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Thread: Question for Dr. Young/anyone - Bone fragments left on spine

  1. #1

    Question for Dr. Young/anyone - Bone fragments left on spine

    I was injured Sept 21, 2003, burst fracture T6/8, complete. Due to pulmonary complications I was not operated until Sept. 30, 2003. The Doctors placed Harrington rods that go from T2 to probably T10. After the operation I was told that they were not able to remove all the bone fragments from my spine as fluid was leaking to a dangerous point, so some bone fragments were still in my spinal cord when the operation was finished. My question is this;

    I am 42 years old, thank God I am happy and have accepted my situation even with all the difficulties involved. If a cure is developed in my lifetime would I be able to benefit from it given the bone fragments in my spine?? Common sense indicates to me that if a cure is developed, applying it to me would be very difficult and probably result in incredible amounts of pain (which I don't have now) and thus do more harm than good. Can you give us your thoughts on this??

  2. #2
    There is the chance that sensory return could expose pain that's been masked by the paralysis.

  3. #3
    Paramoto,

    Bone fragments in the spinal canal have two potential effects on the spinal cord. First, they may compress the spinal cord. This compression reduces blood flow to the spinal cord and, depending of the degree of compression, can cause some damage to the cord. Second, the bone fragments may result in adhesive scars forming between the spinal cord and surrounding membranes. This tethers the spinal cord. The spinal cord normally slips and slides in the spinal canal during movement and the tethering may result in mechanical stresses on the spinal cord.

    I appreciate your doctors making a decision at the time of injury to not go after all the bone fragments in the spinal canal. I know of some cases where aggressive efforts can endanger the spinal cord and your life as well. Given the pessimism that use to prevail concerning recovery of from spinal cord injury, that decision is probably justified. On the other hand, there is increasing experience by many surgeons to operate on spinal cords that have residual compresson of the cord. As I describe in an artlcle here, Dr. Henry Bohlman at Case Western University has been decompressing people as long as 3 years after spinal cord injury and finding such decompression can restore some function.

    Much depends on whether your bone fragments are compressing your spinal cord and contributing to tethering. If so, I think that you may want to consider decompression of your cord. Not only may it restore some function, decompression will eventually be important for other therapies aimed at regenerating and remyelinating the spinal cord.

    Wise.



    Quote Originally Posted by paramoto
    I was injured Sept 21, 2003, burst fracture T6/8, complete. Due to pulmonary complications I was not operated until Sept. 30, 2003. The Doctors placed Harrington rods that go from T2 to probably T10. After the operation I was told that they were not able to remove all the bone fragments from my spine as fluid was leaking to a dangerous point, so some bone fragments were still in my spinal cord when the operation was finished. My question is this;

    I am 42 years old, thank God I am happy and have accepted my situation even with all the difficulties involved. If a cure is developed in my lifetime would I be able to benefit from it given the bone fragments in my spine?? Common sense indicates to me that if a cure is developed, applying it to me would be very difficult and probably result in incredible amounts of pain (which I don't have now) and thus do more harm than good. Can you give us your thoughts on this??

  4. #4
    Senior Member Aly's Avatar
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    About a years after my injury I got a really bad pressure sore. I had to go home bound the last few months of my senior year and spent my days on our couch for about 3 months. I almost didn't get to go to graduation because I still had the sore. Anyway, my Mom was putting the dressing on the sore and notied a piece of bone that she pulled out of the sore. She and the doc think that is what caused the sore. They think that it was a piece of the fracture that didn't get cleaned out during my surgery and made its way down my spinal colum and caused the sore from the inside out. I don't know if this is really what hapened but it makes sense to me. Mom still has the bone fragment in case it hapens again to be able to compare it.
    Last edited by Aly; 04-01-2006 at 12:38 PM.
    www.cawvsports.org
    The trick is in what one emphasizes. We either make ourselves miserable or we make ourselves strong. The amount of work is the same. ~ Don Juan Matus
    We are Virginia Tech… We must laugh again… No one deserves a tragedy… We are strong, and brave, and innocent, and unafraid…We are better than we think and not quit what we want to be…We are the Hokies…We will prevail, we will prevail, we will prevail. We ARE Virginia Tech! ~ Nikki Giovanni

  5. #5
    Thanks for your response. My injury is 2 1/2 years old, and at the time there already was a lot of hope of someday developing a cure. So I must believe that they thought my life or livelyhood was at risk. I would think that a decompression surgery at this stage has its fair amount of risks. Is there a way to measure what type of impact or effect the fragments are having on my cord in order to better determine if the surgery is worth the risk?

    Dr. I recently dicovered this site. Yours and other collaborator's insights and advise are invaluable. There is so much that we need to know and it is incredibly difficult to find trustworthy information. Thanks for your efforts.

  6. #6
    Quote Originally Posted by Aly
    About a years after my injury I got a really bad pressure sore. I had to go home bound the last few months of my senior year and spent my days on our couch for about 3 months. I almost didn't get to go to graduation because I still had the sore. Anyway, my Mom was putting the dressing on the sore and notied a piece of bone that she pulled out of the sore. She and the doc think that is what caused the sore. They think that it was a piece of the fracture that didn't get cleaned out during my surgery and made its way down my spinal colum and caused the sore from the inside out. I don't know if this is really what hapened but it makes sense to me. Mom still has the bone fragment in case it hapens again to be able to compare it.
    Aly, your sore was over the fracture site? I am glad that it came out. Wise.

  7. #7
    Senior Member Aly's Avatar
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    Wise, it was at the base of my tailbone.
    www.cawvsports.org
    The trick is in what one emphasizes. We either make ourselves miserable or we make ourselves strong. The amount of work is the same. ~ Don Juan Matus
    We are Virginia Tech… We must laugh again… No one deserves a tragedy… We are strong, and brave, and innocent, and unafraid…We are better than we think and not quit what we want to be…We are the Hokies…We will prevail, we will prevail, we will prevail. We ARE Virginia Tech! ~ Nikki Giovanni

  8. #8
    Quote Originally Posted by Aly
    Wise, it was at the base of my tailbone.
    Your injury was at your tailbone? That suggests that you had a cauda equina injury. Wise.

  9. #9
    Senior Member Aly's Avatar
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    Sorry about the confusion. My fracture site was C 5-7, the sore I had was at my tailbone. They think a peice of the burst that didn't get cleaned out during surgery moved its way down my spine to my tailbone and caused the sore. Hopefully this make more sense.
    www.cawvsports.org
    The trick is in what one emphasizes. We either make ourselves miserable or we make ourselves strong. The amount of work is the same. ~ Don Juan Matus
    We are Virginia Tech… We must laugh again… No one deserves a tragedy… We are strong, and brave, and innocent, and unafraid…We are better than we think and not quit what we want to be…We are the Hokies…We will prevail, we will prevail, we will prevail. We ARE Virginia Tech! ~ Nikki Giovanni

  10. #10
    Quote Originally Posted by Aly
    Sorry about the confusion. My fracture site was C 5-7, the sore I had was at my tailbone. They think a peice of the burst that didn't get cleaned out during surgery moved its way down my spine to my tailbone and caused the sore. Hopefully this make more sense.
    Aly,

    Migration of bone fragments over such long distances would be very unusual and unlikely. Your "bone fragment" in your sacral area is very likely to have originated from the sacral area and not from your cervical spine. Is it possible that you had an injury to your tailbone, in addition to your cervical spine? In any case, what you describe suggests that your sacral decubitus involves bone.

    Wise.

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