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Thread: should a person have a CT scan after spinal fusion surgery at some point?

  1. #1
    Join Date
    Jan 2011
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    122

    should a person have a CT scan after spinal fusion surgery at some point?

    I have been having so much pain 3 + months post op, but my surgeon doesnt address any issues. Should I be having a CT ? I had the 3 month x ray and asked him if my bones had fused or begun fusing and he said its hard to tell yet.... I thought thats what xrays showed.. I left confused...Since I still have alot of pain, would a CT show or give me ansers? My Dr has never recommended or requested it, but again he is not a good post op dr..

  2. #2
    Join Date
    Jun 2009
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    312
    I dont know that I'm knowledgeable enough to answer your question.

    At each of my follow-ups, I had 2 x-rays, one from the back, one from the side. At my 1 year appt, when I told the dr that my pain had increased, he suspected either a non-union, infection in the hardware, or the hardware itself irritating surrounding muscles. THEN he did a CT. The CT didn't really show him anything difinitive, but he thought he maybe saw fusion. It's difficult to tell with the hardware in. Only last week, 3 1/2 mos after my hardware removal, could he see the culprit on that day's CT: non-union of 3 levels.

    I don't think he does CTs often, because of the huge amount of radiation the pt is exposed to (having a CT is the same radiation at almost 500 x-rays).

    Maybe he thinks that your pain is routine, and nothing that signals a problem. I'm not sure if, this early in the game, he can do much to diagnose a non-union. I know some here have had infected hardware, and that is treated (open you and clean the hardware, and close) until fusion is complete and the hardware can be removed. Hopefully others who know more than I can chime in and tell us if pain at 3+ mos should be worked up, and if anything could be done about a problem this early.
    I'm sorry you're not feeling better. Good luck!

  3. #3
    Join Date
    Aug 2008
    Location
    Indianapolis, IN
    Posts
    416

    Red face

    Hi!
    I had a CT scan 6 months after my revision surgery but ONLY because I was having some significant sciatica that my doc wanted to follow up on. I don't think CT's are routine following fusion surgery unless there is a question of a non-union. Pain at 3 months post op seems to be fairly common so hang in there, everyone recovers at a different pace. After my first surgery I was in pain for a good 10-11 months. Others here have been luckier and seem to recover as fast a lightning!
    May 2008 Fusion T4 - S1, Pre-op Curves T45, L70 (age 48). Unsuccessful surgery.

    March 18, 2010 (age 50). Revision with L3 Osteotomy, Replacement of hardware T11 - S1 , addition of bilateral pelvic fixation. Correction of sagittal imbalance and kyphosis.

    January 24, 2012 (age 52) Revision to repair pseudoarthrosis and 2 broken rods at L3/L4.

  4. #4
    Join Date
    May 2008
    Location
    Central NJ
    Posts
    1,956
    I remember my surgeon pointing out the beginning signs of fusion on Xrays at 5 or 6 months. I don't think it possible to tell by Xray only at 3 months.

    I haven't had any CT or MRI's since my surgery, but then I've been doing great, so no reason for it. I would say that my worst point was at 4 months post op when I woke up one morning feeling like a knife was going through my chest every time I took a breath. It was a bad case of muscle spasms that took a few weeks to work out, with the help of muscle relaxants. At the time I wasn't sure that it was muscle spasms, I thought I screwed up my fusion, but the Dr. was right.
    __________________________________________
    Debbe - 50 yrs old

    Milwalkee Brace 1976 - 79
    Told by Dr. my curve would never progress

    Surgery 10/15/08 in NYC by Dr. Michael Neuwirth
    Pre-Surgury Thorasic: 66 degrees
    Pre-Surgery Lumbar: 66 degrees

    Post-Surgery Thorasic: 34 degrees
    Post-Surgery Lumbar: 22 degrees

  5. #5
    Join Date
    Jan 2011
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    122

    Debbei

    Thanks for sharing your experience. The pain ( knife like ) you described is also some what I am feeling now I think. The pain is so intensei ts really hard to describe when some areas are numb but still have pain..its confusing pain! The left side of my upper back now at 4 1/2 mos post op is stinging inside in some areas, and feels like a razor/knife is cutting me. Its very bad and really makes day to day difficult. The right side has some intense pain as well but not as bad. Cant even lay on my back at all now, and laying on my sides is very painful too. I dont feel spasms moving, and muscle relaxers dont and have never helped. I keep trying them randomly. Percocet helps but wont even completely elliviate the pain. If I touch the spot on my upper left that has the worst sharp pain, it is SO sore I can barely stand to touch it ( hard to REACH it too ) This painful spot is between my shoulder blade and the hardware. Kind of an odd spot for pain like this..

  6. #6
    Join Date
    Jan 2009
    Location
    Virginia Beach, VA
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    455
    I was told that I would be having a CT scan upon my last follow up....I've put off my last follow up because my surgeon retired and I haven't wanted to deal with the new docs but I'm working on getting in there.

    I did have two mishaps and one of them was 4 months post op and my surgeon did a CT scan because I was having significant pain and he said better to be safe than sorry. Every doc seems to be different in how they go about treating their patients. It seems their decisions always come back to what insurance may or may not cover. Luckliy at the military hospital that doesn't come into play as much as in the civilian world.......

    Good luck
    Susan

    Diagnosed at 10, Boston brace from 11-13 yrs old.
    50* Lumbar w/ 5 centimeter shift to the left and slight rib hump...
    Surgery Date: April 15 and April 22, 2009
    X-LIF approach for disc repair L5,L4,L3,L2
    Posterior Approach for fusions L5-T5
    Dr. Fox @ Naval Medical Center Portsmouth
    Nice and straight now!!!!!

  7. #7
    Join Date
    Nov 2008
    Posts
    129
    just FYI...i, too, was having EXCRUCIATING knife-stabbing pains for a few weeks/months after surgery -- more so on my left side, felt like it was in-between my ribs. took awhile to get an accurate diagnosis (i was told muscle spasms, nerve pain, pneumonia, etc.). a couple more x-rays and ct scans later, it turned out to be a VERY large pleural effusion. my left lung cavity had a huge amount of fluid in it and it was causing severe inflammation and breathing difficulty. i ended up having to get a chest tube inserted that stayed in for a week, to effectively drain all the fluid. i hope you don't have what i had! it sucked.

  8. #8
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    Jan 2011
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    jesscv

    How would I know if it is a lung problem ? I ahd a CT the other day and the nurse said CT's only show bone and hardware, not soft tissue. This may souns dumb, but is a CT the same as a Cat Scan ?

  9. #9
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    Jan 2011
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    jesscv

    I also want to add I am sorry about what happened to you, and I'm really glad you got through this pleural effusion. I just looked it up to see what it was really. I hope thats not what I have. I guess my recent Cat Scan wasnt intended to look for that, so maybe if I have this it was missed. ...The Dr just said " Hardware looks Ok, screws are ok, and fusion is about 50 % with some areas fused and some not. ( am 4 1/2 mos post op ). Thats all I know...

  10. #10
    Join Date
    Nov 2008
    Posts
    129
    leanne,
    i wouldn't worry too much. i actually could not walk for more than 5 steps without getting winded and feeling like i was going to faint. the shortness of breath was THAT bad w/ my pleural effusion. and if i ever tried to laugh, cry, yawn, etc., it amplified the pain and shortness of breath times a million. my breaths were extreeeemely shallow and my stomach/diaphragm wouldn't even move when i inhaled and exhaled. and yeah, normally i would go to the ER in such a case like that, but i was only a month out of surgery so i just pegged it as a really unfortunate complication that would eventually just go way on its own... but of course it didn't. if you have trouble breathing and the pain becomes completely unbearable, insist on a proper diagnosis. oh, and a CT scan (or CAT scan) showed my pleural effusion immediately. so i'm sure they would've caught yours

  11. #11
    Join Date
    Jan 2011
    Posts
    122

    jesscv

    ok. Thank you. Those symptoms dont seem like mine at this time. I called my family physician today and asked for a blood test for Shingles. Although I only have a little mini rash near my incision, I guess you dont have to have a rash to have it. Its rare if its internal, but if I have it, it is internal.. It is burning stinging stabbing pain mainly on the left that is spreading. It feels itchy to me when Jer rubs my back in these areas to help the pain. Hopefully, and praying for some answers. Went to pain management clinic yesterday and they want to just do hit or miss things to help with pain. They dont find the source. So an anti seizure drug ( Lyrica or Pregabalin ) was suggested for pain, and trigger point muscle injections to paralyze the muscles... I dont like drugs to remedy pain when there are no answers to the cause or source of it when it isnt normal pain and its taking over my life. But if I cant find out whats causing it I will have to resort to these things because the pain can be too much and never goes away even with percocet now.

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