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View Full Version : going in for surgery new method:XLIF



taohappens
01-30-2007, 01:31 PM
:o My surgery is for Feb. 1, 2007. The surgeon, Dr. Paul, in Naperville, Il, is very excited about a new minimally invasive method called, "XLIF." In the procedure the dr uses a computer/xray guided system with monitors on each important nerve and enters the surgery site from the side of the spine. The patient is attached(I'm not quite sure how) to a surgery table that has a hinge. When the hinge is dropped, the spine bends sideways and hopefully, depending on the degree of my scoliosis and disk slippage, he can insert screws and rods into 4 lumbar vertibrae through small incisions just big enough for one finger to pass through to the spine. In addition to the new miracle technique, I have to have work done lying in my other side on the table to cut away bone that is pinching nerves.
I am really scared. Although the doctor is excited about the reduced trauma to muscles and nerves, he has told me that my top rib will probably be in the way of the surgery and some of it will have to be CUT OUT! My affected discs will be replaced with little plastic boxes and some type of sponge will be inserted that has a substance that encourages bone growth. If he cuts off the rib, it will be used for grafting. He also has mentioned several times that it's an 8 hr surgery and he might have to do part on the first day, then take me back in the next day and do more. I am in perfect health other that a slight case of hypertension brought on by taking voltaren, an nsaid, for 14 years. Not sure why it might take two days, that's scaring me, too. I will be wearing a chair back brace and using a bone growth stimulator. I've been told I can't take nsaids for months after the surgery; already the arthritis in my hand is starting to hurt constantly.
I just joined the site, having found it when entering the diagnosis the doctor wrote on my chair back brace order. I'm 59 and have known since I was 12 that I had scoliosis but never had a brace. I remember a doctor recommend it along with physical therapy, but my mom and I decided against it. That was about 1961. As you might expect my scoliosis has morphed since then. No one has ever told me the degree, but judging from diagrams I have seen, it's about 45% and mostly confined to the lumbar spine. My spine is also "twisted" which doesn't show on the films. My left hip is several inches forward of the right and the curve in my spine goes toward the right. At a glance, one wouldn't know I had scoliosis because my shoulders are almost even and my hips look even, too. I also have osteoarthritis which has made my condition worse. I have had leg pain in my left leg from the sciatic nerve at L5/S1 which has increased over the past 14 years. I was never before properly diagnosed as having slipped discs in my lumbar spine although I went to several ortho doctors and to physical therapy numerous times over the years.
In the last ten years, the distance I can walk has decreased from a few blocks, to 100 yards, and lately to 10 feet with a walker. I have been frustrated and anxious due to my pain and to not being able to walk anywhere with my friends and family. Sometimes I feel so angry with the doctors I saw in the past, that I wish scoliosis was like rabies, if it were, I would bite them and they would get it!
For a while I took antidepressants because I was acting "emotional" about my condition. I gained a lot of weight on them. Since I went off, I have lost 22 lbs in 8 months. I was spacey, but less anxious. Prescribing those meds instead of ordering proper diagnostics was just another part of the dis-service done to me by my old HMO ortho doctor who never even ordered an MRI.
Lately, my worse symptom has been excruciating pain in the bottom of my left foot, it's called plantar fasciitis. I believe it's from strain to the connective tissue in foot because my left calf has been cramped and shortened by my "sideways" way of walking.
I found Dr.Paul through a referral from a friend who had the same surgery in the old, more invasive way. I took a long time to become stubborn enough to advocate for myself with doctors, I hope it pays off!
I plan to write back during my recovery for the benefit of other readers.

LindaRacine
01-30-2007, 01:42 PM
Hi...

My one BIG recommendation would be to wait until Dr. Paul has done at least 8-10 of these procedures. There has been quite a bit written about learning curves, especially in terms of thorascopic procedures. For example:

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=16371914&query_hl=1&itool=pubmed_docsum
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=15534421&query_hl=1&itool=pubmed_DocSum
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=15363428&query_hl=1&itool=pubmed_DocSum

Also, I'd encourage you to get a second opinion from another scoliosis specialist. You can find a list of specialists here:

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

Good luck.

Regards,
Linda

CHRIS WBS
01-30-2007, 02:01 PM
Good luck with your impending surgery! I will be most interested in hearing how your story unfolds.

Best wishes,

Chris

macky
01-31-2007, 12:28 AM
I would not be at all impressed either if I was you taohappens. Fancy getting to 59 years of age and having to look at going through surgery when things could have been made a lot easier if it had been picked up earlier. I realise you were 12 when diagnosed in 1961 but over the years there would have been a number of things they could have done to help you.
I agree with Linda 100% please take her advice very, very seriously. No doubt your doctor is very excited about this, but I would wait until I knew for sure that it was successful for other people.
I am not being negative, please dont think that, and I know you are in pain, but please get another opinion. Its better to be sure isnt it.

Regards.
Macky

Shari
02-01-2007, 01:04 AM
Hi Taohappens,

Welcome to this forum!!! Your surgery is coming up so fast, and I know you must have a thousand thoughts going through your mind.

I just hope you know that you have come across a group of people that will be here for you in any way they can. No matter what kind of support you may need in the future, we'll be here.

It's a situation that you don't have to go through alone!!! Just know that any fears, concerns, or emotions that you may go through in the the next couple of months, you can feel free to express them here!!!

Shari

tommyo
02-01-2007, 09:46 PM
Wow! I live in Naperville. I've been seeing guys in Chicago. Keep us posted, this sounds like an interesting alternative to more invasive techniques. I wonder how they get a rod in or if they even use them?

joeb-z
02-02-2007, 09:22 AM
Believe it or not, I spend a fair bit of my time on my job studying the latest in minimally invasive spine surgery techniques and hardware. It is all wonderful stuff, but may be a poor match for complex spine surgery, which scoliosis generally is. Proper correction requires optimizing the curves in both the front-back and side to side planes including proper lordosis and also derotation. This is limited by minimally invasive techniques. MIS is typically directed toward a one or two level fusion and the surgeon has less ability to correct curvatures or even see what is really going on. For scoliosis, I would always see a surgeon who has demonstrated full proficiency at more invasive procedures also. Remember as to new techniques "to a man with a hammer, the world is a nail".

macky
02-02-2007, 08:30 PM
joeb-z, excellent post. You have put that so very well. I totally can agree with you and see exactly what you mean. This is what I was afraid of when I suggested taohappens to see another surgeon for another opinion.,

The operation is over now and I pray that all went ok and it was a success, but I am so worried.

Thankyou
Macky

joeb-z
02-05-2007, 10:32 AM
I want to provide a little balance to my prior post and link together an article posted in another thread. I am not against a minimally invasive surgery (MIS) if appropriate and by a docter who is fully proficient in both MIS and traditional scoliosis surgeries. An example would be Dr. Lonner as described in the article at the bottom of this post.

You need to read carefully however. Dr. Lonner's website says the method he uses is best for thoracic curves, not for lumbar or combined lumbar-thoracic curves. The only hint you get in the article is that the incision is "beneath the arm". So the real story is that, for a small percentage of scoliosis cases, MIS may be appropriate.

MINIMALLY-INVASIVE SURGERY FOR SCOLIOSIS PERFORMED AT LENOX HILL HOSPITAL

Different Surgical Route Offers Less Scarring and Quicker Recovery

minimally invasive surgery for scoliosis, a sideways curvature of the spine, is now being performed at Lenox Hill Hospital. The procedure, which has evolved over the past five years, is performed endoscopically, through one-inch incisions, using video cameras and monitors.

Baron Lonner, MD, an Orthopedic Spine Surgeon at Lenox Hill Hospital in New York, is one of only a few doctors in the country to perform this minimally invasive procedure. Rather than making a long incision along a patient's back, Dr. Lonner enters the patient's chest through several small incisions beneath the arm. "Working on the front of the spine allows more maneuverability and allows a better correction than a surgery done through the back," Dr. Lonner says. "It also produces cosmetically better results, less scarring, and a shorter recovery period. Patients also require less pain medication following surgery and are mobile.

Best wishes to taohappens in your recovery. Everyone need to make their own choices and this website is a great source of information and support!

joyfull
12-06-2009, 05:28 PM
Hi, Taohappens. I am considering MIS and wonder how you are doing two years later? I hope well. I am 57 and will be having surgery for the first time in June. I hope to hear from you. All the best, Joy

jrnyc
12-06-2009, 06:37 PM
Dear Joy
i dont know that what was written about in 2007 is exactly the same as what dr anand is doing in 2009...did you ask him? cause they are telling me that i qualify for it, but dr lonner & the other doctors always told me, in the past, that i didnt qualify for their minimally invasive...that where my lumbar surgery needs are located is too low on spine to qualify...

best regards
jess