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Help for Thoracic Herniations
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Help for Thoracic Herniations

Dear Dr.,

I am a late 30's male with degenerative disc disease, herniations or bulges at T5-6, T6-7, T8-9, T9-10, T10-11.  My MRI and Myelogram test results show these issues and others such as spondylosis, foramen compression, osteophytes, osteo-arthritus, etc.  We think these issues stem from a car acident I had 9 years ago.  I was rear-ended and my car was totaled.

As of my MRI (2 years ago), and my visits to numerous doctors, the herniations are not exceedingly large, so the surgeons in my area were reluctant to perform thoracic surgery because it is so invasive and "may cause as much pain as it cures".

I have tried many different medicines, am in my third round of physical therapy, had three sets of steroid/epidural injections, tried chiropractic, tens units, ultrasound, soft-tissue manipulation, core strengthening exercises, bed rest, accupuncture, etc.

However, my condition has gotten worse over the last 3 years, and it is making normal daily activities a real challenge.  I take pain medication but that does not treat the actual condition.  

So, my question is, are there any new, minimally invasive procedures available for thoracic herniations that may provide someone like me some relief?  I see advertisements for places like The Bonati Institute which advertise minimally invasive procedures (i.e. laser) for thoracic cases but I contacted one (Laser Spine Institute) and they stopped calling me back once they realized I was thoracic.

I know thoracic issues are much more rare than the more common lumbar or cervical, and that historically, thoracic procedures are complex, invasive, and risky.  However, I pray there are new options available for thoracic issues as I am losing my pain battle and need to do something about this condition.

I appreciate any information that MedHelp's doctors may be able to provide.

Thank you,
Sidddharthha
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Avatar_m_tn
No doctors willing to comment on thoracic disc problems, huh?  I'm not surprised.  It's the same story I hear from every doctor.  "Thoracic disc problems are really rare and there is nothing we can do for problems on multiple thoracic levels".  Oh well, when I saw this forum I hoped there might be a doctor on here that might have some advice.  
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Avatar_f_tn
Hello --
   I have sent you a private message regarding your inquiry.  I would be happy to try and assist you further if you are interested in pursuing your request for additional information regarding the treatment of thoracic disc herniations.

Community Leader
Back and Neck Community
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Avatar_f_tn
I am a 42 yr. old female..with a ruptured T-7. I stay in pain constantly. I have saw a couple of surgeons and was told both times" this is rare, too dangerous to operate"...they say that it is to close to the spinal cord. I understand that ...but it really effects my life..something as simple as trying to hang clothes in the closet is almost unbearable. I have had this problem for a few yrs. including problems with more discs in other parts of my spine.I have deg.disc disease also. The other day I was sitting in a chair and I just barely turned to the site...and pain so awful it was even hard to breathe, hit the T-7 site.I actually felt like I was dying...it seemed to effect so much. The pain soared around to my sides and up my neck into my head and I felt like my head was going to explode. It went down into my legs out my feet. I truly felt lie it was effecting my breathing. Then tingling started in my arms, hands legs and so on.And it has not went away...also the T-7 site is still killing me. Can anyone please tell me what may have happened?
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Avatar_f_tn
Welcome to the Back and Neck Community.  The members are here to provide assistance and support to individuals experiencing symptoms related to possible abnormal conditions of the cervical and/or lumbar spine.  Thoracic conditions are much less frequent, but you may find some individuals who are dealing with similar conditions.
The advice given is non-professional and is based primarily on personal experiences.  Post on the Expert Forum if additional medical advice is needed and one of the medical doctors will respond as appropriate.

As you stated in your post, thoracic disc herniations are more complex and difficult to treat than similar conditions in the neck or low back.  The surgery can be more complex and involves not only the treatment of the affected discs, but the risk of significant complications.  There are not many surgeons who will undertake this type of surgery as you have found during your search for medical treatment.
The fact that your pain is so intense and unrelenting is certainly a major consideration.
Most doctors will use as many conservative txmts as possible and resort to surgery only in the most difficult cases.  They usually need to feel that the spinal cord is in danger of being compromised and that there are already symptoms of myelopathy. This would include not just pain, but difficulty walking, loss of muscle control, evidence of severe nerve impairment, possible absence of major reflexes, loss of bowel and bladder control, etc.
I do not know if you are currently under the care of a physician, but the only recommendation I can provide is to get a consult with a neurosurgeon who has had experience with difficult thoracic spine conditions.  This may mean contacting a major medical center in a large metropolitan area. (Similar to patients contacting the Mayo Clinic for their complex medical conditions.)
If you have not had a recent MRI or other diagnostic test to confirm the extent of nerve involvement, a repeat of these tests may show significant interval changes that may help persuade a skilled neurosurgeon to assess the treatment options available to you.
Please post back and let us know of your situation and if you were able to obtain a neurosurgical consult.  No one should need to suffer so intensely without options.
Best wishes -----
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Avatar_m_tn
I sympathize with your condition, missygt.  It sounds like your T7 may even be worse than mine.  But, the pain you live with every day that you described is exactly how I am.  There are many days each month where I feel like just giving up copletely.

But, as a husband, father, and sole wage earner for a family of four, that is not an option for me.  So, I get steroid/epidural injection in T6-7 and T9-10 (my worst spots) about every 6 onths or so.  I also take two different pain meds every day.  They help, but they do not alleviate my pain by any means,  But, they allow me to keeo getting up and going to work every day.

I agree with kittluv1 that you need to find a neuro/thoracic spinal surgeon who has experience with thoracic spinal conditions.   You may have to cal around some.  I have.  I have seen 4 different doctors and am going to see my 5th at the Baylor Clinic later this month.  You should also talk to your doctor about referring you to a pain management doctor.  They are very experienced with different medication options and can also administer the injections I mentioned above.

I live in the 4th largest city in the U.S. and I have had a hard time finding a doctor with experience with my issues.  However, there is a Doctor Wong at ULCA who is on the cutting edge of spinal treatments.  If you do not libe in that area (like I don't) you can call his office and ask if he knows any doctors in your area who may be able to help you.  I actually did that and his office was very nice and gave me the name of a surgeon in my area.

I am so sorry you are suffering so much.  I will pray for you for healing.

Take care,
Sidddharthha
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Avatar_f_tn
Thank you so much for taking the time to answer me. I have been seeing a pain Doctor for about six mths. I take percocet  4 times a day. Which like you said  it on no way takes the pain away...but thank the good Lord it helps!...Do you have problems standing?...for me standing just 4 or 5 minutes makes the pain so severe that it brings me to tears.The Doctor said that were the rupture is at T-7 ...it takes a lot of the weight.
Also at times at that spot it feels like I am getting stung by a hornet, thats the only way I know to explain it. ...my lower back stays swelled non stop from the problems there.
I take the injections also every 3 months...but I can't tell a difference.
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Avatar_n_tn
"Glad I found this site" First and foremost, I do so sympathize with you. I read your article and the symtems that you are going through. Myself, I was hit by a forklift. So in essense, along with other parts of the body hence...cervical, lumbar, hip, left arm and elbow, the neck and of course the thoracic to say the least.

Unfortunately for me it's a workmans comp case and I have sustained the ungodly pain for over a year due to our w/c system and the insurance company that violates as many state w/c rules as they possibly can expected only a slap on the had. Meanwhile, the injured party suffers tremendously without the proper medical care for such a serious violation of the body.

The significance in this community is that I am learning what to expect in the future as I start (hopefully) somekind of diagnosis in the future.  Unfortunately, ever since March 17, 2008 my issue with my thoracic injury has not been addressed yet. So I guess I know about pain. I remember and still do have pain levels that are out of the scale and having to deal with the pain without medications.

Thanks for listening...lets hang in there.
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Avatar_n_tn
I had Thoracic surgery April, 2005 (T4-T7) and I'm worst now than ever before. This was due to an auto accident in 2003, I also did evrerything I could before doing surgery. I which I could go back before surgery. I'm told there's nothing that can be done. I have chronic pain everyday, spazms, stabbing, burning pain and what feels like electrical shocks and not just in my back, also in my arms and legs. Medication helps get me out of bed but that's about it. I've thought about the Pain Pump but have read people have had issues with them. Think real hard before having that surgery, you can never go back. I went to the best doctors in Kentucky, but that didn't keep me from having nerve damage now.
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Avatar_m_tn
Dear JJ721,

I am so sorry to hear about your condition.  I know how difficult my life can be for me sometimes so I can't even imagine what you are going through!  I am so sorry to hear that the surgery was not successful for you.  Is there anything they think can be done to help?  I know another thoracic patient who has had several surgeries because his initial one did not result well for him either.  It has been a real struggle for him but he has been able to have follow-up procedures to try and correct.  This past month's procedure gave him some relief for the first time in a very long time.  Thank you for posting your experience so I would know how that surgery affected you.  So far, I am sticking with my current therapies and protocols and praying that my condition will improve over time.  I will pray for relief for you and that your condition improves.  

God bless you,
Sidddharthha
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Hi. I was wondering if you have found relief with your condition? I too have thoracic problems - DDD, compressions throughout almost all of thoracic, compression fractures from t7-t12, 4 herniations in thoracic (2 are pressing on my spinal cord), schmorls node at t10 (as well as 2 herniations in lumbar & 1 in cervical). I'm in same boat as everyone else I've been reading about with no one willing to perform surgery on the thoracic. The pain has become so unbearable that I'm having to stop teaching fitness/dance classes because I can no longer bear the pain. Each & every class is pure agony for me & I fight nausea & dizziness from the pain & I have between 3-4 each day. It is simply too much for my body to handle now. I too have contacted the Laser Spine Inst, sent my info & they haven't even bothered to call me back. I see a specialist at Vanderbilt University next week (the 3rd one) & all my prayers are on him being able/willing to help me. I couldn't imagine living the rest of my life with this horrible unrelenting pain. I'm so miserable - it has been a year now since my mid back pain began & my condition has only been getting worse... So I need to know have you found luck getting help?? If so where??

Thanks so much. And my prayers are with all of you strong people who like me is forced to endure this painful condition!!
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Avatar_m_tn
I completely understand your pain. I too am going through the same thing and our backs are almost identical. My disc herniation start a little higher, but there are six of them as well as the other issues you mentioned.
I am having a hard time to get a good clear answer on the same questions your asking.
I was very happy to at least see I was not alone.
Good luck!
Todd
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