Not sure what this means

[jackieg412]

In the beginning at age 24, I had never been told I had scoliosis. I had no idea what it meant. So after the birth I ask the OB doctor why it was mentioned and what to do. His words were it just means you will have more backaches. I had several flare up that were managed with change of position, heat, over the counter meds and steroids. I never got treatment from an orthopedic.
Until the accident at work was in 2007. A steel beam landed on me and really made the situation worse. That was my first true study of the scoliosis. The largest curve was at L 3 and over 50 degrees. It was very concentrated in the lumbar.the first surgery was the t10-pelvis. After that in rehab I fractured through t9. So it was very obvious I really should have been fused higher. All I did was reach for a tissue.
The rest is history.
About the children, I almost never appeared to be pregnant, except with the twins. Now I think that was because of the scoliosis, I had no natural loridosis. I am small in structure but could hide the baby.
That is just my thoughts. Caring for the babies wasn't difficult until they out numbered me. I could carry 3 at a time but not all 4.What doesn't kill you makes you stronger.
My first cervical fusion was anterior. Very easy and I don't think they would remove the facets. In fact the CT scan of the broken neck showed them . Dr said they were locked and I think that was the spinal cord being compromised. Why I couldn't move my arm , why my hand was numb, and the right leg was so bruised that the Dr thought it was broken. It didn't hurt so I must not have been able to feel my leg. It was noted that there wasn't normal movement. All and all I guess I am very lucky to just have my hand acting up.. I do drag my right leg some since the last surgery.

[jackieg412]

I had another EMG today. I don't think the nerve is healing as hoped for. The neurologist told me to place a call to the neurosurgeon and she would get the results to him today.
Last time she told me the results, this time she would not comment on if there was improvement. She would not tell me but said I should reach out to him and absolutely not to wait until my next scheduled appointment.
We will see what he says. His assistant will call me back by Wednesday as to the next step.

[titaniumed]

Jackie, thanks for letting us know...

Your probably going to have to do more focused diagnostics on the osteotomy sites.

On the previous post, you made it a long time from age 24.....How many corticosteroid shots did you have? and when was that first shot?

My fingers are crossed...

Ed

[jackieg412]

I did hear from the neurosurgeon 's office- the EMG showed moderate compression of the ulnar nerve. Now this can be at my cervical level but the neurologist said she couldn't test there because of top much scar tissue. It is now showing compression at the elbow.
Not sure how we eliminate the wrong reason and find the real reason.
I do know gabapentin ,lyrica, and PT did not make a difference. The band is numb most of the time, hurts some of the time and now moves on it's own. The moving is newer and can be interesting.

[titaniumed]

Jackie, are the "ring and pinky" fingers curling in? This would be an ulnar nerve palsy or ulnar claw hand. They have orthotics for this. When my dad had ALS, one of his hands curled into a fist, and he had an orthotic device for the hand that held the fingers straight. I forgot about this....I am so sorry this happened to you. Hopefully, the pain will subside.

We don't talk about scar tissue around here too much....but we sure end up with it, no doubt about that.

Ed

[jackieg412]

No they do not curl on there own but I curl them a lot to try to stop the numb feeling. I also curl up my forearm and wonder if that is causing some of the findings on the elbow.I also stretch them out often.I do the nerve glide exercises often and have tried not to over do them.
The moving on it's own is in the muscle along the outside of the hand, it moves in and out. Almost like a heartbeat. Also it can go from body temperature to iceberg cold.
I can move them but it seems like they aren't strong.
I guess I will find out more when I see the neurosurgeon.

[titaniumed]

All the hand problems started after the last surgery correct? Did you wail your arm in the car crash? (with the airbag)

If we are going to crash a car, we are supposed to think right before impact and drop the hands to the lap. If your hand is on the top of the steering wheel, the airbag is going to slam it hard, and almost cause more harm than it's worth. Airbags can and do break bones....

Ed

[jackieg412]

Yes Ed these fingers were hurt in the car accident. And of course there isn't time to change anything . Accidents are lightning fast.
However I remember looking at the hand with instant numbness. Now knowing it was from the cervical break. Once the first surgery was complete the pain down my arm was so difficult too bear that I had to stay laying down to get as much relief as I could. So we know there is nerve injury at the cervical.
At times the numbness remained inbetween that surgery and this one in October.
This latest one the numbness is increased 10 fold. There is pain at times that comes quick and leaves quick.
I can move it but not do some things like use a knife or write.
It now also can be iceberg cold and then okay.
Now apparently there is compression at the elbow which I think I'm causing by cuddling my arm up against my body. I curl and twist the wrist to make it more comfortable.
It is my dominant arm and hand.
So I need to see if it is the neck, the displaced shoulder pushing on the brachial nerves, the elbow or the wrist. I'm not sure how it can be determined if the EMG can't be done thru the scar tissue.
I feel the neurosurgeon ,who has been so invested in my care may shed some light on this.I hope.

[jackieg412]

Well I was at the neurosurgeon today and he is going to decompress the nerve starting on the elbow. But he wants me to address the displaced shoulder. We did another EOS xray today. He thinks the shoulder is worse so we will see.

[titaniumed]

Jackie, All your problems are on the right side. I hope this elbow procedure is easy...

Does he want to proceed with the scapula fusion procedure? It's been awhile since you talked about that.

Ed

[jackieg412]

Yes Ed the decompression at the elbow is a more minor procedure and outpatient surgery.
The complete problem is more complex. There is mild carpal tunnel , the compression of the ulnar nerve both at the cervical and the elbow. The neurosurgeon said there isn't anything more that can be done at the cervical level. But this has now caused muscle loss. The 4th and 5 th fingers and outside of the hand and palm are painful then numb and then turn cold. The neurosurgeon said the cold is from the nerve and not circulation. So this can be improved but some problems will remain.
The spine surgeon is now concerned about the shoulder being so out of place. He thinks it is worse and did another EOS xray to compare from 2019 xray.
The spine surgeon wants me to revisit the upper extremity specialist about it. I will but need to wait a little while. The neurosurgeon said that the orthopaedic could also do this decompression but I want the neurosurgeon to do this nerve and later will revisit the shoulder.
This is actually the first time the spine surgeon spoke so openly about the need to fix the scapula.
The scapulothorasic fusion is much bigger and more complicated. Things to think about.

[jackieg412]

I did see a doctor that I know that practices physical medicine. His opinion on the displaced shoulder that I need to find a solution to keep it in position. He feels the reason the ulnar nerve is reacting so much after the last spine surgery is the head is in a better position ,the shoulder is further depressed and the nerve is being streached.
I am going to see the shoulder specialist that is known to do the scapula fusion surgery. But I am hoping he has a different approach. His name is Anthony Romeo and was at Rush in Chicago, then in New York, and now is back in Illinois and at a location near where I live. According to my doctors it is like seeing the best of the best.

[titaniumed]

I did see a doctor that I know that practices physical medicine. His opinion on the displaced shoulder that I need to find a solution to keep it in position. He feels the reason the ulnar nerve is reacting so much after the last spine surgery is the head is in a better position ,the shoulder is further depressed and the nerve is being streached.
I am going to see the shoulder specialist that is known to do the scapula fusion surgery. But I am hoping he has a different approach. His name is Anthony Romeo and was at Rush in Chicago, then in New York, and now is back in Illinois and at a location near where I live. According to my doctors it is like seeing the best of the best.

Jackie, I am not understanding what you mean by different approach....Are there different methods on this scapula procedure?

When do you see Dr Romeo?

Ed

[jackieg412]

I can only hope there could be a different way of fixing this. I'm not convinced that other than the scapula fusion that the shoulder can be helped.But I am open to listening to what my doctors describe as the best of the best. If you look online he has a rescent utube discussion on another device that is not the wires that are used.idea
A necessary consideration is my age. So on that, I don't know if it can be done.
The doctor I saw at Rush was willing to do it about 2 years ago. When I asked him how many scapulothorasic fusion he has done ,he said 2.
From what I know, Dr. Romeo does 4 or 5 a year and has been in practice for many years.
I go on July 16

[titaniumed]

He sure looks like he is into shoulder....all you can do is see what he says....

It is amazing what these orthopedic specialists can do....and not just for scoliosis.

My shoulder re-build came out great and have no complaints at all. I couldn't lift my arm at all after the ski crash. If our orthopedic problems would have happened over 100 years ago, things would NOT be good. I think about this quite a bit, (especially after watching a Clint Eastwood western) and also think about all the advancements that have been made over the years. People that have no medical problems take all of this for granted....

(BTW, on advancements, they are getting closer on many cancers, AIDS, Etc. Antibody trials will start soon in Russia and Europe. COVID accelerated this research....) Intel has been involved with super fast computing speeds.

How many people would think that repairing an orthopedic problem would extend their life? Most would probably think about other procedures like Heart surgeries etc as far as extending life, but orthopedic problems can play a big part in this regard. The pain and disability can be extremely taxing....Scoliosis itself can be extremely disabling. It's not just a curve in the spine...

I changed out 4 heavy 6 volt house batteries in my RV last week, and doing all of that with a friend doing the heavy lifting, tag teaming back and forth for a minute or two, on and off, left my whole back (soft tissues) just screaming.... It was the bending forward and struggling with the arms mounting all the thick battery cables. All this physical stuff is not getting easier these days....

Ed