Pain management in a 90 year old sp spinal fusion now with multiple compression factures. tylenol (acetaminophen) #3 not providing relief?

Delicate situation: Be cautious using any stronger opioids as it can lead to increased chance of fall and further injury. If he is having bone pain, would think short course of toradol (couple days) with follow up interventional techniques like facet inj and transformainal nerve blocks for fusion related pain. If thoracic compressions, consider tlso or cruciform brace. Physical therapy and gait/safety eval.

Pain clinic.: Have him evaluated @ a pain clinic 4 help in pain management. There r lots of meds that may help but need 2 b closely monitored @ age 90.

Drug tx. or surgery: Consider kyphoplasty for the compression fractures. I have witnessed remarkable reduction in patient's with compression fracture pain immediately after the procedure in the recovery room. A neurosurgeon or orthopedic surgeon may do this under local anesthesia.

Try different meds: I recommend seeing a board certified pain physician. There are other options including vertebroplasty or kyphoplasty. Try paindoctor.Com to find a doc near you.

Compression fx: You can initially try calcitonin this may provide some relief although you will need to monitor his serum calcium levels. The first step that i usually do is to attempt to relieve the pain with a simple epidural steroid injection. If this is insufficient, i was strongly consider kyphoplasty.

Compression fracture: One would expect to find degenerative spinal disease at 90 years old. Chronic use tylenol (acetaminophen) #3 with Codeine can lead to constipation. At your age, i would recommend a lumbar brace for support during ambulation and to prevent further damage to the spinal column in case of a fall accident. Perhaps using topical pain ointments such as bengay or icy hot, etc, could be helpful to alleviate pain.