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View Full Version : Minimally Invasive Surgery-Possible????



golfnut
04-25-2010, 06:13 PM
I am fairly new to this forum and since I've already scheduled surgery with Dr. Lenke, I am fairly committed to the idea that I've made the right decision to have major surgery. Although I have little pain, Dr. Lenke didn't think my prognosis years from now would be very good without surgery. I usually only go to the first time surgery section of the forum and have found that most people have the same type of surgery that I will have. I have read a little on the internet about a laser surgery that would be less invasive with a shorter recovery time which sounded good to me. I called Dr. Lenke's office and Kelly said that I would not be a candidate. I believe that I have an excellent surgeon and that the surgery will give me the best prognosis for the last 40 years of my life (both grandmothers lived to 100), but I still have a few doubts. Who actually can have the laser surgery for scoliosis and not need further surgery down the road? I have 3 brothers who keep telling me that I should get a 2nd opinion for a less invasive procedure, especially since I have very little pain and I'm extremely activie. What do you think?

loves to skate
04-25-2010, 07:16 PM
Hi,
I don't know of anyone on this forum who has had minimally invasive laser surgery for scoliosis or even Dr. Anand's minimally invasive surgery of whom Jess speak. As to the laser surgery, if it sounds too good to be true, it probably is. If I were you, I would trust Dr. Lenke's opinion, but a second opinion wouldn't hurt.
Sally

LindaRacine
04-25-2010, 08:24 PM
Laser surgery cannot correct (or even halt) scoliosis curves. Laser surgery is used for things like tumor surgery.

Tall Paul
04-25-2010, 10:49 PM
There is a lot of information regarding minimally invasive surgery for scoliosis on the internet. In the area of the lumbar spine it appears to best applied to adult degenerative scoliosis, which is what I have. I see you are from Illinois. You are already seeing one of the best doctors, but if you want to see a minimally invasive doctor try Dr Fessler from Northwestern University Hospital. I met Fessler and he will be operating on me. He is one of the pioneers of this surgery. While I never met him, there is a doctor at Rush who is involved in a clinical trial on this procedure. Just curious, if you're not in pain, why are you doing the surgery?

jrnyc
04-26-2010, 02:31 AM
there is now minimal invasive for lumbar...thoracic was first area for minimal invasive......but it is not with laser....i would see Dr Anand, Dr Fessler, or Dr Lonner for consult for such surgery....it can be done for any size curve.....

best regards
jess

CHRIS WBS
04-26-2010, 12:31 PM
When I saw Dr. Hammerberg at Rush in Chicago in December í05, I asked him if he foresaw any new developments in adult scoliosis surgery within the next 10 years, and he responded with a resounding NO. Personally, I donít think that the more seasoned surgeons (i.e., Boachie, Neuwirth, Rand) would accept minimally invasive surgery of any kind in favor of traditional adult scoliosis surgery. I think they will stick with what has proven to be most successful for their patients.

golfnut
04-26-2010, 06:53 PM
I've heard nothing but praise for Dr. Lenke and I'm thankful that he is so close, but since I am so active, the idea of going in reverse for at least a year, is stressing me. To answer your question about why I would have major surgery when I'm only in occasional pain, it's basically to give me better odds at an active life the next 40 years. Dr. Lenke told me that my prognosis was not good if I didn't have surgery. I am really thinking about seeing one of the doctors that you have recommended for less invasive surgery.
Thanks for your suggestions.

Back-out
05-05-2010, 12:25 AM
Tall Paul:

if you want to see a minimally invasive doctor try Dr Fessler from Northwestern University Hospital. I met Fessler and he will be operating on me.
THAT's the doctor whose name I've been trying to remember! He has a 1/2 hr. video up of him performing a lumbar fusion using M.I. technique. Can't believe I watched most of it! Or at least, listened to him talk about it while he was operating.

You'll be in good hands, Tall Paul.

FWIW he particularly said it wasn't suited to long fusions "yet". Note Jess - yours is NOT considered "long" according to Fessler's cut off standards for M.I. Mine is :(

I would love to have a M.I. approach as it spares the muscles, allows for much less blood loss and an easier recovery. When told I needed a standard double fusion for cervical stenosis, I went to a lot of trouble to find a qualified M.I. surgeon - completely against most that standard approach (fusion with rods etc). Luckily, I found a world famous neurosurgeon (in my "Backyard" - Pittsburgh) who specializes in it.

It was still frightening to go against reputable medical advice! I'm so glad I went that route, though, as otherwise now I'd be looking at being fused all the way from C2 to the pelvis, rather than leaving a few mobile vertebrae. :eek:

OTOH when it comes to scoliosis surgery, I don't want to be a guinea pig, or talk some surgeon - even a good one - into experimenting on me, by trying it. M.I. is far less widespread for deformity surgery than for cervical stenosis.

My surgery will take long enough as it is. Not sure, but it seems to me M.I. is more painstaking for the surgeon and perhaps surgeon fatigue is one of the reasons against using it for extra long fusions at this point in time (defined here as upper thoracic to pelvis, like mine, - or greater) . For lumbar fusions there ARE expert M.I. practitioners - not that everyone approves nor that everyone knows how to do them.

I envy you, T.P. Dr. Fessler impressed me in his "movie"! :)

jrnyc
05-05-2010, 01:10 AM
i will say what i said on other threads...i FLEW out to CA ONLY to see Dr Anand, all the while knowing he doesnt take my insurance. I paid for the flight, the hotel, and the $560 to see him....to specifically ask and be told that YES, minimal invasive lumbar can be used for LARGE size curves...
Dr Anand said he gave a seminar in minimal invasive lumbar surgery last year in Manahattan...i know that Dr Lonner and Dr Boachie attended...dont know about the others, but Dr Neuwirth was not there....

there is a growing number of surgeons who are beginning to do minimal invasive lumbar.... i think there is a confusion as to whether folks are discussing large curves...or long fusions....i am trying to say that larger curves can be approached this way....not referring to length of fusion...

this is LUMBAR fusion i am referring to...not upper body fusions for thoracic or cervical...just lumbar..
but Karen, it is not laser surgery...it is minimal invasive technique with less blood loss, less muscle cutting, and less trauma to body.

jess

CHRIS WBS
05-05-2010, 09:29 AM
Note: Dr. Bridwell defines a long fusion as anywhere from 5-17 vertebrae fused with instrumentation to sacrum. http://www.ncbi.nlm.nih.gov/pubmed/16985461

Jess, itís minimally invasive surgery, not minimal.

jrnyc
05-05-2010, 11:55 AM
yeah, i know..just get tired of typing out the whole deal...so "minimal" is what i use...

jess

rohrer01
05-05-2010, 11:46 PM
Here's a new doctor that I found that does minimally invasive surgery AND specializes on the cervical spine. I have a sister that live in the Salt Lake City area. Maybe I can get my second opinion from him:

http://healthcare.utah.edu/orthopaedics/aboutus/physicians/patel.html

Back-out
05-05-2010, 11:54 PM
If anyone should need minimally invasive in the neurosurgery domain (his super specialty is cervical - but not for anything involving imbalance) the world's greatest is in Pittsburgh. Dr. Hae Dong Jho .

http://www.drjho.com/

Great man, great doctor. Accepts Blue Cross and "lesser" insurances too. Not money mad, but very proud of his innovations.

Hey, did anyone ever notice going through the SRF list (I once did, one by one) how extremely many of the members are in Korea?

At one point of desperation, I considered going there for surgery as a "medical tourist". It may yet come to that, too! Especially with a rising dollar exchange.

jrnyc
05-06-2010, 02:27 AM
again...i KNOW it is "minimally invasive surgery", not "minimal"...i get tired of typing the whole thing...so i often refer to it as"minimal"....
again, i flew to CA, 6000 miles round trip, to meet with Dr Anand and find out all i could in person about "minimal", as i call it...and believe me, i heard more about it than anyone writing on this particular thread, unless you guys also met with Dr Anand!!

i WAS NOT discussing minimally invasive for THORACIC OR FOR CERVICAL...because lumbar was the area we were told COULDNT be done with minimal invasive aproach....the doctors "wouldnt be able to reach where they needed to get to" (wrong), or "wont be able to do large curves" "(wrong)
i do know that thoracic was done with the minimal approach for years...so it was A BIG DEAL to some of us "pelvic needing people" to hear about minimally invasive approach to lumbar....a REALLY big deal!!!! some of us have been just waiting for that to happen to schedule surgery!

jess

CHRIS WBS
05-06-2010, 12:11 PM
Dr. Hey's thoughts on minimally invasive...

http://drlloydhey.blogspot.com/2010/05/xlif-scoliosis-patient-i-saw-in-clinic.html

loves to skate
05-06-2010, 01:09 PM
Thanks for posting that Chris,
I haven't spoken out about this minimally invasive approach mainly because of lack of knowledge on my part, but I can only say that even though I have had to have a minor revision ( more like a tune-up), I am so glad I had the tried and true approach to my scoliosis surgery. When it comes to a twisted degenerated, lumbar spine, I want my Surgeon to be able to see exactly what is going on when he is operating on my body. Just because one Doctor, or even a few, thinks his newer method is so much better than the tried and true, I wouldn't necessarily believe him, and unless I actually had that type of surgery done on myself, I certainly would not be touting it as the way to go. Too much is at stake here and if someone wants to be a guinea pig, so be it, but don't be claiming it as the procedure for others to have just because so and so said. Sorry Jess and I know you don't like Dr. Hey, so you probably don't value his opinion, but since his opinion agrees with my surgeon's, I do value his opinion. BTW, it is not muscle that bleeds so much, it is bone, especially in us older women. And just two weeks after my last surgery, whatever muscle was cut to get to my spine is already healed.

When my husband had his prostatectomy done the open and tried and true way, he lost no blood and he is completely cured. At about that same time, a less invasive approach was beginning to be done. No way would we have consented to have him have the less invasive approach done since there were no long term studies done at that time.

If I have offended anyone, I am sorry. I just had to get this off my chest.

Sally

jrnyc
05-06-2010, 04:22 PM
i have several reasons for not respecting any of Dr Hey's opinions...and that has not changed

the patient referred to did not have the lower lumbar done, as witness reference to problems with L5-S1 (which was not fused)...i will be having L1 to pelvis fused...and there is no one i trust more than Dr Lonner....
this is the first time that he offered me minimally invasive...and that is what i have been waiting for...it is not the blood loss i was concerned about, which is less with minimally invasive surgery...it is the muscle cutting...that is one thing i do not want...

i have complete faith in Dr Lonner...and i am sure Dr Kessler is excellent as a surgeon as well...Dr Anand is considered to be in the same category...

in the history of medicine, as well as lots of other areas, people have always resisted change...but change is the way of the world, and change has always benefited patients...i do not need to be cut open like a "fillet of fish" to trust what my surgeon can do...arthroscopic surgery has been around for decades...and has been an important advance in many kinds of surgeries...one day, minimally invasive will be the norm...i will be happy to be with a surgeon in the forefront of such an advance!!

i am not offended...my opinion is what it is...and i have faith in medical changes and advances, as i have faith in Dr Lonner!

jess