Not sure what this means

[jackieg412]

Well after many surgeries and a very horrific car accident here is one more problem.
After partial hardware removal in January I have had severe thoracic pain and balance issues.
This week I had an appointment with a scoliosis specialist. Again.
After new xrays there is evidence of sagittal imbalance. A full spine myelogram is ordered.
In the office notes by the neurosurgeon among many things he has written
C6-T4 hypnosis of -26 degrees. What does the negative mean?
He is saying from a combination of PJK and the bilateral C7fracture.
We discussed an upper thoracic osteotomy.
Another big decision. Walking is difficult

[LindaRacine]

Well after many surgeries and a very horrific car accident here is one more problem.
After partial hardware removal in January I have had severe thoracic pain and balance issues.
This week I had an appointment with a scoliosis specialist. Again.
After new xrays there is evidence of sagittal imbalance. A full spine myelogram is ordered.
In the office notes by the neurosurgeon among many things he has written
C6-T4 hypnosis of -26 degrees. What does the negative mean?
He is saying from a combination of PJK and the bilateral C7fracture.
We discussed an upper thoracic osteotomy.
Another big decision. Walking is difficult

I assume you mean hypokyphosis, not hypnosis. :-)

The amount of kyphosis in a "normal" spine is 20-40 degrees. This refers to the "hump" in the thoracic area of a normal spine. When the measurement is negative, it means that the normal curve has been replaced with a flattening (when viewed from the side), at the top of the back.

[jackieg412]

Thanks for the correction and information

[titaniumed]

Jackie, You have had so many procedures, I can't remember.... Do you have "any" hardware left up high in the thoracic? I thought they removed it all due to your scapula problems?

You surgeon pointed out C6-T4, which is up high. Negative 26 degrees in this area alone. If you have any new "side" x-rays, can you post those? It sounds incredibly painful.

What did your surgeon say about the osteotomies? Posterior only?

One day at a time...

See attachment below for Hyper and Hypo kyphosis.

Ed

[jackieg412]

You are right I have had a lot. Of procedures. I have had parts removed on left side t6-10th on the right side in January I had t4-6 removed because of the non healing wound. When I tried to get up right after surgery i t was like someone removed the string that held me upright. At the six week checkup I was still a little off balance. But it kept getting g worse and sharp pain developed around t5-6 area. A bite your fist type of pain. I am still being seen by pain management and have a pump that needs filling. So I worked with the Dr through steroids, injections and finally a spinal cord stimulator trial with a little help. But I knew I was off balance. I needed to see a neurosurgeon for implementing, but he took xrays that showed many problems. A lot of very prominent cervical hardware that must come out. He wants a complete spinal myelogram that will be this week and through the pump. I am to make an appointment right after that for further discussion.
I will ask more questions then as he will have better information.
I have a daughter getting married in October so nothing will be done before that.
It is very difficult walking with my head down . If I try to base forward I loose my balance. It can't stay like this or I will soon not walk much .
I don't have X-Ray copies yet. It is a little much as the surgeon said it was a massive undertaking.

[jackieg412]

Ed i looked at the pictures but my X-Ray shows the head almost completely resting on the chest. It is hard to get comfortable.

[titaniumed]

Jackie, I think you might have misinterpreted what the surgeon was saying in the reports....your positive instead of negative if your chin is on your chest. He mentioned PJK and that's hard to do if there is hardware in there. (Unless screws pull out, bone degrades, or hardware breaks) That's why I asked. I am assuming that all your levels are fused. (hardware of not)

How is your osteoporosis? How are your vitamin D3 levels? I would ask these questions when you go in next. In my case with my jaw bone, I will find out if the bone grew back in on the next x-ray. Jawbone, or spine, it all remodels. Vitamin D3 helps with osteoporosis per the study I posted on the other thread.

If your neck is falling forward because of bone degeneration, they might want to operate here real soon. I would prepare for this. Your spinal cord needs to be preserved which is probably the most important thing right now. I think that they will have a few specialists in the OR on this one. Have they mentioned anything about going in from the front? I am not sure they do this up so high in the thoracic. ??? It's not your everyday scoliosis procedure that for sure.

I do not doubt you one bit on not being able to get comfortable....

Can you sleep on your side? That's my only real position these days...get the pillow height set just right. Super soft down pillows. The softest you can find at any cost.


Ed

[jackieg412]

I actually copied what I posted by using the doctors notes. This according to him was present to a lesser degree in 2017. Then I broke my neck in auto accident. They hooked the posterior cervical rods to The ones in the thoracic. A lot of pressure on the thoracic at about t5-6 level and then internal pressure wound.When they took that portion out, I had a very difficult time standing up..
He said we would think I was fused but it is difficult to say for sure. It is very obvious that something is worng. The myelogram will be this week and once it is done he said he would see me right away.I
So far there isn't osteoporosis showing up on the dexa scan. No other broken bones.
Another issue is an extreme curve in the lumbar area and matching the hardware to my size. A lot of the hardware is very prominent. The posterior cervical hardware is very visible and is almost through the skin.
He said it isn't usually a problem but I am on the small bone size.
I can usually fall asleep but just can't move without waking up.
I should know more this week

[titaniumed]

I forgot about the infection. Do you feel infected? The infections really run you down and are so taxing.

Try to lay low for now, stay off your feet. I hope you have someone helping out with your transportation needs. The Chicago traffic can be intense...

Ed

[jackieg412]

No I don't feel worn out. I don't have any more leaks from my back at this time. I do feel a struggle and easy imbalance issue a lot when I walk. I keep walking into the walls of my own house.
I did find out the myelogram will be on Friday. My pain doctor will do it though the pump. So it is a stick in the pump area but not in the traditional area. I hope it is easier. Plus I will get to talk to the pain doctor about the issues in the fusion. The neurosurgeon and pain doctor know each other.

[titaniumed]

Jackie, your right, it was the infection, debridement and hardware removal....at T5-6 (smug face)

I think they are going to have to check that site. Staph infections can be deep seated within a healed wound. (regardless of any leakage) It's hard to trust infection...

Linda and Susan would know more They use CT, MRI, Blood work, Cultures, Etc.

You understand about osteotomy? If not, I can post more about this if you like. They are wedge cuts in bone to correct sagittal plane issues.

Suzie Bee comes to mind when I think about osteotomies. She had a few done in her scoliosis surgeries in 2007.

Ed

[jackieg412]

You are right the pain is in that area and the way I responded after the partial removal of the hardware might be a telling sign.
The neurosurgeon commented on the extreme lumbar curve that was created in my first surgery. He explained that newer instrumentation would have allowed that to be less.
I don't think he would want to remove everything and start over. I can't even imagine that.
I do know what an osteotomy involves and maybe that is how we match the extreme lumbar.
Also he said they can use smaller hardware as I have so much hardware that is too close to the skin.
The cervical hardware is so prominent that it is stretching the skin . Any straps , tags or rubbing collars I have to avoid or I can scratch it open.
So hard not to get discouraged.

[titaniumed]

Jackie, I have a really long post in process but sometimes I am afraid to post too much information here.

Given some of the issues with extreme spine surgery, the one thing that happens is that knowledge and technology keep improving every day. Surgeons are presented with new products and procedures and this changes things. Removal of hardware in infected areas can present neurologic compromise, and pseudarthrosis, but they do have new coatings, and anti-bacterial cements that they wrap the hardware with to prevent future infection.(Biofilm) The infection point is the focal point, there are going to be looking real close in that area. How they deal with this I don't know..... but it will take things to the next step.

I think that its most important to remember that the intent is sound, the intent to do good. Not all procedures go the way we want them, but there is always a new plan, or a plan B. You have been extremely patient in understanding the difficulties of spine surgery, much better than I would take it. It's difficult to continue struggling with all of this. Melissa has not posted, but she told me she is doing well after her last procedure.

They will be looking with that CT. They also use MRI to look for infection which could be ordered.

I would address your immune system. Ask your doctor if there is a dietician that you can talk to. I would be eating ONLY the best foods right now. Address vitamins, and medications. I like blueberries. I have read that they are probably the best thing you can eat. Bananas for potassium. My old bookeeper ended up in the hospital almost in a coma. When he came back I asked him what happened. He told me they want him eating more bananas. No meds, just bananas. Wow!

Let us know how things go. Symptoms are always a sign of suffering organs. -Charcot

Ed

[Tina_R]

I'm sure blueberries and bananas are good for you and maybe not replaceable by many other foods. But I don't believe in superfoods, a food that's supposed to cure what ails you. It's just something people want to believe in, like magic.

[titaniumed]

I'm sure blueberries and bananas are good for you and maybe not replaceable by many other foods. But I don't believe in superfoods, a food that's supposed to cure what ails you. It's just something people want to believe in, like magic.

I didn't believe in Vitamin D either....and never targeted any specific vitamins or foods for that matter. When it comes to foods, doctors will say eat a balanced diet. I guess that covers everything except all the processed foods in the middle of the grocery store. You know, like the Cheeze-its. "Balanced, not processed". One thing that's interesting is that you can google best foods, or good foods and you will find a list. When you google BAD foods, the list is HUGE. Frozen chicken pot pies are usually on the top of that list. (Chemicals, Dyes, Preservatives Etc)

A good idea for an App would be a bad food identification system on your phone. Point it at a food product and have a safety value pop up. The really bad stuff would have a large red X right across the screen. There is a lot of stuff that deserves the red X. Have the phone say "Don't do it" as your grabbing that frozen pizza. Ha ha

After losing my gall bladder and being lactose intolerant, eating bad food's can cause me a lot of grief and heartburn. It just stresses out my system, heartrate and blood pressure increase's and it's a struggle. It happens once in a while because diet is not easy. I have learned to be more selective when eating. Some areas of the world are 80-100% lactose intolerant. Things like milk can almost send me to the ER. We are all different of course, unless you are in that 100% group. I get my calcium elsewhere, and doesn't matter if your vitamin D deficient. You can't absorb it.
https://en.wikipedia.org/wiki/Lactose_intolerance

https://www.bones.nih.gov/health-inf...m%20the%20diet.

Proper nutrition is especially important. Especially important "before and after" doing major surgeries. There are studies on this. Just ask and I will post.

Dr Boachie's kids in Africa are prime examples of improper diet. (and lack of vaccination) They become susceptible to infection, and virus's.....You can see this on the FOCOS site. Some of the worst scoliosis and kyphosis cases in the world.

When I have back pain now, I automatically think diet... What did I eat? There is usually a result of some sort. Bad foods, bad results.

Ed