My August scoliosis surgery has been delayed

[jChris]

I went for my final pre-op visit with my surgeon today. He was having second thoughts about my cervical stenosis. He decided today(for safety reasons) that he wants to fix 3 levels of stenosis before I have the big surgery.

I am OK with this as I want to be in the safest condition when I have my scoliosis surgery. I will have the cervical surgery on August 2nd, and my scoliosis surgery about 6-8 weeks later. I may still fall into the September group, but not sure yet.

Has anyone gone through this? My doctor said he will go in through the front of my neck to work on the cervical issues. He does not want to go through the back as this is the field he will be working through with my scoliosis surgery. I may have some issues for a brief time with swallowing after this surgery.

Remaining positive about it all,,,,,

[titaniumed]

Chris,

I was wondering exactly what he had in mind for your neck? Some times the surgeons will do trim jobs, partial corpectomies, etc. from the front. It doesn’t seem like he would "fuse" in your cervical area, if he told you that he was fusing T2-Pelvis....

I have not had any neck work done. Just everywhere else. LOL

It might not be a bad idea to "clarify" by e-mail. Ask him if he is doing a corpectomy. When you find out, post the lingo here.

Be specific, and ask if he is fusing any levels in your neck.

OBTW, welcome to the forum, and it wouldn’t be a bad idea to get yourself some SOFT, SOFT, SOFT down pillows, and foam for the bed.
Ed

[jChris]

Thanks for the advice. I will ask and post back.

[JenniferG]

Hi Chris, it's great to hear you so positive about this shift in plans.

I had a friend who, nearly 20 years ago had surgery to his cervical spine (not scoliosis) through from the front and he hasn't had so much of a twinge since. He was fused three levels.

Best of luck Chris, keep us informed!

[Back-out]

Hi, Chris!

Don't know exactly what you're having done, but if it's minimally invasive rather than a fusion, I've "been there, done that". I had a great neurosurgeon who did a decompression of 3-4. 4-5 via anterior (right) incision in March of 2007. Very easy operation - for the patient, anyhow. I don't remember any discomfort or difficulty once I got home after a single overnight in the hospital. (Technically, I WAS given a 4-6 week recovery period. though).

I'm even thinking of returning soon to the same guy for a bit of a "touch up" since this approach can only work on one side at a time, and the disk degeneration is still a bit shaggy on the left.

I'm SO glad I did it this way as it allowed me to greatly reduce my projected fusion length now!

Best of luck, with both. If that's what they're doing with you, I congratulate you on your surgeon's good sense on your behalf. Cervical stenosis is indeed very dangerous even if it's virtually asymptomatic (as it was for me). "Asymptomatic", compared to my scoliosis and associated conditions, anyhow.

[jChris]

I have some additional information to share. I will be having an anterior cervical discectomy with decompression and fusion with instrumentation. I will have 3 levels fused from C-4 to C-7 with decompression at C4,5/C5,6 and C6,7.
He is doing this to stabilize my cervical spine before I have the scoli surgery. He said this will make my scoli surgery much safer. I will be in the hospital 2-3 nights sans any complications.

Let me know if you have any further questions. Thanks for all of the feedback.

Chris

[titaniumed]

Chris

You are having some levels fused, no doubt. I'm sure you are aware that your neck mobility will be compromised but the main thing here is that you come through all of this pain free. Going in with a positive attitude, and knowledge is important. I will be thinking and praying for you, as you will be one of our longer fusion members.

Ed

[jChris]

Thanks Ed. Yes, I know my neck will be compromised. When the surgeon first told me about this, I was very worried that I could no longer drive. He assured me that I will be able to drive. As it is now, I am so stiff that I can hardly turn my back or neck so driving is already a challenge. I rely on mirrors a great deal.

I may be one of the most fused foundation members after my scoli surgery. Not an honor I wish to have, but I plan on being very positive, as you have been, and learn to live and love life again in my new body.

I will keep everyone posted as I put the pedal to the metal so to speak!

I am buying a bunch of soft pillows,,,,

[Back-out]

Chris,

It sounds like you're having a more elaborate (than me) surgical approach to your cervical stenosis.

Forgive me if this is belaboring the obvious but does that mean you will have a different length fusion from what your signature indicates (i.e, starting at T2)?

If so, does this mean your surgeon is dividing your fusion surgery into two parts - physically? Of course, I understand the surgery itself is being PERFORMED in two parts (the purpose of your thread). I'm wondering, though, whether the two fusions will be physically connected.

I'm interested since as noted, my cervical stenosis was addressed in a minimally invasive procedure several years ago. I knew when I elected to have this done, that it was always possible I'd need a "standard fusion" later on. This became a very important issue once the possibility of major deformity surgery arose. I wonder if such a cervical fusion needs to be joined to that "regular" long scoliosis fusion some levels below it - or whether mobile segments can be left in-between.

I know "everyone is different", etc. but I'd still be very interested in learning what was decided for you.

Thanks and best of luck!

[titaniumed]

focus on healing

Chris

The driving thing will be a little scary in the beginning, after you do a few short drives, you will get the hang of it. Just drive slow....

You will gain height, so what happens is you bang your head a few times, till you lower the seat, and perfect the motion of entering the car.

I wouldn’t worry about things like this. The main thing is focusing on you, focus on healing. You cannot worry about anything else, and your loved ones will need to understand this. You will need some help with things like cooking, laundry, and someone to go shopping for you. The first 6 weeks after the scoli T2-pelvis surgery will be basically a "survival mode" where meds and pain are the main factors. Your body has just been "shocked" beyond belief, and its telling you to take it easy, "I'm healing as fast as I can!" and it does. Sleep is valuable, and hard to do right after surgery. That’s why my signature mentions the foam. It truly will be needed, 2-4 inches thick. There are threads here on that subject.

Another thing that you might consider is that after your neck surgery, you might ask your surgeon to be flexible with the date of your main fusion... I'm sure he will work with you on this, you will need to be ready, when "YOU are ready". I was not comfortable having my broken shoulder repaired for quite some time. (I broke it 2 weeks before my scoli surgeries) Stuff happens. Sigh.

I think back on those days as chapters in a book. Some chapters are hard, but you know deep down that the ending will be fantastic. Look forward to the end of the book, and be patient, it’s a long slow read with good days along with the bad. As time passes, and you heal, the good days outweigh the bad days. You will learn to adjust, and eventually you adapt, and forget how life was before being fused... I've forgotten quite a bit! The traded pains, which are completely different, should eventually dissipate in time...

Ed

[titaniumed]

Hi Amanda

It sure looks like 2 separate fusions since C7-T1, and T1-T2, have not been mentioned. Chris's surgeon is probably going to leave these two, for mobility in her neck.... That’s the way I read it. If it had been a C4-T2, cervical anterior, and a T2-Pelvis posterior, then that would ring a bell.

I wonder if any surgeons have staged lower levels and upper levels with staged dates on purpose, and tied them together within 30 days? It doesn’t seem to make any sense, but then again, you never know.

Ed

[jChris]

Back-out, what Ed has described in his last post basically summarized what will be done. The cervical fusion will be 3 levels, C-4 to C-7. This will be for the stenosis.

My scoli surgery will be a separate deal, T-2-pelvis. This will not be one entire fusion. I recall reading in another thread that they do not perform those long fusions involving C's anymore. I know I would not be agreeable to that.

My surgeon just presented a study to the SRS relative to the cervical surgery that I will be having. Patients that have stenosis measuring 6 or less are candidates for surgery. Patients with stenosis measuring 8 or more are not candidates for surgery. Let me emphasize that this is my doctor's study and not necessarily endorsed at this point by the SRS. I know that I am over simplifying his study as I am sure there are other factors involved so take this as my disclaimer! As luck would have it, I am a 7 so he considers me to be a borderline case. The fact that I have 3 levels of stenosis has caused him to play it safe with me and proceed with the surgical correction, especially since I am facing the big scoli surgery. The consulting radiologist on all of my tests also agrees that I should have the cervical surgery.

I hope I am not providing too much detail here. I am just trying to clarify what is going on with my individual case. Each patient should always work with their respective physicians as to what makes sense for their unique circumstances.

[jChris]

I need to clarify my comment "this will not be one entire fusion". The C-4 to C-7 will be one fusion. The T-2 to pelvis will be one fusion. They are separate. Sorry for the conFUSION.

[Back-out]

Thanks very much, Ed and Chris! This is very interesting to me as you may well imagine. I/ve been thinking I'd have to have one long fusion, if and when the time comes to turn the decompression into an out and out fusion (for instance, for stability).

I've also been assuming I narrowly avoided the long fusion since I "discovered" the minimally invasive approach and surgeon five years ago.

I'm pleased that, at least in your instance, they are not afraid to leave unfused segments even with a high thoracic fusion. For me, of course eveything depends to a large extent whether I go with one of the T4-S1 surgeons or one of the T10 to S1- guys (So far, they are falling into these groupings which for some reason, also seem to be generational).

I need to clarify my comment "this will not be one entire fusion". The C-4 to C-7 will be one fusion. The T-2 to pelvis will be one fusion. They are separate. Sorry, for the conFUSION.

Heh! No problem. I can't tell you how I had to work on editing my inquiry post...It gets VERY conFUSING indeed to ask or answer questions about this issue!

[Back-out]

I've been thinking about this issue still more and realizing how instructive your experience is for me in my (probably) pending scoli surgery. First, I realize that what I've been assuming is not necessarily true.
Namely (To quote from myself above):

I'm SO glad I did it this way as it allowed me to greatly reduce my projected fusion length now!

Your surgical experience is making me rethink the whole thing - and with no little relief.

I am also going to make sure my surgeons attend to my cervical stenosis with an eye to how I'm manipulated on the table. Since the previous surgery, I've been requesting that care be exercised about my neck. both in other operations (when I'm unconscious) and in the dentist's chair - when I'm awake and can ask for pillows and stretching time.

I can easily see my residual stenosis causing dangerous neurological compromise during the long scoliosis surgery. I am very grateful to your thread for orienting me to this precautionary move by your surgeon. The minimally invasive approach was deemed dangerous for me by several neurosurgeons way back when. It does seems that they were erring on the side of caution to an excessive degree based on my then-current health status.

However, it is entirely possible there IS risk now in how I am handled during the scoli surgery (plural - P AND A) - based on this condition. I want to make sure whatever surgeon I decide to work with, has considered this condition when planning my long staged procedure.

Thanks to you and your surgeon. I feel I had a narrow escape. (Nb I will NOT be going back to my M.I. surgeon for a "touch-up". In light of this thread, it seems it would be asking for trouble - would certainly make my neck that much more unstable!).