Follow Up

[llanning]

I saw an orthopedic surgeon yesterday. He has a good reputation here and lists adult scoliosis as a speciality. I had a fusion (no instrumentation) back in 1962 and had never really had any followup. I have been having pain and just kind of wanted to know what to expect. My xrays showed the fusion is good, my thoracic curve (fused) is sixty degrees and my sagittal plane is OK (no flat back). My lumbar (non fused) curve is forty degrees. He said that degenerative disk disease is usually genetic but they have found that a long fusion can certainly cause degenerative changes also and mine is most likely a combination of the two. The pain rating scale I was asked to complete was difficult. It asked questions like, "Does the pain keep you from walking over a mile, a few feet, confined to a chair, etc." It doesn't keep me from doing just about anything, it just hurts. He kind of implied that surgery was a last ditch maneuver that involved fusing the lumbar vertebra and stabilizing them to the pelvis. He said usually an anterior approach was used but not always. He seemed pleased that I was doing pilates and also suggested swimming as a way to keep the core strong. Other than that, he offered nothing else. He said any changes in the lumber curve would take two to three years to be noticeable on xray. I guess I have a baseline now. He did say that if the nerve roots starting being impinged and I had leg pain, then injections could be tried. Do any of you have any thoughts on all of this? Does it all sound typical to your experience? Thanks in advance.

[rainbow2010]

My scolisosis doctor sent me to a real good pain management doctor that does brain and spine rehab. He tried steriod injections first to take down swelling. Then he has given me nerve root blocks to see if that gives me relief from my pain (most of mine is thorasic). If they work and they have, he then does nerve root ablation. That is where they stick a needle in my back to the nerve and burn the nerve. It creates scar tissue that stops the pain. They last for about a year and he said it could take 3 treatments before the nerves stop growing back. I like it because I hate taking pain medicine and they can't operate to remove the discs in the area where I am having problems.

[PNUTTRO]

The doctor was probably trying to keep you from rushing into a surgical treatment. Its pretty typical, I think.

You seem to be a "functional" person in pain. The doctors can only judge your pain by how it appears to effect your life. If your pain is so great that you think its time to do something different about it, you have really press the point.

p

[Kate]

Hi Rainbow, I have been a "visitor" mostly to this site since 05 and just joined as my surgery will be in Dec. (revision from May1990). Since early 2006 I have undergone 9 steroid injections PLUS the ablation you refer to, epidurals, SI block and eval for spinal stimulator. Well, two years, 60 lbs of weight gain (steroids and lack of ability to do much) and VERY opiod tolerant later (I wear a 50 mcg fentanyl patch plus oxycodone for breakthrough PLUS all these injections). I guess I would just urge you to consider if it is worth jumping through all those hoops or doing (as I wish I did, and it ended up being the result anyway) the surgery. I too was able to work and function, but looking back I could've been better at my job and saved a lot of money and time.

Everyone is different, I just wish now that instead of meekly saying "yes doctor" after 6 months of no results that I insisted on surgery. Just a thought.....

[rainbow2010]

Kate -
I have had a weight gain problem due to steroids also. I now exercise at a therapy pool where they keep the water at 90 degrees. I haven't lost much weight, however my cholestrol has gone way down. The warm water also gives me some pain relief.