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Rae
12-03-2015, 07:12 PM
Hi,

My daughter is 16yrs and had a spinal fusion 20mths ago due to scoliosis (64 degree curve in thoracic area). The operation and healing went well. However, 9mths ago she developed severe pain to the left of her spine around the T6 T7 area. The pain radiates from this area towards lower back, and over to right side (becoming less severe as it moves away from the apparent source). She rates this pain at around 8 out of 10, and currently feels so nauseous from it that it is a struggle to get her to eat small amounts. She also has trouble sleeping. Imaging shows all metal is intact, and the fusion has taken well. She has had two lots of CT assisted cortisone injections in 2 different areas to the spine at 2 separate times (T12 as there was a slight fracture in fusion, and then T6-7 which is source of pain), and muscle surface injections of cortisone. She was taking 10mg endone, panadol (osteo) and nurofen with no effect (the endone helped when she first started taking it at 5mg). She has just changed today to trial tramadol (fast acting and slow release) and lyrica. The fast acting tramadol had no effect today. She has had physio to strengthen overlying muscles, and tried one session with a chiropractor - nothing changed (bit worse after chiropractor). Doctors seem to now be scratching their heads. Any suggestion for new direction very much appreciated!!!!!:sad:

Dr Scoliosis
20-03-2015, 05:24 PM
Dear Rae

Your daughter's pain is clearly severe. It is unusual for it to occur so long after the surgery. From your description, it sounds quite localised. The cause, however, is not clear.

Possibilities include loosening of the implant, nerve root irritation, non-union and infection. I assume investigations have been done to look for these possibilities. (Xray, bone scan, CT, blood tests)

It is not uncommon that no cause can be found. In that case, analgesics including the types your daughter has tried are used. A pain management specialist can be helpful to work out the best combination.

Occasionally the pain is such that removal of the implants is needed. Unfortunately, this does not always settle the pain. Persistent pain can be very debilitating and frustrating. The following website may be helpful in explaining the nature of the problem.

www.aci.health.nsw.gov.au/chronic-pain