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Thread: Complication from rib removal

  1. #1
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    Jan 2005
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    Complication from rib removal

    Since my original surgery I have had permanent spasms going from my back, round the right side to the stomach, and spreading over time from to include the left side. Instead of reducing like the other post-surgical spasms they have got steadily stronger, and drastically since the hardware was removed in March. They were not due to a failure of fusion, which was tested thoroughly on my insistence, and nothing helps - everything that help ordinary spasms makes them worse. No medication has affected them even slightly, whether pain relief, muscle relaxants or anti-spasmodics. It has now got to the stage where their impact on breathing, standing and walking mean my everyday functioning is now very limited. With any slight stimulation they go from being acutely uncomfortable to a feeling of being cut in half and being unable to breathe.

    The surgeon and the pain specialist have been unable to diagnose them until the last appointment, the second with the two of them. The consensus is that they are due to the removal of the rib at the original surgery setting up a nerve irritation which has taken on a life of its own, proliferating and intensifying instead of settling at some level. The good news is that there is now a treatment plan for intensive physiotherapy, rehabilitation and especially biofeedback as an inpatient, to see if the muscles can be trained to act differently.

    It has been really hard watching the deterioration and not knowing what is going on with my body, especially since March. Neither of the specialists seemed to have seen this complication before, and nor have I on any scoliosis site. So I thought I'd post this up in case anyone else has a similar experience.

    Spinal fusion T2-T12 Nov 04, reducing curves of 77 and 52 degrees by half.
    Removal of hardward March 06, because of inflammation and swelling the length of the spine, and consequent loosening of a screw.
    Last edited by Lavinia; 06-17-2006 at 03:43 PM. Reason: inaccuracy

  2. #2
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    Jun 2006
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    Quote Originally Posted by Lavinia
    Since my original surgery I have had permanent spasms going from my back, round the right side to the stomach, and spreading over time from to include the left side. Instead of reducing like the other post-surgical spasms they have got steadily stronger, and drastically so the hardware was removed in March. They were not due to a failure of fusion, which was tested thoroughly on my insistence, and nothing helps - everything that help ordinary spasms makes them worse. No medication has affected them even slightly, whether pain relief, muscle relaxants or anti-spasmodics. It has now got to the stage where their impact on breathing, standing and walking mean my everyday functioning is now very limited. With any slight stimulation they go from being acutely uncomfortable to a feeling of being cut in half and being unable to breathe.

    The surgeon and the pain specialist have been unable to diagnose them until the last appointment, the second with the two of them. The consensus is that they are due to the removal of the rib at the original surgery setting up a nerve irritation which has taken on a life of its own, proliferating and intensifying instead of settling at some level. The good news is that there is now a treatment plan for intensive physiotherapy, rehabilitation and especially biofeedback as an inpatient, to see if the muscles can be trained to act differently.

    It has been really hard watching the deterioration and not knowing what is going on with my body, especially since March. Neither of the specialists seemed to have seen this complication before, and nor have I on any scoliosis site. So I thought I'd post this up in case anyone else has a similar experience.

    Spinal fusion T2-T12 Nov 04, reducing curves of 77 and 52 degrees by half.
    Removal of hardward March 06, because of inflammation and swelling the length of the spine, and consequent loosening of a screw.
    I had a rib removed left side March 23rd. and I am going threw the same problems and pain. As soon as you start the rehab will you post what actions they take with you?
    March 23, 2006 Anterior/posterior Ileum-T2
    15 1/2 Hours
    Dr. Tom Lowe R.I.P.

  3. #3
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    Jan 2005
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    Sorry you are having such a hard time. But try not to worry too much - you are a very short time out of your surgery and there are bound to be adjustment problems that are to be expected, and not like mine. I had many other spasms in the months after surgery which gradually disappeared.

    I'll certainly let you know what happens in the physio programme, when it eventually takes place: may be any time from 3-6-10 months' time, apparently.

    Best to all

  4. #4
    Join Date
    May 2004
    Location
    Houston, Texas now live in Colorado Springs, CO
    Posts
    543
    Hi Lavinia,

    I have the same problem. It is also from the rib removal. We even tried trigger point injections. We are looking at possibly doing a medial branch neurotomy. They will go in with the help of x-ray and pinpoint certain nerves and inject medicine to destroy the nerves. They regrow back in about six months to a year, but hopefully with PT during that time you can successfully work on the area that needs it. I am on my way to PT right now so I'll right back later.
    Theresa

    April 8 & 12, 2004 - Anterior/Posterior surgery 15 hours & 7 hours
    Thorasic - 79 degree down to 22
    Lumbar - 44 degree down to 18
    Fused T2 to sacrum
    June 2, 2005 - Pedicle subtraction osteotomy @L3 7 hours
    MAY 21, 2007 - Pedicle subtraction osteotomy @ L2, extended the fusion to S2 and added pelvic instrumentation 9 hours

    FUSED T2 - SACRUM 2

  5. #5
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    Sep 2003
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    Spasms?suit of armor?

    Lavinia:

    If I get very sedentary-like when I just had the hysterectomy in March and needed to recover I get those similar feelings. I think the muscles contract down in the areas of the trunk which are fused. If I keep moving, walk, and exercise I seldom have that feeling-but it does return with laziness.
    I'm not even sure it's spasms but muscles tightening from lack of movement.

    Last Fall I spent a lot of time sitting in a car touring. because of the high altitude I din't do much walking and really noticed it coming home.

    The good news is that there is now a treatment plan for intensive physiotherapy, rehabilitation and especially biofeedback as an inpatient, to see if the muscles can be trained to act differently.
    I bet you will get great relief from it; let us know.

    I know the feeling is rather maddening.
    Original scoliosis surgery 1956 T-4 to L-2 ~100 degree thoracic (triple)curves at age 14. NO hardware-lost correction.
    Anterior/posterior revision T-4 to Sacrum in 2002, age 60, by Dr. Boachie-Adjei @Hospital for Special Surgery, NY = 50% correction

  6. #6
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    Jan 2005
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    Thanks, Theresa and Karen.

    Theresa - I am really thrilled to think there is one other person in the universe who has experienced this. I shall review your history, do have a look at mine and perhaps we can pass any useful info on to each other off-line. Very best of luck with your neurotomy, if you decide to go ahead with it.

    Karen - you are such an inspiration and success, I do hope you continue going from strength to strength. I hope you are over your hysterectomy, and continuing largely comfortable. I also hope for the best with the inpatient package, and shall start physio privately beforehand since it may be a long wait.
    Last edited by Lavinia; 06-17-2006 at 08:18 AM. Reason: inaccuracy

  7. #7
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    Jul 2005
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    California
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    Lavinia, I know what you are going through. I had a thorocoplasty with my fusion in Feb of '05 and did not know why I was having constant pain in my Rt upper back for so long. About a week after I got out of the hospital I had to go to the Emergency Room because I couldnt breathe and it was determined that I had pneumonia, part of my Rt lung had filled up with fluid and partially collapsed. They had to drain the fluid with a needle and give me antibiotics for the pneumonia and hope that the lung would expand itself. Over time it was not getting better. The pneumonia went away and the fluid almost came back (it did but not bad enough to drain agian and then went away) but the lung did not re expand. I was sent to pulmonary rehabilitation to try to regain function of the lung. No matter how hard I tried to get it to work again I still had A LOT of pain that would put me in tears. I could not raise my arm over my head and still felt like I could not breathe. I never got feeling in my back back, I was just not getting better. Finally after 7 months my doctor decided to just take the rod on the Rt side out because he thought that might be causing the problem. I had it removed in Dec. '05 and have had much relief since then. The only thing that we can think of is that it was sitting on a nerve that would have paralized the bottom of the daiphragm (just under the lung) keeping it from expanding. Causing all the pain and not allowing me to raise my arm.
    I know what you are going through and I hope you are able to find relief soon. I know that it is frustrating to not have a normal life or be able to do the things you want to do or the things that feel normal. I hope that the inpatient therapy works. Good luck to you. Let us know how it goes.
    Mandy

  8. #8
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    Jan 2005
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    Mandy, thanks for your kind words. I had pneumonia too, just after the second stage of the surgery, and it was truly frightening and horrible. I'm really glad they have found the answer for your pain and problems. Thanks for writing.

    Theresa - I would be really interested to know about your spasms, to see how similar to mine they may be, and if you have found anything to relieve them. I'm also happy to describe mine in more detail, do ask me by email if that would be helpful to you. Hope your PT is going well - it encourages me that you can get there!

    Lavinia

  9. #9
    Join Date
    Dec 2005
    Location
    new jersey
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    This is making a bit nervous about the upcoming rib removal for me!!!! Just got back from a long weekend trip & nice & relaxed but it's all getting too close!!!!!!! Ly
    surg Aug. 1st....ant/post.. .......
    http://lynnebackattack.blogspot.com

  10. #10
    Join Date
    May 2004
    Location
    Houston, Texas now live in Colorado Springs, CO
    Posts
    543
    Lavinia,

    I sent you a PM.
    Theresa

    April 8 & 12, 2004 - Anterior/Posterior surgery 15 hours & 7 hours
    Thorasic - 79 degree down to 22
    Lumbar - 44 degree down to 18
    Fused T2 to sacrum
    June 2, 2005 - Pedicle subtraction osteotomy @L3 7 hours
    MAY 21, 2007 - Pedicle subtraction osteotomy @ L2, extended the fusion to S2 and added pelvic instrumentation 9 hours

    FUSED T2 - SACRUM 2

  11. #11
    Join Date
    Jan 2005
    Posts
    96
    Update on my situation, just in case, again, it's informative to anyone else. I have just had my week in hospital, where the plan was to try physiotherapy and biofeedback to try to reduce the permanent thoracic spasms. As it turns out, however, neither were really usable. The spasms are not actually in the muscles, although they are intense enough to severely limit my breathing and my mobility, so there was nothing to show up on the EMG/biofeedback monitor. Equally, phsyiotherapy or any movement, massage or other stimulation made them instantly worse, for hours or days, as has happened since they started.

    But at least the situation is now a bit clearer, which is a help to me and hopefully might be to others who find themselves in a similar position. It seems the symptoms are a version of chronic pain where the central nervous system keeps reproducing pain signals and sensations even after the tissues have healed - a kind of neurological loop that becomes entrenched and is therefore very hard to interrupt. The reason the medics were so confused is that there is no sign of nerve damage or interruption of the nerve signals, and in my case the symptom is extreme and permanent contraction of the back, side and front, rather than normal pain.

    There seems not much available in the way of treatment or prospects, because the problem is in the nervous system rather than the muscles or bones. Medication has absolutely no effect, which is a mixed blessing. The best hope seems to be to imrpove my functioning by finding a (low) level of activity which does not make things too much worse, and then slowly building up.

    Probably other people have this kind of chronic pain, and everyone who does has my sympathy!

    Lavinia

    Spinal fusion 2004, curves of 77 and 52 reduced by half.
    Instrumentaion removed entirely in March 2006, because of widespread inflammation and swelling which had loosened the whole structure.
    This greatly exacerbated the thoracic spasms which had begun to build up from the 2004 surgery.

  12. #12
    Join Date
    Apr 2005
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    913
    Hi Lavinia,

    thank you for giving us updates, as it is informative and I really hope you find some relief I do have some pains in my thoracic screws, and it's a tightening/stabbing pain and like you, gets worse when I do things. I do find that sometimes, if I don't do much and start again it gets worse, and so it's better that I keep moving on a level that is in between-it's a fine line and hard to live with.

    Hoping time can make you feel better. Sometimes pain goes away or lessens when we least expect it.
    35 y/old female from Montreal, Canada
    Diagnosed with scoliosis(double major) at age 12, wore Boston brace 4 years at least 23 hours a day-curve progressed
    Surgery age 26 for 60 degree curve in Oct. 1997 by Dr.Max Aebi-fused T5 to L2
    Surgery age 28 for a hook removal in Feb. 1999 by Dr.Max Aebi-pain free for 5 years
    Surgery age 34 in Dec.2005 for broken rod replacement, bigger screws and crosslinks added and pseudarthrosis(non union) by Dr. Jean Ouellet

  13. #13
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    Sep 2003
    Location
    Northern California
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    6,797
    Hi Lavinia...

    I'm so sorry to read your report and really hope that you can eventually find some help. I have a friend who has a similar situation (from spine surgery). You might want to Google "Reflex Sympathetic Dystrophy" and "Complex Regional Pain Syndrome."

    Regards,
    Linda

  14. #14
    Join Date
    Jun 2006
    Posts
    131
    Livinia, I have found a temp. fix to the heavy spasams. I have found a 10's unit set on high will slow things down to where I can manage the pain. I can put the patches on the nerves between my rib area and my brain (whats left of it) and it interups the spasams. Will not make them go away but helps in the pain management.
    Jess
    March 23, 2006 Anterior/posterior Ileum-T2
    15 1/2 Hours
    Dr. Tom Lowe R.I.P.

  15. #15
    Join Date
    Jan 2005
    Posts
    96
    Linda and Jess, thanks so much for your messages. I'm feeling a bit more reconciled to things now, at least not feeling totally confused is a help and the hospital physios were wonderfully patient, explaining things about 3 times each, which was great since they couldn't actually do much physio with me.

    Best to all,

    Lavinia

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