Question: I had a T12 burst fracture & surgery to repair in Nov 2012. The Thoracic Surgeons made the incision anterior, removed two ribs, then around to the posterior spine, so the neurosurgeons could remove all the pieces of the disk that were now in the spinal column. They then packed a titanium cage packed with rib bones & replaced the missing disk. Of course, you know how this works. I was in a TLSO from 11/2012 until 5 or 6/2013. I had regular followup every 3 - 4 weeks with Neurosurgeons. Early on during followup, I made my MD aware that I felt something wasn't right with the area under the incision. It wasn't painful as my left side was totally numb, and I really have only gained all the feeling back this year -- long time, normal?? If you know, I'm curious!! The area continued to get larger & as I continued to complain, my Neurosurgeon ordered a CT Scan when I told him my belly button had shifted approximately 2" to the right. He never did a PE. I thought it was a hernia. CT was perfectly normal. So, he referred me to the Thoracic Surgeons. I didn't see my Thoracic Surgeon as someone was covering but the one I saw just looked at the CT Scan done by the Neurosurgeon & declared me good to go. Early in 2014, I tried a Gastroenterologist, saw his NP, who I made look at it, and she blurted out "HERNIA" & then ordered another Pelvic CT as well as every other test possible on my GB, including every lab, the works! Everything normal. I expected to hear from her for a referral or something. After about a month, I went to her office & was informed that if nothing is abnormal--she has no further contact. I have to say, if she actually thinks that a patient post surgery, who looks like they're nine months pregnant on the left side, first of all, has a GB problem, & then no problem at all, I don't think she's a good fit for her job. By this time, I had talked to your doctor, who advised me to see a General Surgeon, who could easily dx the problem, probably on PE alone. Wrong, he just looked at the Gastro NP's CT & said I was fine. By this time, being inactive since 2009, d/t having broken leg/ankle, torn rotator cuff as well ACL injury, I had gained weight. I think he thought I was just an over eater so referred me for a Bariatric Sleeve. Next I went to my Stepdaughter who Is an APRN who simply got me try to do situp. My left abdomen jumped up 8 or inches higher than. R.side. She referred me to a General Surgeon who did another Pelvic CT. However, while the Tech wasn't looking, instead of laying flat, I rolled my left side up as far as I could as the affected area had moved more to the posterior. After all this time, the CT showed advanced atrophy of the l. Rectus abdominis muscle with deformation. Referred to Plastic Surgeon who can easily fix but still must have bariatric surgery to lose weight gained from being inactive. No exercise per order. Truthfully, I don 't have much appetite & have been underweight but not overweight. Now, that you heard my life story, were these doctors remiss in not thinking outside the box? I know they didn't listen to the pt. My credibility is not the one in question in the matter. My main question is when I repositioned myself, did that make the difference? The conclusion now is that the Thoracic Surgeon in 2012, in my back surgery, accidentally hit a nerve causing the problem. Is there a radiological test or certain technique they should have been aware of to use?? A problem was obvious on observation alone. Thanks.

Hello Doctor-Having had a problem since early 2013, how is damage to this muscle diagnosed early on, before it has come to an advanced atrophy with deformity. I have read much on this subject & as a nurse, I only use credible websites such as NIH, Mayo Clinic etc. I know it is a common injury in athletes, & that there are several interventions that can be taken because the damage is diagnosed early on, with surgery being reserved only in extreme instances. How, then, is it diagnosed? I know you are a Radiologists, so if you like, you may pass it back to Dr. Tayal, the Ortho Surgeon who has helped me also, if available. Thanks again for your help.