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Anterior vs. Posterior

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  • Anterior vs. Posterior

    Hi everyone. I just had a pre-op visit today with my ortho and had a question. When I saw him a few months ago and first started talking about surgery he told me he could do posterior only surgery - a couple hours - and I talked myself into it thinking at least that would be better than A/P and having the ribs removed and all.

    So I go today and he looked at the xrays again and changed the story. He now says he would do A/P with one rib removal. I was completely shocked and started crying....surgery time went from 5 hours to 10 hours now and he also said that once he got started he may decide that it was too much for one day and would do the anterior one day and the posterior a week later with me being in the hospital for about 2 weeks. I won't know until I wake up what was done. He is saying he feels he could get a better correction doing the a/p instead of just the posterior.

    Does that sound right? I read of a lot of people who have it done all on one day or 1-2 days later. And does anyone know WHY they do the ant. and post.? I would be happy with even a 20 - 30 degree curve left over...seriously, I don't care if I'm completely straight if it means having less time on the operating table.

    I have an MRI in 2 weeks and a follow up w/surgeon beginning of October. His office said they could probably schedule me for end of Oct but I am in so much doubt now. I convinced myself that the 1st senerio would be OK but now I'm faced with a totally different senerio.

    I have had a 2nd and 3rd opinion over the years and they all say surgery but each surgeon is different as to HOW they would do it...and I expect that is normal. Dazed and Confused now.
    43 y.o. married w/a 12 and 14 y.o
    62 degree curve T7 - L2 that is now being measured at 54 degrees?????
    Never had surgery/Thinking about it and gathering all the info I can!

  • #2
    Hi Lostfan,

    It is so funny I have a very similar situation to yours and as soon as I posted mine I went to see if there were any new posts and saw your post with a similar title as mine and you posted 20 minutes earlier but when I started writing my post your post wasn't there. At first I thought that maybe I accidently send the post twice but then I saw that it was someone elses story which is very similar to mine.LOL.

    I know exactly how you feel as I feel the same and if you'll read my post you'll know exactly what I mean.

    I am having surgery on the 19th. I hope to make an informative decision myself and want to wish you all the best as well.

    Good luck

    Mariya
    30 yrs, mom to two girls ages 9 and 7
    8/9/04 - 18* thoracic and 42* lumbar
    3/7/06 - 22* thoracic and 45* lumbar (38*kyphosis)
    4/8/08 - 38* thoracic and 50-52* lumbar (54* kyphosis)

    2007 - Scheduled surgery but cancelled due to no major health issues at the time.
    2011 - Back pain, spasms, sciatica, difficulty doing any physical work/activities w/o following back pain and spasms. Revisiting surgery decision and soon to schedule a doctors appointment to determine the progression since 2008.

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    • #3
      Hi...

      I think that surgeons usually do a combined surgery because they feel they can't get good enough correction with only one approach. (They can tell how flexible your spine is (how well it will correct) by doing bending xrays.) In most cases, they go in first and remove some discs from the front. Then, they go in from the back to place the implants and correct the curve(s).

      If you feel strong enough about it, you might want to go and get other opinions. Doctors usually do the procedures with which they're most comfortable. Maybe you can find someone who prefers anterior approaches. You'd still have to have the anterior incision with rib removal, but at least it would be only one procedure.

      Best of luck in your decisions.

      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


      • #4
        I would get a second opinion as well. I only had posterior, and my doc told me in advance that my spine was flexible enough to only do so. I had about a 15 degree thoracic(down from 60) curve left after surgery and it curved a bit more in the first few months after surgery to about 20ish, and I would rather have that than have had anterior as well.
        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

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        • #5
          I am having 2 procedures in a few days. My surgeon said he likes to do the two procedures to get better correction.
          surgery 9/06
          Rothman institute

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          • #6
            Hey Lostfan,
            I know how you must feel. I went to my specialist a month ago to see if i need an op thinking it would most likely be posterior, but no i was told Anterior and Posterior. I was very upset and to be told it will take 8 hrs was even more heart breaking. But i then read that some people were under 10 and 14 hrs everyones different. But all i was say the Doc's know whats best and i know im in good hands. So if you have faith in him/her you have nothing to worry about.
            Keep smiling
            Lee xx
            Had surgery May 28th 2007 Anterior/Posterior getting fused from T3 - L3

            http://curvedgirl.blogspot.com

            Comment


            • #7
              my surgery time........ant/post...

              I believe my surgery was about 9hrs in total.....with both anterior/posterior being done in the one day. From what I understand from my husband, the anterior took from about 10:00am untill around 4:30-5:00 & then the posterior was done in a shorter amount of time. I was out by about 7:30 says my husband! In my case, they told my husband that they would keep me'under'(sleeping until the next day...) When he visited me the next day, I was still out of it....
              My surgery included a thoroplasty/ribs removal & I had horrible kyphosis so I was a 'big' case!

              surgery Aug 1st, 2006 by Dr. Boachie/Dr. Kim
              thorocolumbar curve was 95%--reduced to 42%, rib removal
              Kyphosis was 85%/big hump---but it's gone now!!!!!

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              • #8
                Everyone is very different

                Lostfan,

                I know how you feel! At first it was thought that I was only going to have Posterior surgery... then my ribs collapsed and that was then out of the question... it was A/P then- he needed to do both to get better correction and to "fix" the ribs. My A/P surgery took just shy of 8 hrs. I had an amazing correction! I'm glad my surgeon did he A/P as I now like the symetricalness (sp) of my new body. I havent had that for sooooooo long!

                The one thing I can say is that if you do not "trust" your surgeon it may only lead you to more doubt. If you still doubt your surgeon than maybe more opinions would be a good idea. Just a thought.
                Angela
                29 y/o f w/76 degree curve.Surgery done on June 26th, A/P, rods, instumentaion, rib removal- now 18 degrees!!

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                • #9
                  I went through the same situation as well. If you love your surgeon and feel comfortable then just do whatever he decides. I don't even remember my first surgery. I had anterior on a Monday and posterior on Wed.
                  Jenn
                  37 y/o female
                  60 degree lumbar
                  45 degree thoracic
                  1st time anterior/posterior surgery May 8th and 10th 2006
                  T 5 to S 1
                  NYC

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