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vertebrae fracture “nothing else we can do”

i’ve written before about a vertebrae fracture that occurred in 2010 that I have never gotten relief from that doctors have told me I will always have pain from.

I’ve pretty much done the whole gamut To become an injury, from physical therapy to taking a break from riding to doing exercises on my own, To getting a second opinion.

At this point I am so overwhelmed and wondering if anyone has had any experience with any surgical options.

When my accident occurred they told me that I wasn’t a candidate for surgery (The procedure where The cement is injected into the spine) Because of my age. I’m just wondering if any advancements have been made or if anyone Else is in my shoes out there

I’ve never heard of someone being disqualified for kyphoplasty or vertebroplasty based solely on age. However, there are a number of contraindications; if you have already had a second and concurring opinion from a qualified interventional radiologist, it may be that there is something else going on that they have not adequately explained to you.
Sorry to hear you are having so much pain. That’s not fun at all.

My personal opinion is if you decide to explore the surgical option, I’d try to talk to both a neurosurgeon and orthopedic surgeon for their opinions. Either can do surgery on the spine.

Advancements are always being made… maybe there is a different option and/or opinion now to help you.

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i just made another appointment with an ortho doctor. we will see

Curious as to your age; I was under the impression that a kyphoplasty could be performed on any age patient; however, it’s best performed within a month of the fracture. I have unfortunately had two separate kyphoplasties, the most recent being last week. The first time helped my pain quite a bit. This second has not helped so much yet. I am sorry you are having back pain. It is the worst.

OP, where are you located?

My Aunt went through a windshield as a teenager and has had significant problems ever since (decades later). Insurance refused to cover her mri so she paid out of pocket. They found significant issues on the MRI and she had to have surgery. Her recovery was painful but she is doing so much better. She should have had treatment years ago. It had gotten so bad that she was on disability and unable to sit down due to pain. She could only stand up or lay flat.

im 30 and in central va… unfortunately this injury happened (or at least was discovered on x-ray) in 2012

Please a neurosurgeon NOT a orthopedist, you want smart, competent with a great record. And there are some very new approaches to your situation so do your research. do not have a fusion…once you do that its all over for new options.Surgeons are as different as grand prix dressage horses , interesting how we know how different performance levels are with horses yet seem to think surgeons are all pretty comparable.
You are looking for your Olympic horse not a trail horse.

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Frankly, IMO based on my research prior to my spine surgery, orthopedic surgeons with spinal surgery experience can be just as good as a neurosurgeon. IN MY OPINION.

I would not categorically state to see or not see either type of specialist. I would categorically state that you may want to get opinions from both and not summarily dismiss either type of surgeon.

My orthopedic spinal surgeon had only one malpractice suite filed against him and a) it was dismissed as a known potential side effect of the type of surgery the individual had (and yes, the same thing could have happened if a neurosurgeon did the surgery) and b) he disclosed it to me independently of me doing research on him and discovering it.

I felt that my orthopedic surgeon was smart, competent and had a great record. No surgeon is perfect.

I agree some are very good however they do not have the education or training of neurosurgeons and tend to do more extensive surgeries. many neurosurgeons now do minimal surgeries , small ones and the good ones rarely do fusions anymore. However if your surgeon is working for large hospital system or new graduate needing to pay for her education then watch out . Get several options before making any decisions. BYT malpractice almost never shows up ion Medial board sites unless its for serious offenses or prescribing opioids.
I know there ar new surgeries for the OP described issues , really cool stuff with new approach.
I think people would be shocked to discover how little research is behind most surgeries and medical devices.
I worked in pain management for 10 years and am close to several northo and neuro surgeons and still its tough to know what to do.
I am not recommending anything except be careful and don’t do anything that will destroy your chances of doing whats new as things are changing real fast.

My orthopedic surgeon specializes in spinal surgery. He actually developed the procedure for doing neck fusions from the anterior and people literally come from all over the world to learn how to do it that way from him. Thankfully I haven’t had to have that surgery yet as my neck is doing pretty well right now despite the two herniations but if I ever do he is my guy. I am going to consult about a spinal surgery for this fall.

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OK, this is comparing TBs to WBs …

So, it happened in 2010 (cf. your OP) and was discovered in 2012?

There used to be a surgeon in Miami who became known for finding a therapy that could replace surgery in some patients. At the time, where I lived, surgery was still the only “option.” I don’t know if this guy is still practicing but it might be worthwhile to look him up. I don’t remember his name but he was connected with the University of Miami I think. You could try Googling him.

Perhaps the best advice that I got regarding spine surgery was from a friend of mine. This was many years prior to me even seeing a surgeon. She told me that any spine surgery was elective (excluding traumatic injury). You live with the spine and pain that you have until one day you may elect to consider and have surgery.

I saw a total of 3 different ortho surgeons over about 10 years before I chose to take the plunge with the last one I saw. Spine surgery was all he did. He was no youngster paying off student loans. Yes, there are new procedures and options every day but at some point, waiting for the next best thing may no longer be what you wish because your pain and mobility issues are impacting your quality of life. Every single person is different and only you know what to do.

Talk to as many different people as you can. Find a surgeon, whether it be neuro or ortho, that you feel comfortable with and that you trust. Discuss potential side effects and decide if you can live with them if they happen to you. Only you know when the risk vs reward balance changed such that you are willing to take the risk.

Any good surgeon will support you getting a second and maybe even a third opinion (I ended up having my ‘second opinion’ surgeon do my work because I felt they were more competent than either of the two first surgeons I talked to.) Ask them about new treatment options. If you find something in your own personal research, ask them about it. Ask them how much experience they have with any new option. Also remember that newer options may have less long term outcome information just because they are newer.

FWIW, even if I’d read what I quoted here, I personally would have still done my fusion. True that maybe some day there would be a treatment option that would have meant a fusion wasn’t necessary but was I willing to wait in increasingly more pain over time for that magic to happen? For me, no, I wasn’t.

The part that is true is it is tough to know what to do. Both for the surgeons you’re seeing and for you.

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A physiatrist helped me the most when I fractured L5 in 2 places. First PT and then years of figuring out what kids of abdominal strengthening I can tolerate. It took me well over 10 years for the pain to get more tolerable. It still flares up sometimes but not least it used to. TENS might also be helpful.

can you describe how the procedure was for you? I fractured my L1 and L3 last weekend and both of those are being discussed as options.

I am a research scientist in ortho spine. I also have program arms with neuro spine.

I will absolutely state your assumption is false. Ortho spine focuses on degeneration, deformity, trauma and infection of the cord and spine even more so than neuro spine. While the fields are highly intertwined, neither is superior I terms of desired patient outcomes.

The biggest reason for likely non-treatment at the time is pediatric spine is very dangerous in terms of patient outcomes. Any slight restriction in a still growing spine can lead to a massive deformity in adulthood. We do quite a few of this reconstructions every year.

I suspect a significant surgery will be required to decompress the roots now. When I say “significant” I am saying that noninvasive methods most likely won’t work well and an open procedure will be necessary.

As for spine research and improvement there is a huge body of research out there and more is done everyday. Just in our own group we cover everything from spine genetics to infection to instrumentation design and biomechanics.