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domkam
02-16-2010, 12:36 AM
Hi all,
I'm one week out from my surgery. I'm very nervous...This is morbid, but I'm wondering about serious complications. How often does one "die" during this surgery? What about paralization? Of course i'm aware that every surgery poses risks. I asked my surgeon if he's had anyone die on him and he very honestly told me only once. he said this was a complication regarding this patients heart (an unknown condition to the patient). Do you guys know of anyone having serious implications with this surgery?
Thanks....Trying to be positive, but "freaking out" all the same...

Shari
02-16-2010, 12:56 AM
Hi Dom,

You have already done the best thing by asking your Dr. those questions!!! And it's wonderful that he had the integrity to tell you the truth.

It is so common and normal for you to feel the way you are right now. Scared to death, worried and probably have hundreds of thoughts going through your head. You are not alone, most of us here have had the same fears.

All surgeries have some type of risk, but with the medical technoligies that keep improving from year to year, is somewhat comforting.

Never forget there are no stupid questions here, and any fear or concern with never seem stupid to any of us. We have all have the same feeling at one time or another.

Keep up the questions,
Shari

JenniferG
02-16-2010, 01:44 AM
This is a very difficult, nerve-wracking time and I can understand your thinking of the possible worst scenario. For myself, I updated my Will but it did not play on my mind. I knew I was in good health and I also knew that dying during surgery was a very tiny risk. The risk of paralysis is only fractionally higher. I believed the odds were very much in my favour, as they are yours.

The precautions they take to ensure they do not damage your spine include spinal cord monitoring. This was explained to me as being an alarm system which alerts the surgeon when he is too close for safety. My surgeon told me that the monitoring is done by a specialist who he employs on all his surgeries and is highly experienced and reliable. Monitoring the cord is her sole responsibility. He would not go ahead without her, he told me.

They take your safety very seriously and will do the best they can to give you the best possible outcome.

Try to think past the day of surgery, to your recovery. The surgery is just one day, and you'll sleep through most of it, after that, you're on the road to recovery, straighter, taller, healthier and happier!

Good luck!

Vali
02-16-2010, 02:19 AM
domkam, so sorry you are going through all this anxiety. I know from experience what is was like. I also had spinal cord monitoring and as Jen said, this is their sole duty during the op. Have you had other surgeries? Surgery in general and not just this surgery carry all types of risk. The risk of paralysis doesn't always have to be during spinal surgery. Complications with anaesthesia and other meds can cause paralysis or death as well. I don't say this to scare you but to help you if i can. :)

Jimbo
02-16-2010, 05:56 AM
If you need this surgery, just put these possible complications aside. I know it is extremely difficult to not keep thinking about them, and they are a possibility, but you must believe they wont happen. There really isn't anything else you can do.

Just make sure you have the best surgeon you can find and make peace with your friends and family, and draw strength from wherever you can.

Stay +

domkam
02-16-2010, 09:27 AM
Thanks everyone for all the positive feedback....I'm so happy I found this forum!

debbei
02-16-2010, 09:51 AM
Thanks everyone for all the positive feedback....I'm so happy I found this forum!

Believe me, I had all those worries too. It is perfectly normal. I asked all kinds of nutty questions here and I outright asked my doctor as well. It was comforting to hear that he never lost or paralized a patient on the table.

RitaR
02-16-2010, 05:54 PM
I, too, have had those questions, as well as multiple others, run through my head on occasion. But, from all the other surgeries I've had ( knee surgery X3, back surgery for slipped disc three years ago, cholecystectomy, hysterectomy) those kinds of thoughts just cannot weigh on you. There's absolutely nothing you can do about it - what happens happens I guess - but, one thing you can do is positive thoughts - recovering thoughts. That's what I will be (trying) think about....

LindaRacine
02-16-2010, 08:55 PM
Hi Domkam...

This is from an article on Spine Universe:

Surgical Risks
This topic is covered not to frighten, but to provide some information about the potential risks of surgery. Keep in mind, the majority of patients who undergo surgery do so without serious complications. Several potential problems are outlined below.

Neurological risk: The risk of injury to the spinal cord or nerves is very small; less than 0.5% in most cases. This risk is minimized by using spinal cord monitoring during surgery. A specialist continuously observes electrical signals in the spinal cord and nerves during surgery and reports changes to the surgeon. Spinal cord monitoring also allows the surgeon to assess how much curvature correction is safe. Both sensory and motor (movement) tracts of the spinal cord are monitored so that a complete picture is available to the surgeon almost instantaneously.

Bleeding: Bleeding occurs during all major surgery. However, bleeding is kept to a minimum by careful surgical technique and hypotensive anesthesia (low blood pressure anesthesia technique). Blood pressure is lowered but kept in a safe range for the patient. Cell saver is used to collect blood in the operative field, filter and wash it, and then immediately return it to the patient. If the patient donates blood before the surgery, they are unlikely to receive a blood transfusion from the community blood bank in most cases.

Infection: The risk of a wound infection is low. Antibiotics are given before, during and after surgery to minimize this risk. If an infection does develop, it might require an operative procedure to cleanse the wound followed by a period of antibiotics given intravenously and / or orally.

Instrumentation problems: The risk of an implant becoming loose or breaking is low. If such a problem developed, a relatively small procedure could be performed to revise the instrumentation.

Blood clots: Blood clots are uncommon after spine surgery. The concern about blood clots is their potential to dislodge and move to the lungs blocking normal oxygenation of the blood stream. Special stockings (TED stockings, Thrombo-Embolic Deterrent) and compression wraps are worn by the patient in the hospital to reduce the risk. Mobilizing the patient out of bed and having them exercise their legs when in bed and out also lowers this risk.

Anesthesia complications: The anesthesiologist speaks to the patient about their personal risk the day of surgery. If the patient has a significant medical condition, they will meet with the anesthesiologist before the surgery date.

joyfull
02-16-2010, 10:05 PM
dhugger, I haven't heard of all the negative outcomes you mentioned. Can you briefly explain what they are? (So we can have some more things to worry about? - Just kidding!) Joy

joyfull
02-16-2010, 10:06 PM
Sorry I reversed your initials! It's too late for me to be typing, I guess.

LindaRacine
02-17-2010, 12:08 AM
Two comments on hdugger's post:

Pseudarthrosis is the same thing as failure to fuse.

And, I believe the vast majority of people with proximal junctional kyphosis will never require revision.

debbei
02-17-2010, 05:33 AM
This - [url]
I'm not seeing much description of infection around the instrumentation. Maybe I'm overestimating that risk? I thought I'd seen, somewhere, that that was the most common complication.

My surgeon told me the risk of infection was 1%. I can't remember if that was HIS rate for his patients, or all the dr.'s at his practice, or the hospital, or overall patients everywhere.

jesscv
02-17-2010, 12:57 PM
just to clarify, sagittal imbalance is actually when you're not balanced vertically from the top to the bottom of your body - not from front to back, as stated on a previous post.

joyfull
02-17-2010, 09:51 PM
Dr. Lonner said that there is a risk of infection, that he has had them. ("We all have," were his exact words.) He said that if that happens he may have to go back in and clean it out. He didn't mention the other problems you spoke about. I suppose I'll ask when I see him next. Take care, Joy

Shari
02-18-2010, 02:06 AM
Hi Hdugger,

I have to say that your posts have confused me in a few ways. I have read it 3 times now, nd still don't know where you're coming from. I'm sure it's just me.

Could you explain it more clearly for this dumb hillbilly???
Shari

Shari
02-19-2010, 04:42 PM
I read your link this time... I'm just curious about the imbalance part.

My Dr. put me on 2 scales, one for each foot, told to look straight forward, and it showed that I was carrying 10% more of my weight on my left leg.

I asked him it that would cause me problems, and he told me that my body would adjust for that. Is this not the case???

It looks to me that I am standing straight,
Shari

titaniumed
02-19-2010, 07:21 PM
Shari

Sounds like a coronal imbalance issue. Scroll down to pg 67 and 68. If you are not balanced left to right, that would explain why the scale readings are not equal.
With a "plumb line" running right down the center, the readings should be equal.
It seems likely that your body would correct itself as long as it isnt severe, and 10% doesn’t sound severe. Time will tell.

http://books.google.com/books?id=cZu3_EezS_wC&pg=PA66&lpg=PA66&dq=coronal+imbalance&source=bl&ots=JriNznym_V&sig=3nIgLlN0nP5-DtJTi1x9WFRRJOk&hl=en&ei=Bi9_S_iwKYz-sgOiqen8Cw&sa=X&oi=book_result&ct=result&resnum=5&ved=0CBIQ6AEwBA#v=onepage&q=coronal%20imbalance&f=false
==========================================

Sagittal imbalance definition. (looking from the side) This is leaning either forward or backward.

http://www.spineuniverse.com/conditions/kyphosis/spinal-curvature-problems-fixed-sagittal-imbalance

Scroll down to figure 7 for plumb line pic.
http://images.google.com/imgres?imgurl=http://www.medscape.com/content/2003/00/44/83/448307/art-nf448307.fig7.gif&imgrefurl=http://www.medscape.com/content/2003/00/44/83/448307/448307_fig.html&usg=__kDFPalolgKEHxBA-02HcLKODGBI=&h=363&w=550&sz=51&hl=en&start=1&um=1&itbs=1&tbnid=2DfqOFXcIhdExM:&tbnh=88&tbnw=133&prev=/images%3Fq%3Dsagittal%2Bimbalance%26um%3D1%26hl%3D en%26sa%3DX%26tbs%3Disch:1

Hd
You know that I was in a similar situation as your son. Uninsured for years...... When you are older, you worry about these things. When you are young, you just go for it. "Living on a prayer" by Bon Jovi was my insurance policy years ago. There will be plenty of opportunities in the future.
Ed

Shari
02-19-2010, 09:21 PM
Thank you very much for the info. I keep asking my Mother and my sisters if I look crooked in anny way to them, they say no. In pre-op pictures I see the shoulder dropped, now I don't. And the surgeon said my head was centered w/ my hips. It baffled me then and now. This is the 1st time I've noticed it brought up here.

Shari

LindaRacine
09-04-2010, 12:55 PM
A new paper on complications in older individuals undergoing scoliosis surgery:

Spine (Phila Pa 1976). 2010 Aug 26. [Epub ahead of print]
Functional Outcomes and Complications After Primary Spinal Surgery for Scoliosis in Adults Aged Forty Years or Older: A Prospective Study With Minimum Two-Year Follow-up.

Zimmerman RM, Mohamed AS, Skolasky RL, Robinson MD, Kebaish KM.

From the Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD.
Abstract

STUDY DESIGN.: A prospective study. OBJECTIVE.: Our purpose was to evaluate prospectively the complications, clinical outcomes, and self-reported quality of life in a relatively homogenous group of adults aged >/=40 years undergoing primary surgical treatment for scoliosis. SUMMARY OF BACKGROUND DATA.: Relatively few reports have examined surgical outcomes in adult patients with scoliosis, especially adults aged >/=40 years, whose outcomes may differ because of more rigid curves and more frequent and severe comorbidities. Although most studies have shown patient benefits despite high complication rates after such surgery, most were retrospective and conducted before the introduction of third-generation instrumentation techniques. METHODS.: We prospectively studied a consecutive series of 35 patients of age >/=40 years (average age, 56.3 years) undergoing primary surgery for scoliosis by one surgeon. Most of our patients (86%) had at least one comorbidity. We collected complete radiographic measurements and Oswestry Disability Index, Short Form 36, and Scoliosis Research Society 22 questionnaires before surgery and at each follow-up, and recorded the number and type of complications. Outcomes were assessed in the context of complications, degree of correction, and procedure characteristics to detect significant (P < 0.05) correlations. RESULTS.: The overall complications rate was 49%; 26% of the patients had a major complication and 31% had a minor one. There were no deaths. Coronal curve correction was 30.8 degrees (61%) on average. There were statistically significant postoperative improvements in Oswestry Disability Index, Short Form 36, and Scoliosis Research Society 22 scores. Patients whose fusions ended at L4 or L5 showed greater improvements in some of the Short Form 36 component scores than patients whose fusions involved the sacrum (P = 0.041). There were no significant differences in outcomes related to presence of complications or operative staging. CONCLUSION.: Adults >/=40 years with symptomatic scoliosis benefit from surgical treatment, despite the high complication rate.

PMID: 20802387 [PubMed - as supplied by publisher]