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  • T12-L3 Fusion

    Hi all,
    Has anybody had any thorocolumbar anterior fusions, like a T12-L3 fusion? I was wondering if anybody would share some of their personal experiences with the anterior approach and the risk of additional complications. I am male, but my doctor says that the incision should be high enough that I won't have to worry about any sexual disfunction issues.

    Also if anybody has had a fusion above their spondylolesthesis, I'd be interested to know if the fusion from the scoliosis has exacerbated any spondo pain. It has been difficult for my doctors to decide if the scoliosis and the spondo should be treated together or separately. A fusion to the sacrum is probably inevitable, but right now I am young enough (21) that I should get good life out of my L5-S1 disc before a revision fusion later in life.

    I'd appreciate any feedback or personal experiences!

  • #2
    Hi...

    My fusion is considerably longer than yours will be, so I'm not sure if I can be of any help. I would, however, encourage you to get a second opinion, especially since there's a question about whether to fuse to the sacrum. There was a question in my own case about whether to fuse one or both curves. I was comfortable enough with my surgeon that I decided to let him make that decision. In retrospect, I wish now that I had gotten a second opinion.

    You can find a list of specialists here:

    http://www.srs.org/directory/directory.asp

    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


    • #3
      My daughter who will be 14 in a few weeks is almost 8 months post-op. Although Jamie's fusion is longer than yours will be (she is fused from T3-L2) and was done posteriorly, she too has spondylolisthesis. (at the L-5-S-1 level) I asked her doctor in he would be fusing to that level so we could possibly avoid surgery for that in the future. His comment was that he only fused that area if absolutely necessary because of the amount of mobility that is lost when fusing that low. Like Linda, we trusted our doctor and left him decide since he knows a lot more about this stuff than we do. By the way, the doctor who did the surgery was our fifth opinion. As of right now, her spondylolisthesis has remained the same and hasn't caused her any pain.

      Mary Lou

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      • #4
        Thanks for the info. This is my 7th opinion to date, with the most recent being from Dr. Bridwell is St. Louis. My second recentmost recommendation was for T12-S1 fusion by Daniel Gelb in Baltimore (who underwent Bridwell's fellowship). Ironically, Bridwell said the one fusion he would NEVER do in someone my age with a grade I spondo is a fusion to the sacrum. You'd think that doctors who have studied together for a few years would have similar surgical views. Needless to say, I think I have ruled out a long fusion to S1 at my age, especially if Bridwell says he would never perform it on me.

        What grade is your daughter's spondylolesthesis?

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        • #5
          Jamie's spondo. is a grade II (not sure what grade I or II means though,) and it is at about 27%.

          Mary Lou

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          • #6
            Hi MSL,

            My daughter had a thorocolumbar anterior fusion from T11 to L3. As compared to a posterior procedure, I would say the pain in the side and inside the chest wall is unbelievably intense in the beginning. The chest tube is pretty miserable. Interestingly, in our case, there was very little back pain. She was in the hospital 7 days, had no complications, and was back to school after 8 weeks.

            At 5 months post-op, she has some numbness along the incision and along her lower abdomen. She did lots of work with her PT to break up adhesions along the incision sight. The ribs are a tough place for a major incision, and you'll need to work at this to prevent problems. She needs to work at the cardio, as she lost some capacity from sitting on her bum for 2 months. Plenty of walking post-op will make your recovery quicker. At this point, she's pretty much pain free, no back, shoulder, or neck pain. The muscle spasms and shortness of breath she was having prior to surgery are gone.

            Feel free to ask any questions.
            Susanna
            ~~~~~~
            Mother of a 17 year old daughter. Her "S" curve was 40 degree thoracic from T3 to T9, and a 70 degree rotatory thorcolumbar from T9 to L4. She was operated on March 9th, 2005 by Dr. Boachie-Adjei at the Hospital for Special Surgery in NYC. She was fused from T11 to L3, using an anterior approach, and the major curve corrected to 20 degrees. She's doing great!

            Comment


            • #7
              Anterior spinal fusion

              You are fortunate to have a doctor like Bridwell, he is the best in our area of course that is along with my doctor which is Lenke. He is also an associate of Bridwells and he is in St. Louis. Three years ago I had an anterior/posterior spinal fusion with hardware replacement. Dr. Lenke did about a 6 inch cut on my left side just a little bit down from the umbilicus. He put in 2 cages at L3, L4, turned me over in the same operation and took out my Harrington Rod and replaced it with 5 others, some plates and screws. In 2 weeks I will be having my 3rd surgery to remove my sacral iliac screws and a plate in my upper thoracic area that is causing pain in my shoulder area.

              I would recommend the Barnes Jewish Hospital Doctors to anyone in the St. Louis area, they are the best.

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              • #8
                lower fusions

                I did have a fusion from T-11 to L5. I had both anterior and posterior incisions. I remember questioning my surgeon with regard to only fusing to L5 and not to the sacrum. The idea has been to maintain my mobility. I might be just fine, but I know in some cases, the remaining disc between L5 an S1 could become problematic.
                Heather
                Surgery date: April 20, 2004
                Anterior/posterior surgery
                Fused T-11 to L-5
                Pre op lumbar curve: 70 degrees, thoracic curve: 42 degrees
                Post op lumbar curve: 19 degrees, thoracic curve: 18
                Surgeon: Dr. Boachie-Adjei
                Had successful pregnancy and birth 2 years post-op

                Comment


                • #9
                  lumbar fusion L5 & S1

                  Hi im just wondering if anyone has had this fusion. My husband had his op 5 days ago and is due home tomorrow . And we have not been told how long he can sit for in chair how far he should walk for first fews and how long the recovery period is ... So please if someone has had the same operation and can open eyes just alittle bit we would be very grateful. We live in a home with 14 stairs to climb and im more worried about that more then anything because my bathroom and toilet are down stairs could he do himself any damage keep going up and downstairs at this early stage
                  many thanx ... maz x

                  Comment


                  • #10
                    T-12 to L3 fusion

                    Hi...I am surprised the hospital/surgeon did not give you this information. I was in the hospital for 13 days following my surgery, then went to rehab for 3 days. When I got home I was able to climb stairs (slowly and carefully), but my husband set up a bed in our family room downstairs, which is also near a bathroom, so during the day I was always on the same level. At night, I managed the once-a-day climb upstairs to the bedroom. However, if you don't have a bathroom upstairs at all, I would recommend him (or both of you) sleeping downstairs for a few weeks until your husband is more comfortable with the stairs.

                    I had some guidelines for walking and sitting...mainly to do every day, and as much as I could tolerate. I gradually increased the time I was able to comfortably sit and/or walk each day.

                    I was told my recovery period would be 3 months, which was quite accurate. However, this is different for everyone.

                    Good luck with your husband...and although it may seem difficult in the beginning, things will greatly improve after about the first month. Keep us posted...
                    Last edited by Heathmoose; 09-03-2005, 09:24 PM. Reason: typos
                    Heather
                    Surgery date: April 20, 2004
                    Anterior/posterior surgery
                    Fused T-11 to L-5
                    Pre op lumbar curve: 70 degrees, thoracic curve: 42 degrees
                    Post op lumbar curve: 19 degrees, thoracic curve: 18
                    Surgeon: Dr. Boachie-Adjei
                    Had successful pregnancy and birth 2 years post-op

                    Comment


                    • #11
                      Hi maz...

                      Your husband should be able to climb stairs when he returns home, and in fact, it will be good for him to do so. He'll need to be walking around at least every few hours. I think that the faster he can build up his stamina, the quicker his recovery should be.

                      I have a page on my website about resuming activities after scoliosis surgery:

                      http://www.scoliosislinks.com/PostSurgActivities.htm

                      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


                      • #12
                        I am also a male and I had posterior/anterior T4 - L3 fusion on 6/28/05 and I have had no complications to date. My doctor warned me about possible sexual dysfunction with the surgery but that was included with the generic complication warnings. I was sore but everything worked fine. Of course it was about 3-4 weeks before I felt well enough to try. My wife was more afraid than I was.

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                        • #13
                          Driving a car after six weeks is making me laugh as I could barely bent at that stage to get IN the car and go for a drive, seriously now. I know that some can drive at that time and that recovery is different for everybody, but I honestly think that for one's person's safety and everybody around, driving a car should be held off for a while.

                          I think moving the most a person can after is best, but with exercises and resting periods in between. I was majorly anemic after the surgery even if I had taken iron supplements before and wasn't told this till a year later, and so I am convinced that low iron levels did not help me get my strenght back as well as heal properly. So getting iron levels checked is my recommendation of the day.
                          35 y/old female from Montreal, Canada
                          Diagnosed with scoliosis(double major) at age 12, wore Boston brace 4 years at least 23 hours a day-curve progressed
                          Surgery age 26 for 60 degree curve in Oct. 1997 by Dr.Max Aebi-fused T5 to L2
                          Surgery age 28 for a hook removal in Feb. 1999 by Dr.Max Aebi-pain free for 5 years
                          Surgery age 34 in Dec.2005 for broken rod replacement, bigger screws and crosslinks added and pseudarthrosis(non union) by Dr. Jean Ouellet

                          Comment


                          • #14
                            more advice needed

                            Hi Yet again

                            thankyou to all who replyed to my question , well my husband is now 14 days
                            post op. He is not doing so well he thinks! pain in left leg and swelling in lower left side of back where stapels are has anyone else had the same prob round about this time of post op ?

                            many thanx maz

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