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Thread: shoulder blade dropping

  1. #16
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    Dec 2008
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    Here is the update. The shoulder doctor and spine doctor are sending me to the University of Chicago for a possible scapulothorasic fusion. The doctors there may see something that the group treating me can not find . So there is hope that a different treatment will be available. That will be a big decision. Both said doing nothing is not a good choice. The shoulder and blade just gave up.
    The shoulder doctor mentions checking the spinal accessory nerve as it controls this area. All other nerves checked are OK. Muscles are Ok that nerve may be the problem as this happened really quickly right after extension of cervical fusion.
    If nothing is done the shoulder is down and causing off balance walking. The blade rubs on something and creates a very unusual feeling. Like ants crawling around inside . I am not looking forward to this trip to Chicago as it is a difficult area. I need some help though and local doctor cannot help.
    It will be interesting to see if it is that nerve . However surgeon uses left site approach and this is the right side. And I am right handed.
    Ed can you have any info to help?
    T10-pelvis fusion 12/08
    Fractured t-9 six days out of surgery
    C5,6,7 fusion 9/10
    PJK at t-9
    T2--T10 fusion 2/11
    Removal of left side t6-t10. 8/14
    C 4-5 fusion 11/14
    Right scapulectomy 6/15
    Right pectoralis major muscle transfer to scapula
    To replace the action of Serratus Anterior muscle 3/16

  2. #17
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    Quote Originally Posted by jackieg412 View Post
    . Both said doing nothing is not a good choice. The shoulder and blade just gave up.
    Jackie, what do you mean “just gave up?”

    It is looking like you will need to go. This will be a diagnostics trip.....Do you have someone to go with you? When are you going?

    Be sure to let us know what they think

    Try to stay calm....

    Ed
    49 yr old male, now 58, the new 53...
    Pre surgery curves C12,T70,L70
    ALIF/PLIF T2-Pelvis 01/29/08, 01/31/08 7" pelvic anchors BMP
    Dr Brett Menmuir St Marys Hospital Reno,Nevada

    Bending and twisting pics after full fusion
    http://www.scoliosis.org/forum/showt...on.&highlight=

    My x-rays
    http://www.scoliosis.org/forum/attac...2&d=1228779214

    http://www.scoliosis.org/forum/attac...3&d=1228779258

  3. #18
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    Dec 2008
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    illinois
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    The shoulder blade just let loose. The shoulder and blade are dropped. I can raise them by bringing up my shoulders but if I am not thinking about it the right is down. The angle and weight of the arm are causing strange feelings and I true struggle to keep my balance walking. If I bring the arm up I am balanced.so wobbly walking makes me remember to bring the arm up or hold it on my hip. It is tiring to walk off balance. I do have all my studies on disc. There was one nerve not addressed and that one may need to be checked. My doctor said that the university would check it. It may be the problem and may have been injured during the last cervical surgery. It goes through that area however it is on the opposite side. It puts the upper trap muscle in palsy. Drops the shoulder and doesn't allow the shoulder blade to work properly. Minimal raise to my right arm. And it does not hurt. Only when I try to lift through the trapped shoulder blade. I am so glad to get an appointment so quickly. I am sue it will be a long day as it is a teaching hospital. So far no one is able to goo with me and the drive alone will be a challenge. Chicago is big and busy. I don't know the transit system well as I live in the suburbs and we really don't have much of public transport. This will be interesting and I really doubt it will be a one time shot to the big hospital. I just hope they have some answer. And I hope it isn't having the scapulothorasic fusion.
    Last edited by jackieg412; 04-18-2015 at 06:07 PM.
    T10-pelvis fusion 12/08
    Fractured t-9 six days out of surgery
    C5,6,7 fusion 9/10
    PJK at t-9
    T2--T10 fusion 2/11
    Removal of left side t6-t10. 8/14
    C 4-5 fusion 11/14
    Right scapulectomy 6/15
    Right pectoralis major muscle transfer to scapula
    To replace the action of Serratus Anterior muscle 3/16

  4. #19
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    Dec 2008
    Location
    illinois
    Posts
    758
    Up date---I went to the University of Chicago yesterday. The resident thought the problem was the spinal assesory nerve. The specialist said No. The shoulder blade is out of position. It is trapped down and to the side. It will not allow me to raise my arm. The specialist wants another CT scan of the rib cage. He thinks the problem is the fusion and the ribs are not allowing the shoulder blade to clear. Hopefully this scan will show the answer. I know some people have the ribs adjusted after surgery. I have not. I know it can be considered cosmetic due to rib hump. Has any one had this done? This would not be cosmetic but for function. Interesting that while it has been a problem all along, that it took 4 years to happen.
    Ed or Linda do you have any input. Also who does this type of procedure.
    With the arm and shoulder trapped down, I fell very unbalanced.
    T10-pelvis fusion 12/08
    Fractured t-9 six days out of surgery
    C5,6,7 fusion 9/10
    PJK at t-9
    T2--T10 fusion 2/11
    Removal of left side t6-t10. 8/14
    C 4-5 fusion 11/14
    Right scapulectomy 6/15
    Right pectoralis major muscle transfer to scapula
    To replace the action of Serratus Anterior muscle 3/16

  5. #20
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    May 2008
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    reno,nevada
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    Quote Originally Posted by jackieg412 View Post
    I know some people have the ribs adjusted after surgery. I have not. I know it can be considered cosmetic due to rib hump. Has any one had this done? This would not be cosmetic but for function. Interesting that while it has been a problem all along, that it took 4 years to happen.
    Thoracoplasty. They are not all that common in the US, or at least on this forum. Modern spinal implants do correct rotation quite a bit and reduce rib humps...

    I don’t think something of this nature is warranted since you have a specific problem and they need to find out what is causing your shoulder to drop. I hope they can find it and correct the problem. Doing another extreme type of surgery like this doesn’t seem logical. Its extra surgery and its involved.

    Something has happened since your last 2 surgeries....or was it after the neck surgery? You need to be “exact” on describing what happened and when your shoulder started dropping....I’m sure you have done this, but I will mention it anyway for other readers.

    Are they going to look at your neck also with CT’s or MRI’s? Did you bring this up? You would think that the problem would be in either of your last 2 surgical locations.

    Ed
    Last edited by titaniumed; 04-22-2015 at 08:52 PM.
    49 yr old male, now 58, the new 53...
    Pre surgery curves C12,T70,L70
    ALIF/PLIF T2-Pelvis 01/29/08, 01/31/08 7" pelvic anchors BMP
    Dr Brett Menmuir St Marys Hospital Reno,Nevada

    Bending and twisting pics after full fusion
    http://www.scoliosis.org/forum/showt...on.&highlight=

    My x-rays
    http://www.scoliosis.org/forum/attac...2&d=1228779214

    http://www.scoliosis.org/forum/attac...3&d=1228779258

  6. #21
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    Dec 2008
    Location
    illinois
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    Yes Ed I was very careful with telling when things changed. I made sure to repeat things in order. On this visit, I had the resident first. He thought it was the spinal accessory nerve and ordered another EMG on that nerve. The doctor came in and told him why he was wrong. This nerve has come up a few times. So the main doctor cancelled the order and Ordered another CT . This time not just of the shoulder but the entire rib cage. I have that on Saturday and see him next week. I wish they would just do the EMG and then they would know .It seems more like a nerve because it happened so quickly. I wish I could just ask them to do it. That nerve controls the trap muscle.. It can be injured during surgery. However the surgeon operates from the left side and this is the right. There are some issues in the shoulder but not causing this. And the muscles are not weak. Everything they come with doesn't fit in all areas. So we have to keep looking and ruling things out. When he reads the CT , I hope to know what has happened and what to do about it.It has been quite an ordeal.
    I thought, just like you said that this isn't done very often any more.I will post what the test is read
    T10-pelvis fusion 12/08
    Fractured t-9 six days out of surgery
    C5,6,7 fusion 9/10
    PJK at t-9
    T2--T10 fusion 2/11
    Removal of left side t6-t10. 8/14
    C 4-5 fusion 11/14
    Right scapulectomy 6/15
    Right pectoralis major muscle transfer to scapula
    To replace the action of Serratus Anterior muscle 3/16

  7. #22
    Join Date
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    Location
    illinois
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    The results of the CT SCAN . The university specialist read the scan and he has identified where the shoulder blade is trapped. It is mid scapula on those ribs. Not a growth but a deformed set of ribs. He recommends a thoracoplasty of those ribs and referred me back to my spine team. He has sent them a letter. I have been explaining this catching for years to the spine doctor but it took someone else to keep looking until an answer is found. The shoulder blade is now locked on this rib and will not release. However, this doctor feels that once it is allowed to move normally and PT is started that I should be able to regain the muscle and the shoulder should go back in place. If not completely then at least better then where it is now. The arm will work better then
    Ed or Linda do you have any input as I know this isn't done as often as it was in the past.
    T10-pelvis fusion 12/08
    Fractured t-9 six days out of surgery
    C5,6,7 fusion 9/10
    PJK at t-9
    T2--T10 fusion 2/11
    Removal of left side t6-t10. 8/14
    C 4-5 fusion 11/14
    Right scapulectomy 6/15
    Right pectoralis major muscle transfer to scapula
    To replace the action of Serratus Anterior muscle 3/16

  8. #23
    Join Date
    Dec 2008
    Location
    illinois
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    Here is the latest opinion. Went back to my spine team. Will not do the work on the ribs. I understand that because we have to make sure that is necessary. The scoliosis specialist said it is scapula winging. And no one knows why that happens. And the treatment is fusing the scapula to the ribs. He doesn't recommend doing it as it has a high failure rate. In the meantime my shoulder is dropped and balance is way off. I feel like I am listing or floating when I walk. His treatment plan, are you ready for this, just learn to walk while my head is down watching my feet. That will cure the imbalance issue. After years of walk with head up, shoulders back, eyes forward and core engaged. Now it is head down-- not easy with a fused spine and neck. In fact I am not even sure that can be considered medical advice. I will seek another opinion. This opinion came from my scoliosis surgeon. The entire right shoulder is depressed and the X-Ray shows how far out of aligned it is, with the clavicle coming forward and across the sternum and off the shoulder joint. I asked his comment on that and he said that is how a winging scapula looks. I will return to the University doctor for the next option.
    T10-pelvis fusion 12/08
    Fractured t-9 six days out of surgery
    C5,6,7 fusion 9/10
    PJK at t-9
    T2--T10 fusion 2/11
    Removal of left side t6-t10. 8/14
    C 4-5 fusion 11/14
    Right scapulectomy 6/15
    Right pectoralis major muscle transfer to scapula
    To replace the action of Serratus Anterior muscle 3/16

  9. #24
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    May 2008
    Location
    reno,nevada
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    3,535
    Jackie, I sure would like to see a few photos of what is going on.....shoulder heights and this situation with your head.

    I just couldn't imagine having my head leaning, it must be hell on the neck..

    Ed
    49 yr old male, now 58, the new 53...
    Pre surgery curves C12,T70,L70
    ALIF/PLIF T2-Pelvis 01/29/08, 01/31/08 7" pelvic anchors BMP
    Dr Brett Menmuir St Marys Hospital Reno,Nevada

    Bending and twisting pics after full fusion
    http://www.scoliosis.org/forum/showt...on.&highlight=

    My x-rays
    http://www.scoliosis.org/forum/attac...2&d=1228779214

    http://www.scoliosis.org/forum/attac...3&d=1228779258

  10. #25
    Join Date
    May 2008
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    reno,nevada
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    Is it something like this?

    http://www.anatomybox.com/winged-scapula/

    Ed
    49 yr old male, now 58, the new 53...
    Pre surgery curves C12,T70,L70
    ALIF/PLIF T2-Pelvis 01/29/08, 01/31/08 7" pelvic anchors BMP
    Dr Brett Menmuir St Marys Hospital Reno,Nevada

    Bending and twisting pics after full fusion
    http://www.scoliosis.org/forum/showt...on.&highlight=

    My x-rays
    http://www.scoliosis.org/forum/attac...2&d=1228779214

    http://www.scoliosis.org/forum/attac...3&d=1228779258

  11. #26
    Join Date
    Dec 2008
    Location
    illinois
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    No it is out to the side almost right under my arm. It is the right side it is down out an inch below left and out to the arm side not the midline. The nerve they are referring to has even been tested by an EMG. Nerve and muscle are testing normal. It was tested in March. This is why it is not fitting the path of this problem. Nerves, muscles appear normAl and strong. If the spinal nerve was involved there would be atrophy in the muscle. I am told not only is it not atrophied that it is a 5 out of 5 strong. The pieces of the puzzle don't fit. But the scapula is pulling the shoulder down by being out of position. It has locked on me since the thoracic hardware was put in. It would catch and I had to have PT release it. Now it is not catching but stuck.it limits arm movement forward and to the side. Hurts at times in the shoulder and by X-Ray is forcing the clavicle on the right past the sternum. That is sore. I am going to try to pull the image off of the disc from the Ct scan. I had my PT look at it and he said he has not seen anything like it and it is more than scapula winging because they treat that and this doesn't fit. But by being depressed like it is my balance is off. Rather difficult as I am bruising myself by walking into door frames. It is a puzzle and annoying. I see a spine specialist at the University of Chicago on Monday. I do think my spine is alright but will ask him to determine if the ribs are the problem. I know the CT shows 2 ribs further apart then they should be. My scoliosis surgeon refused to look as he said it was not the ribs. He was almost angry at me for asking. I was sent to the University hospital by his partner and was told by that doctor to discuss it with my spine team. I guess I now know how my team feels about it. It is sad because I really liked my doctors but they must not like it when a patient has a problem. So on Monday I will have another doctor review the Ct. There will be an answer somewhere.
    Last edited by jackieg412; 05-09-2015 at 05:35 PM.
    T10-pelvis fusion 12/08
    Fractured t-9 six days out of surgery
    C5,6,7 fusion 9/10
    PJK at t-9
    T2--T10 fusion 2/11
    Removal of left side t6-t10. 8/14
    C 4-5 fusion 11/14
    Right scapulectomy 6/15
    Right pectoralis major muscle transfer to scapula
    To replace the action of Serratus Anterior muscle 3/16

  12. #27
    Join Date
    Dec 2008
    Location
    illinois
    Posts
    758
    Ed I could not post the pictures but I sent them to your email address. They are from the CT scan. We do look different when the skin is removed. I can't get over how unstable the arm movement feels when the shoulder blade is loose feeling. It wobbles back and forth. And like the comments on the link you sent it compromises all movement of the right arm.
    T10-pelvis fusion 12/08
    Fractured t-9 six days out of surgery
    C5,6,7 fusion 9/10
    PJK at t-9
    T2--T10 fusion 2/11
    Removal of left side t6-t10. 8/14
    C 4-5 fusion 11/14
    Right scapulectomy 6/15
    Right pectoralis major muscle transfer to scapula
    To replace the action of Serratus Anterior muscle 3/16

  13. #28
    Join Date
    May 2008
    Location
    reno,nevada
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    Jackie

    I did get your CT scans but I don’t know how to read them......and Crystal is in Louisville.

    I have to admit that the 3D CT scans are very neat looking.......too bad your in the situation having to do all of this.

    I noticed your hardware removal on the one side.......What are they saying about this? Could a nerve been damaged when they removed this hardware? Do nerves grow into fusion mass material?????? This is a good question to ask at some point, I would like to know this answer.

    Has anyone pointed a finger at any particular area? In other words, which surgery might have caused it, neck or thoracic hardware removal?

    Ed
    49 yr old male, now 58, the new 53...
    Pre surgery curves C12,T70,L70
    ALIF/PLIF T2-Pelvis 01/29/08, 01/31/08 7" pelvic anchors BMP
    Dr Brett Menmuir St Marys Hospital Reno,Nevada

    Bending and twisting pics after full fusion
    http://www.scoliosis.org/forum/showt...on.&highlight=

    My x-rays
    http://www.scoliosis.org/forum/attac...2&d=1228779214

    http://www.scoliosis.org/forum/attac...3&d=1228779258

  14. #29
    Join Date
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    Location
    illinois
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    It is hard to read them but they are so cool being 3d. The front view can show how depressed the right shoulder is .If you look under the arm it will read r or l. The view from the bottom of spine up, shows the right blade off of the back. And I was laying on my back. If you look at the scan from the rear view and look on the right, you can see the extra space between rib 3 and 4. That has been discussed but I don't know the significance of it.
    As noted earlier, my spine team does not what to deal with it. I saw a scoliosis specialist from the university of Chicago today, and he feels the spine is fine . He did another scoliosis X-Ray. However, it shows very clearly that right shoulder is depressed. He is going to review all of the scans with the shoulder doctor down at the university. I was told to make an appointment on a Wednesday down there because they are both there on that day. He also said that they have been discussing this issue between them. So my appointment is on June 10 and maybe they will have a more detailed plan of action.He did talk about the possibility of having the scapula fused to the ribs or a muscle and nerve transfer. So far no one has come up with what happened. He did say that it could be an injury in a muscle or tendon.
    He also commented on my scoliosis doctor just telling me to walk watching my feet until I can get the brain used to the change in balance. This doctor does not think that is the answer. I Really Don't Either.
    So far no one has been able to determine why this happened or the cause. It is making me tired.
    T10-pelvis fusion 12/08
    Fractured t-9 six days out of surgery
    C5,6,7 fusion 9/10
    PJK at t-9
    T2--T10 fusion 2/11
    Removal of left side t6-t10. 8/14
    C 4-5 fusion 11/14
    Right scapulectomy 6/15
    Right pectoralis major muscle transfer to scapula
    To replace the action of Serratus Anterior muscle 3/16

  15. #30
    Join Date
    Dec 2008
    Location
    illinois
    Posts
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    an unusual fix

    Well the team of doctors from the university has come up with a plan to try to fix my shoulder blade. They also found the cause. My right scapula is trapped on ribs 3,4,and5. Of course it is because of scoliosis and kyphosis. I have tried to exercise the area for 4 years as this has been trying to happen for 4 years. It is now trapped and has developed what the doctor called dyskinesis. That means the scapula is not following the normal movement of the scapula when you use your arm. It moves on it's own and does not move when it needs to to lift your arm.
    An ideal treatment would be a thoracoplasty. However, we decided that was too risky of an operation for the benefit it would create. So they came up with an alternative treatment. The surgeon will remove a part of the scapula, reattach the muscles and tighten some of the muscles. And then keep my right arm immobilized for 6 weeks. Then a lot of PT to recover the shoulder. It is a less risky operation and hopefully will have the fix to the problem. This surgeon told me that when he does the bone removal it in usually the upper corner, however that is not where mine is catching, so this is more in the middle. Last week he gave me two steroid injections under the shoulder blade. He used that info to determine where to remove the bone.
    I am so disappointed with my usual treating surgeons. No matter how many times I told the of my catching scapula, I was either dismissed or sent back to PT. PT is the correct thing but when it fails something else needs to be looked at. This time the shoulder wouldn't lift and I kept complaining until something was done. I was sent to the University of Chicago and those doctors listened to the whole problem. I should know soon when the surgery will happen.
    I felt that I knew myself and kept pushing the my surgeon until something was done. He acted very unprofessional and actually got angry at me. It is disappointing because I really liked him.
    T10-pelvis fusion 12/08
    Fractured t-9 six days out of surgery
    C5,6,7 fusion 9/10
    PJK at t-9
    T2--T10 fusion 2/11
    Removal of left side t6-t10. 8/14
    C 4-5 fusion 11/14
    Right scapulectomy 6/15
    Right pectoralis major muscle transfer to scapula
    To replace the action of Serratus Anterior muscle 3/16

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