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Minimally Invasive vs Traditional Open approach

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  • Minimally Invasive vs Traditional Open approach

    Hi everyone. I'm very excitied to finally be able to login and pose the following questions. My position is this. I am 33, have a 74 degree right thoracic curve. I was scheduled for a fusion (T1 or 2 to L1)with Dr. Bridwell in St Louis on June 15th, but my insurance won't cover the BMP. We decided to check one last idea out and met Dr Durrani - who does minimally invasive surgeries. The minimally invasive approach and promised results almost sound too good to be true. And now I am confused. Please advise if you can...

    1. Has anyone had minimally invasive surgery to correct a thoracic curve?

    2. Has anyone heard of Dr. Atiq Durrani - Cincinnati -- good/bad?

    3. Anyone know of any studies with results from minimally invasive corrections?

    4. Anybody been fused traditionally by Dr. Bridwell of St Louis? What was the experience like?

    Thank you - I look forward to hearing from any of you...

    Marissa


    cyborg2be
    right thoracic curve of 74 degrees
    left lumbar curve of 44

  • #2
    dont know your doctor...as far as i know, minimally invasive for thoracic has been around for quite a while! it is minimally invasive for lumbar that is new...and exciting for those of us who need low fusion, like to the sacrum or pelvis!

    jess

    Comment


    • #3
      You may want to read this thread. http://scoliosis.org/forum/showthread.php?t=10423
      Personally, I would not want to gamble with my health on something that sounds too good to be true. Sorry to hear your insurance will not cover BMP as I believe it is widely used in scoliosis surgeries.

      Comment


      • #4
        it is not laser surgery, of course...it is rods and screws......sometimes cleaning of discs and placement of "spacers" (cages) as i need for lumbar...it is how they get in that changes...how "open" the body is...and how much cutting of muscles and blood loss...but is not anything like laser surgery...
        there are top surgeons starting to do minimally invasive for lumbar...ones that have always done it for thoracic...it is no walk in the park...just a little less trauma to the body...and thoracic minimally invasive came first...

        jess

        Comment


        • #5
          Thanks for the responses

          Thanks for your input. This is such a huge decision for me. Once I hit 70 degrees a couple years back it stopped being "if I have surgery" and became "when". It is very helpful to read your comments. I just wish one procedure seemed more right than the other.

          Marissa


          cyborg2be
          right thoracic curve of 74 degrees
          left lumbar curve of 44

          Comment


          • #6
            Your doctor

            I have heard very good things about Dr Bridwelll. My surgeon has worked with him and I had great results on my revision surgery. Can he use a different graft material? I had allograft in my second surgery.
            May 2008 Fusion T4 - S1, Pre-op Curves T45, L70 (age 48). Unsuccessful surgery.

            March 18, 2010 (age 50). Revision with L3 Osteotomy, Replacement of hardware T11 - S1 , addition of bilateral pelvic fixation. Correction of sagittal imbalance and kyphosis.

            January 24, 2012 (age 52) Revision to repair pseudoarthrosis and 2 broken rods at L3/L4.

            Comment


            • #7
              Dr. Bridwell is Dr. Lenke's partner. Both have excellent reputations on this forum and my local surgeons speak very highly of them.

              As for the minimally invasive approach, search the PubMed website. There are some recent studies on it. Basically they say it looks promising but there have been some complications and it is too early to judge whether it will ultimately be viewed as superior to traditional surgery. But I agree that what I've read says more positive things about minimally invasive for thoracic than for lower curves.

              Good luck!

              Evelyn
              age 48
              80* thoracolumbar; 40* thoracic
              Reduced to ~16* thoracolumbar; ~0* thoracic
              Surgery 3/14/12 with Dr. Lenke in St. Louis, T4 to S1 with pelvic fixation
              Broken rods 12/1/19; scheduled for revision fusion L1-L3-4 with Dr. Lenke 2/4/2020
              Not "confused" anymore, but don't know how to change my username.

              Comment


              • #8
                Hi Marissa...

                May I ask your age? BMP is not routine in scoliosis surgery, but is often used in patients who have a high risk of not fusing using more conventional methods. It can add $50,000 to $100,000 to the cost of surgery.

                I truly would not even consider a surgeon who promised specific results. That sounds really desperate. No one can guarantee an outcome.

                Regards,
                Linda
                Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
                ---------------------------------------------------------------------------------------------------------------------------------------------------
                Surgery 2/10/93 A/P fusion T4-L3
                Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

                Comment


                • #9
                  ditto about promising results! i have had doctors, or their staff, promise pain free results after scoli surgery...i do not believe honest surgeons do that...cant do that, as no one can guarantee pain free afterwards!
                  i stay away from surgeons who make those kinds of promises!

                  jess

                  Comment


                  • #10
                    My age...BMP

                    Originally posted by LindaRacine View Post
                    Hi Marissa...

                    May I ask your age? BMP is not routine in scoliosis surgery, but is often used in patients who have a high risk of not fusing using more conventional methods. It can add $50,000 to $100,000 to the cost of surgery.

                    I truly would not even consider a surgeon who promised specific results. That sounds really desperate. No one can guarantee an outcome.

                    Regards,
                    Linda
                    Sorry - I don't get on the pc much on weekends.
                    To answer your question...
                    I am 33 and I didn't know BMP wasn't routine. I know Dr. Bridwell uses it because it has better fusion results and less morbidity than harvesting from the hip. The BMP they estimated for me was 100,000-200,000, and I completely understand the insurance company not wanting to pay that. And the min. inv. dr didn't promise me specific results, but he showed a picture of a patient stretching down toward her toes at her 2 wk followup, and he says I'll be out of bed on the 2nd day, and only be in the hospital for a max of 5 days.

                    Again, I'm throwing the question out there...does anyone know anybody who has had a thoracic fusion done with minimal invasion?


                    cyborg2be
                    right thoracic curve of 74 degrees
                    left lumbar curve of 44

                    Comment


                    • #11
                      Hi. I am having a minimally invasive thoracic procedure done on Tuesday with Dr. Lonner at NYU/Joint Diseases. The "anterior" part is done with a small side incision and a fluoroscope to remove the discs. Then a posterior procedure will be done to insert the hardware. I will be on my stomach the whole time. Is this what you are talking about? Joy

                      Comment


                      • #12
                        Min Invasive for JOY

                        Joy,

                        I am thrilled to hear from you, and you will be in my thoughts and prayers tomorrow.

                        Your procedure is the EXACT same procedure I'm scheduled to have in Sept. My hubby is pretty worried about the disc-replacing, but I think my non-flexible curve w some degenerated discs won't really miss the old ones.

                        How long is your expected hospital stay? Which vertebrate are you having fused? Mine are expected to be T1-L1

                        Again, glad to meet you.

                        Marissa


                        cyborg2be
                        right thoracic curve of 74 degrees
                        left lumbar curve of 44

                        Comment

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