your thoracic vertebrae might be able to heal in a better position than mine. I would absolutely brace it now as my surgeon said if it was braced I wouldn't still be in so much pain. Everyone is different though.

    Sleeping with a pillow between my knees also helps me. Heat packs help as well. Painkillers didn't work for me until they combined them with a muscle relaxant. The physio has taped my back and shoulder into the correct position so my muscles don't spasm it out again.

    Take care.
  • mickkrmmickkr Posts: 166
    edited 08/31/2013 - 7:37 PM
    thoracic spine pain, why do you say "they do not have good outcomes from thoracic surgery" ?

    It's horrible surgery to be sure, but those I have come across on this and other forums, who have had thoracic spine surgery by and large seem to have done well compared with other spine surgeries.

    This may well be because the thoracic spine is very stable and is not subjected to the same stresses as the lumbar and cervical areas so that once repaired the thoracic spine is better able to heal itself.

    I agree it may be difficult to find a surgeon experienced in this particular surgery, but that is probably because it is uncommon rather than their desperate urge to avoid doing it.

    For sure it is complicated and long surgery but the surgical teams will have prepared for this beforehand, so that is not an issue in itself except that doctors will always put off long, complex, non routine surgery until absolutely necessary because it is long, complex and non routine and therefore costs a lot of money, time, effort and endurance for medical staff and patients alike.

    For me it changed my life and I have never looked back, though I wouldn't like to go through it again !

    I'm not young enough to know everything - Oscar Wilde
  • TSP,
    Where are you getting these statistics that 20% of laying down MRI miss spinal problems?? What studies? This is not good or accurate medical information that you are stating and gives patients the wrong idea about versions of MRI's. Please do not post things like that unless you have studies to confirm those statements.
    Some discussion has occurred and some doctors, in particular radiologists and developers of standing or/and open MRI machines have tried to imply that their versions are more accurate, however, it is not medical fact. The quality of images of standing or open MRI machines is less than it is for conventional machines due to the fact that the magnet does not travel in the same manner , therefore there are less detailed images.
    Some feel that the standing or open MRI's give a better picture of disc bulges, and that conventional machines are 'positional' buthis is also true of all of the machines. They take an image of a moment in time- a single moment . If you are laying down , it may show bulges, herniations , etc, and if you are sitting or standing, it may show bulges where you would not see them in the conventional machine, or more of them when they are not there on the conventional machine.
    All of the machines have their good and bad points, but as far as I am aware, there is no one machine that is better or more accurate than another when it comes to the position of the MRI client.
  • thoracic spine painthoracic spine pain Posts: 566
    edited 09/04/2013 - 5:37 PM
    I got some of the information from this site http://fonar.com/pdf/LondonStudy.pdf also from http://www.fonar.com/standup.htm and other sites that make both prone and standing MRI's. I am pretty sure Fonar makes prone and standing MRI's so there is no value in them exaggerating statistics. There are also a lot of You Tube comparisons where you can see the difference. It just makes common sense to me with spinal injuries a standing MRI would be better than a prone MRI as standing MRI's are weight bearing. I know with some standing MRI's the images are not as good but the figures really surprised me as well.

    Mickkr - the information on trauma thoracic surgery I got from my surgeon who is very familiar with thoracic surgery. I have put the exact quote from my surgeon in the post above.

    A lot of people have no pain from osteoporosis, I think it is because this happens naturally and your ribs are still attached in a natural position. It is incredibly difficult to damage the bones of your thoracic vertebrae even through trauma because the rib cage is there for stability therefore makes it harder to crush.

    I would love to have this operated on as I would do anything to be out of this pain that I have had for eight years - it has cost me dearly, had to give up a great job, my partner left and basically my whole other life. I was never at home and always out with friends, was a bit of a dare devil so have had to give up everything I love which is outdoors because of this constant pain I am bedridden sometimes so it is incredibly isolating. I hate having to take medication. When I had my accident they did not brace thoracic in Australia 8 years ago, it seems to be different now and I thought my injury would heal like all the other damage, broken ribs, ankle, right shoulder injury which they can operate on and only this surgeon picked up after 8 years. Drs used to believe thoracic injuries are stable and should not cause pain. So I believed the doctors and thought I would get better but I never did, in fact it got progressively worse. I would do anything to get my old life back but it isn't going to happen.

    If they offered me a good chance in surgery tomorrow I would take it, but because of my specific injury, I believe my surgeon. I can walk, am grateful for that, but with my specific trauma injury the risk of paralysis is too great for me to take a chance.

    If there is anyone with an 80% or greater wedge crush vertebrae injury from T5 or above who was not operated on straight away and has had a good outcome, I would love to hear from them.

    I would do anything to be out of this pain for the rest of my life, because at the moment the rest of my life is not looking that great but it's no use feeling sorry for myself, it is just this pain is incredibly wearing and isolating after 8 years of putting on a smiley cover every time I go anywhere, like I guess most people do. It just sucks.

  • tsp, no one knows for sure why my t5/6 disc herniated, but the most likely cause is trauma. I fell from a ladder many years ago while repairing guttering on a two story house and this is the incident I think likely caused the injury.A fence broke my fall and I was covered in cuts and bruises but miraculously no broken bones or other injuries - or so they thought at the time.
    By the time I started to exhibit symptoms several years had passed and the connection was not made. Indeed I was suspected as having MS.
    We can all speak about our own experiences but that doesn't qualify us to make sweeping generalizations about what treatments will or won't work for someone else.
    I'm not young enough to know everything - Oscar Wilde
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