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  • fusing or not

    I do not know if this is a silly question But can you not fuse?

    Is that a possibility? Is so what happens? I have my first post -op opportment

    tomorrow with my surgeon and it is on my mind. I keep worrying about it and I

    want to know if this is something that I need to worry about

    Thanks

    Melissa

  • #2
    Melissa--Yes, that is possible. That's why everyone has so many restrictions. Also why they want you to walk. I believe that promotes fusing & healing. Also restrictions on tylenol, etc. etc. It can happen but thankfully most fuse! Janet
    Janet

    61 years old--57 for surgery

    Diagnosed in 1965 at age of 13--no brace
    Thoracic Curve: 96 degrees to 35 degrees
    Lumbar Curve: 63 degrees to 5 degrees
    Surgery with Dr. Lenke in St. Louis--March 30, 2009
    T-2 to Pelvis, and hopefully all posterior procedure.

    All was posterior along with 2 cages and 6 osteotomies.

    Comment


    • #3
      Originally posted by Doodles View Post
      Also restrictions on tylenol, etc. etc. It can happen but thankfully most fuse! Janet
      Sorry, Janet, but I just wanted to correct this before anyone freaks out ...

      It's not Tylenol (acetaminophen) that's restricted after surgery.

      Ibuprofen (Advil, Motrin, etc.) - and other NSAIDs like naproxen sodium (Aleve) and aspirin are restricted by some surgeons because they feel it increases the chance of pseudoarthrosis.
      Fusion is NOT the end of the world.
      AIDS Walk Houston 2008 5K @ 33 days post op!


      41, dx'd JIS & Boston braced @ 10
      Pre-op ±53°, Post-op < 20°
      Fused 2/5/08, T4-L1 ... Darrell S. Hanson, Houston


      VIEW MY X-RAYS
      EMAIL ME

      Comment


      • #4
        when does your body start fusing after surgery? Will it show at the first X-ray?

        Melissa

        Comment


        • #5
          Originally posted by mbeckoff View Post
          when does your body start fusing after surgery? Will it show at the first X-ray?
          I guess in a literal sense, the inflammatory response kick starts fusion immediately (or very soon after) surgery. It's somewhat debatable when it can actually be seen.

          In my case, evidence of fusion was visible on my 8 weeks post-op x-ray (compared to my 3 weeks one) in the form of a distinct softening of the severe angles on the hardware. Each subsequent x-ray showed more of the same.

          Pseudoarthrosis *does* happen, but it's not extremely (or even "very") common. Try not to worry yourself over it - especially if you haven't been identified in the patients most at risk.

          Pam
          Last edited by txmarinemom; 06-08-2010, 01:54 PM.
          Fusion is NOT the end of the world.
          AIDS Walk Houston 2008 5K @ 33 days post op!


          41, dx'd JIS & Boston braced @ 10
          Pre-op ±53°, Post-op < 20°
          Fused 2/5/08, T4-L1 ... Darrell S. Hanson, Houston


          VIEW MY X-RAYS
          EMAIL ME

          Comment


          • #6
            At my 6 week checkup/appointment, the Dr. said it was too soon too see any fusion. At my 9 month appointment, there were good signs of fusion on the Xrays.
            __________________________________________
            Debbe - 50 yrs old

            Milwalkee Brace 1976 - 79
            Told by Dr. my curve would never progress

            Surgery 10/15/08 in NYC by Dr. Michael Neuwirth
            Pre-Surgury Thorasic: 66 degrees
            Pre-Surgery Lumbar: 66 degrees

            Post-Surgery Thorasic: 34 degrees
            Post-Surgery Lumbar: 22 degrees

            Comment


            • #7
              What makes a patient at risk for not fusing?

              Comment


              • #8
                txmarinemom
                I guess in a literal sense, the inflammatory response kick starts fusion immediately (or very soon after) surgery.
                Fascinating! That must be why NSAIDs are forbidden.
                Not all diagnosed (still having tests and consults) but so far:
                Ehler-Danlos (hyper-mobility) syndrome, 69 - somehow,
                main curve L Cobb 60, compensating T curve ~ 30
                Flat back, marked lumbar kyphosis (grade?) Spondilolisthesis - everyone gives this a different grade too. Cervical stenosis op'd 3-07, minimally invasive

                Comment


                • #9
                  Originally posted by mbeckoff View Post
                  What makes a patient at risk for not fusing?
                  Here's what the SRS says ...
                  Fusion is NOT the end of the world.
                  AIDS Walk Houston 2008 5K @ 33 days post op!


                  41, dx'd JIS & Boston braced @ 10
                  Pre-op ±53°, Post-op < 20°
                  Fused 2/5/08, T4-L1 ... Darrell S. Hanson, Houston


                  VIEW MY X-RAYS
                  EMAIL ME

                  Comment


                  • #10
                    Originally posted by Back-out View Post
                    Fascinating! That must be why NSAIDs are forbidden.
                    No idea on that. Personally, I wasn't told to avoid NSAIDs - but a lot of people are.
                    Fusion is NOT the end of the world.
                    AIDS Walk Houston 2008 5K @ 33 days post op!


                    41, dx'd JIS & Boston braced @ 10
                    Pre-op ±53°, Post-op < 20°
                    Fused 2/5/08, T4-L1 ... Darrell S. Hanson, Houston


                    VIEW MY X-RAYS
                    EMAIL ME

                    Comment


                    • #11
                      If the inflammatory response after surgery triggers fusion (and by extrapolation, continues it?), then blocking inflammation must block fusion - at least, the initiaton of it.

                      Shame as inflammation also accompanies pain (and I have found, exacerbates it). WHen my back hurts the most, I seem to always have a low fever. Really need my sed rate checked again as well as tests for RF and ANA. Sure hope I don't have a collagen disease complicating things! Was once so dxed.
                      Not all diagnosed (still having tests and consults) but so far:
                      Ehler-Danlos (hyper-mobility) syndrome, 69 - somehow,
                      main curve L Cobb 60, compensating T curve ~ 30
                      Flat back, marked lumbar kyphosis (grade?) Spondilolisthesis - everyone gives this a different grade too. Cervical stenosis op'd 3-07, minimally invasive

                      Comment


                      • #12
                        Originally posted by Back-out View Post
                        If the inflammatory response after surgery triggers fusion (and by extrapolation, continues it?), then blocking inflammation must block fusion - at least, the initiaton of it.
                        Yes, I agree it makes sense in the early stages of fusion.

                        That said, the inflammatory response is the first phase of fusion (of healing *any* injury), and I'm not sure how long that phase lasts for this surgery. Fairly early on it would seem, the work has to shift to the reparative and remodeling stages - and I don't know how NSAIDs would affect fusion by reducing inflammation that no longer exists.

                        (I hope that was clear enough - LOL ... in re-reading it, it may not even be clear to me! ;-)
                        Fusion is NOT the end of the world.
                        AIDS Walk Houston 2008 5K @ 33 days post op!


                        41, dx'd JIS & Boston braced @ 10
                        Pre-op ±53°, Post-op < 20°
                        Fused 2/5/08, T4-L1 ... Darrell S. Hanson, Houston


                        VIEW MY X-RAYS
                        EMAIL ME

                        Comment


                        • #13
                          Pam--Thanks for correcting me! I knew I wrote that too fast. I'd have been in bad shape with all that Tylenol in my hydrocodone for months. Janet
                          Janet

                          61 years old--57 for surgery

                          Diagnosed in 1965 at age of 13--no brace
                          Thoracic Curve: 96 degrees to 35 degrees
                          Lumbar Curve: 63 degrees to 5 degrees
                          Surgery with Dr. Lenke in St. Louis--March 30, 2009
                          T-2 to Pelvis, and hopefully all posterior procedure.

                          All was posterior along with 2 cages and 6 osteotomies.

                          Comment


                          • #14
                            I think this is an important thread that everyone should read. Great questions, bring great answers. I've always known that this forum is a huge source of intelligent information, from very informed and intelligent people.

                            Proud to be here,
                            Shari
                            Last edited by Shari; 06-09-2010, 09:41 PM.

                            Comment


                            • #15
                              Hi all, i just logged on and now i have to quickly go out again, but thought you may be interested in this site, where it talks about some of the things on this site. I was not allowed NSAIDS either after surgery and my surgeon did state that the inflammatory process was needed initially for fusion to commence.

                              Site is: www.nsg-online.com

                              Catchya soon
                              Vali
                              44 years young! now 45
                              Surgery - June 1st, 2009
                              Dr David Hall - Adelaide Spine Clinic
                              St. Andrews Hospital, Adelaide, South Australia
                              Pre-op curve - 58 degree lumbar
                              Post -op - 5 degrees
                              T11 - S1 Posterior
                              L4/5 - L5/S1 Anterior Fusion

                              Comment

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