Spine Thoracic

Is it OK to have a significant kyphosis where my spine was fractured two years ago?

A significant kyphosis following spinal injury is called posttraumatic spinal deformity. Kyphosis is the most common of the deformities. Studies show that a kyphosis equal to or greater than 30 degrees is more likely associated with chronic pain and potential increase in neurological symptoms.

J. M. Buchowski et al. Surgical management of posttraumatic thoracolumbar kyphosis.SPINE July 2008. Voume 8. Number 4. Pp. 666-677.

Surgical Management of Posttraumatic Thoracolumbar Kyphosis

The authors reviewed available literature regarding current treatment methods for posttraumatic thoracolumbar deformity. In the United States alone, 10,000 to 17,000 people will have a spinal cord injury annually. Those that fracture their spine exceed 150,000 annually. As a result of improved medical care, more people are surviving these injuries. Disruption of the vertebral column and supporting ligamentous structures can result in posttraumatic spinal deformity.

Our nephew was in a terrible motorcyle and broke the middle of his spine in half. He had a six-hour surgery to put screws in place to hold the spine upright while it heals. He's up walking already and not even using a brace. We're more than a little concerned about this. Shouldn't he have some kind of external support?

Reduction and fixation of spinal fractures in the thoracic spine can be a very complex procedure. Sometimes the facet (spinal) joints get disrupted overlap one another. They must be distracted, unlocked, and repositioned.

To do this, the surgeon can place screws through the pedicles of the vertebrae. The pedicle is the area of vertebral bone between the upper facet of one spinal segment and the lower facet joints of the adjacent spinal segment.

Surgical Treatment of Unstable Thoracic Spine Injuries

Severe injuries to the thoracic spine occur with some car accidents. These high-energy injuries cause significant trauma to the spine. Surgery is needed to restore the vertebrae to a stable position. A major goal of treatment is to foster as much neurologic recovery as possible. In some cases, preventing paralysis may not be possible.

I was in a car accident and fractured my thoracic spine in two places. I've been trying to get by without surgery, but I notice the pain is getting worse and so is my posture. Should I wait and see if this is going to get better? Or should I go for the surgery originally recommended by the doctor on call at the hospital where I went at the time of the accident?

Persistent pain, deteriorating neurologic status, or residual deformity all point to the need for follow-up care. Surgery to stabilize the spinal segment may be needed, but it's possible an orthosis (trunk and back brace) will be enough.

My mother's doctor wants to inject her back with medication with an epidural injection to help relieve her back pain. I'm really worried about the potential problems. What can go wrong?

If your mother is living with chronic back pain and has received other types of treatments that haven't helped, it's not unusual for her doctor to suggest this type of injections. For some people and for certain types of back pain, they can be very effective.

Like all medical procedures, epidural injections do have some risks. They include:

- infection at the site of the injection (rare)

Case study of Patient with Giant Spiral Arachnoid Cyst Following Phenol Intrathecal Injection

Intrathecal injection of alcohol or phenol has been an effective pain management technique for patients who live with chronic pain. The injection damages the pain pathways, providing pain relief for up to several months. Although injection into the subarachnoid space can provide pain relief in up to 60 percent of patients, epidural injection is often preferred because of the side effects associated with subarachnoid injections.


How can doctors calculate if you are getting enough oxygen, other than the obvious of you being sick or dying?

Doctors can often tell if someone is going to have difficulty with breathing by examining the upper body. If the rib cage is small or fixed in such a way that it can't expand on breathing, this can compromise respirations and the amount of oxygen that is taken in. This evaluation can be done with x-rays and with imaging such as computed tomography imaging, or CT scans.

I read that some people with thoracic insufficiency syndrome were able to live with less breathing capacity than others. How is that possible?

Researchers recently did a study of patients who had a disorder called spondylothoracic dysplasia. One of the problems that people with this disorder have is a smaller torso and a rib cage that can compromise the breathing.

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