Fusion to the sacrum

[Houston Curves]

I just got confirmation from Eric, one of Dr. Shelokov's PAs, that they will now have to fuse from T2 or T3 to the sacrum (based on the discogram). Bummer as I was hoping to preserve some flexibility. Oh well, I guess it isn't the worst news they could have given me...

Ann

[berta@aloha.net]

I am fused to the sacrum. (T5 to Sacrum). I'm 7 weeks post op and am curious what exact flexibility I will have less of, than say... to be fused to L4 or L5. I won't ever know, and my surgeon said I will adapt, but also said it was not that different than being fused to L5. Just curious if anyone knows. (in my case, my L5 was still in good shape, but as you get older and have a large fusion above it, he said I would for sure have to face surgery again in a couple of years)
But...I'm still wondering IF you have that much more flexibility with only one vertebra left unfused???

[lelc2002@yahoo]

Berta & Ann,
I'm fused to L-5 from T-11. I believe I was down for T-2 to sacrum originally but by pre-op I was told it would hopefully be just the lower half if all went well...which it did..
I dread the thought of more surgery down the road. I don't think I even want to ask that question to my surgeon at next visit!
I notice the loss of flexibility mainly as I garden since I can't bend like I used to. Luckily my arms are long so I can get along by kneeling & working that way for a bit...somewhat rough on the knees, though. All in all it's not a big deal.......Ly :)

[Cakedec]

I am also fused to L5 and there is a slight curving pelvis movement that can be done at the tailbone, but not a lot. Sometimes I will hear a loud "crack" when it moves or feel a twinge there, so I don't "try" to bend it if I don't have to.

I don't think there would be a whole lot of difference if it was to the sacrum, just increased stiffness at the tailbone; you get adjusted to it, like anything.

Deb
age 48
surgery 7/24/06
T5-L5
for s curve T72, L77
50% correction
DON'T WAIT TO GET STRAIGHT!!

[Shari]

I'm T-1 or T-3 to L-5, I think it's T-1, but from the begining my doctor told me the odds of me having to have another surgery 5 to 10 years down the road with L-5 to sacrum would be necessary. He also explained to me that that area would be taking alot of the stress, because it was not fused.

He told me that having that done would feel like minor surgery comapred to my previous one. And I can deal with that. When and if the time comes.

I am 2 years post op, and I am now so amazed at the things I can do. This past weekend I layed 50 patio blocks, of course I hurt like hell for 2 days afterwards, I was hitting some golf balls with no problem.

I guess I just stay aware of the stress factor on the L-5 to sacrum area. I know that possibility will be down the road for me, but I try to adjust how I do things to keep that area safe, if that makes any sense???

Shari

[CHRIS WBS]

If a surgeon feels that extending the fusion from L5 to the sacrum is inevitable at some point, why not just fuse to the sacrum initially and spare the patient additional surgery? Is it because involving the sacrum presents its own set of problems such as a much higher rate of pseudoarthrosis?

Chris

[Karen Ocker]

Chris:

I found that debate in the scholarly literature discussed by the scoliosis surgeons. It's an individual decision. They are more apt to hold off in younger patients; in older patients the disc might be too far gone.

Lynne:

You will have much more flexibility around the hips in time when everything heals.

I personally could not care less right now about being fused to the sacrum; I have a perfectly normal, pain free life and am as grateful as can be. :) I do just about everything I want.

[Shari]

Ann,

Listen to those that have been fused to the sacrum. Karen has always had great input here. If she says she's doing fine then I trust that. And it gives me great comfort in knowing that, in case I ever have to undergo that procedure.

But again that plays into the that fact that you have to trust your doctor, because they all seem to have different approaches to this surgery.

Again I repeat that my doctor choose such a long fusion for me because, he said, that I would eventually have to have the thorasic part done, again because of the extra stress the area would be under, and he felt that doing it all in one shot, even though it would be a rough recovery, that I wouldn't have to have another painful surgery down the road.

He showed me an xray of someone that had the problem when the L-5 and the sacrum had seperated, and it seemed almost minor to what I had gone through.

Bottom line is you have to trust your surgeon, and I trusted mine!!!

It's taken me some time, but I can't really say I regret what I have had done!!!

And after hearing what Karen has had to say, I'm not afraid of the small correction that I may need in the future.

Shari

[bbest]

I am fused to the sacrum and for me, it just feels tight in that area. Obviously, you can't bend at the waist but you shouldn't do that anyway. I can't really twist at the waist, either. When you're thrust into an unfamiliar situation, you just learn to adapt.

[Houston Curves]

My thanks to everyone who repiled (please keep posting if you want as I will keep reading). Your input is great. I'm just trying to mentally prepare myself for what it will feel like / be like post-surgery in order to try and avoid the depression that can happen when you "realize" how much you have changed. Thanks again.

Ann

[CStadler]

My surgeon wants to go to the sacrum as well and I am doing the same thing, trying to envision how it will be after as far as the flexability goes. He said I may be able to touch my toes depending on the muscles in the backs of my thighs, but also said that twisting won't be possible. To get out of the pain I am in it will be worth it but you do wonder.
My surgery just got bumped a second time, and now won't be until Sept.
Thank you to everyone for sharing...all of your feedback really helps.
Carol

[bonjour]

I just got confirmation from Eric, one of Dr. Shelokov's PAs, that they will now have to fuse from T2 or T3 to the sacrum (based on the discogram). Bummer as I was hoping to preserve some flexibility. Oh well, I guess it isn't the worst news they could have given me...

Ann
hello ,I am 5 month post op now ,fused from T7 to S1, (and not from T4 anouced)and i feel much better than before ..the pain left is really just muscular.I was really afraid before about having sacrum fused thinking i would be more handicaped instead of doing less things ,i do more . :o

[berta@aloha.net]

Well, I'm 2 months post op and feeling a little better everyday, even though it's so slow. I think that no matter where we are fused to, as far as lumbar, L4 or L5 or Sacrum, we have to accept our changes, limitations, and new forever body and spinal posture, etc. I was really flexible in my lower spine before, but my curves were progressing rapidly, so my choice was clear: end up with a walker or wheel chair, OR have a whole new body that would be straight, but with lots of new limitations. I just always remind myself how much pain I was in daily and I take a look at my "before" photo of my back and then look at my "after". That really helps me to accept!

Now.... I will just be excited when I can reach my feet, sitting down and crossing one leg over the other! (to cut my toenails, shave my legs....) And what exercises will I be able to do besides walk!? I used to do pilates and yoga.... and now it seems like most of those postures will be impossible. So what will I do for a limbering, stretching or aerobic type exercise!?

And.....when will it be comfy to recline, in a chair or car or plane? I have to sit really straight up on the edge of a chair to feel ok and even that's for 15 or 20 minutes before it feels I have to stand up. So far I last just a few minutes in a reclining position. (that's probably the fusion to the sacrum difference from fusion to L4 or L5?) Anyone have that problem? (relaxing in a reclining position?)

[JoAnn5]

My first trip to the beauty shop after my surgery was not fun. Reclining in that little chair to have my hair washed was uncomfortable.... and then i had to sit there for a few minutes "stuck" when i raised up...before i could stand to move to the styling chair. Now however, it doesn't bother me.

Now about the only flexibility that i am aware of losing is bending sideways while sitting to pick something up from the floor beside my chair. Just can't do that anymore at all...

Oh... nor can i vacuum.... I mean... I CAN vacuum, but then in a couple of hours i'm reallllllllly regretting it because of the pain in my upper back. So i'm holding out for a riding vacuum ;)

[bonjour]

20 minutes sitting is the maximum in a "normal " chair ,but if i 'm on a higher chair ,or bar stall a little longer aslong as it has a cushion.reclining and cuddling up as before is not at all confortable any more ,so i don't even try :cool:
i 'have been told that i should never anymore by able to cut my toe nails so thats that ,i need someone to helps for that well why not! :o

[Linda G]

I am now 6 months post-op and fused from T-9 to sacrum. As I have healed I find that my flexibility gets better all the time. It has not been a big problem. Of course in the beginning I couldn't shave my legs or put on socks and shoes but that is now in the past. Since I fell and broke my hip in Feb I have had more problems with that than my back surgery. The pain prior to surgery is completely gone and I am so happy I did this. If I have gotten results this good at age 63 then those of you who are younger will do great. Of course I give all the credit to my doctor Alexis Shelokov.
Linda G.

[KI Jane]

It was good to read all the comment about what is and is not possible with a long fusion. Of course everyone is different, but it would be so helpful to me to know what is likely to be possible at the end of a year and what I should not be hoping for. It affects my planning ( I am an inveterate planner.)

Both the doctors I saw strongly recommended the long fusion, but I am at an advanced age.

[berta@aloha.net]

Linda G, you give me hope to be able to do more as I heal!
I am just over 2 months post op, fused to the sacrum, and can only reach to my knees without worrying that I'm going to pull something wrong, etc. So my husband puts mositure cream on my legs and bought an electric shaver to shave them for me, and my daughter cut my toenails. But, I hate not being able to do those things for myself! And at the hairdresser, I was thinking of having her put on my color and then going home to rinse it out since there is no way I can bend back to have that done.
When will I be comfy reclining or sitting for a long car or plane ride!?

Here's hoping I'll be able to do more and more as time goes on!

PS Linda, did you wear a brace, and if you did, for how long?

[Theresa]

Bertha,

It does get better!!! I started getting pedicures after my first A/P surgery. It was a little uncomfortable in the chairs at first but the ladies would put padding behind my back to help me out. That's one little bit of pampering that you need to do for yourself.

I flew for the first time at 4 months post op. It was about a 3 hour flight. I had the flight attendant get me a handful of the little pillows to tuck in different places.

On the car trips we started off with just an hour to two hour trip. Of course, again pillows, and recline the seat. That was about 3 months.

I also switch to an electric razor right after surgery for a few months. I find it's a little easier to put your foot on something (not to high) and to shave sitting down. My husband would get the ankle area.

Sometimes it's better to look at want to can now do versus what you were doing a few weeks ago. I know when I kept looking ahead it seemed so far away!!! That was pretty depressing, it seemed like time didn't move at all. That's when my family got me to switch it around and say, "WOW, I couldn't do this last week."

Try to take it one day at a time. I know it's hard!!!! This is my third recovery period and I am really hoping it's the last!!!!!

[berta@aloha.net]

Theresa, boy you have been thru the mill! Is a pedicle substraction osteotomy where they take out a screw? How did you know when that was needed? Did you have a certain type of pain?
You have such a positive attitude for having to have gone thru so many surgeries! And you are even fused further than me and you can do so much, so I DO have hope. Thanks! And looking at it from "how much more I can do now" attitude is so great.
(it's Berta, short for Roberta, not Bertha!)
PS did you wear a brace?

[Theresa]

Hi Berta,

Sorry about the wrong name!!!! A pedicle subtraction ostertomy is where they cut the pedicles off of both sides of the vertabra and cut a v shaped wedge of bone out of your spine. Kinda like cutting down a tree. This last time the wedge was thicker on one side that the other to also try to derotate me some more. Here is a link (http://www.spineuniverse.com/displayarticle.php/article858.html) to describe the different osteotomies. You know when your balance is off. You end up having flatback (http://www.espine.com/flatback.html), that's where you cannot stand up straight without your knees being in a bent position. I was trying to find a picture.

No, I don't wear a brace. My doctor's say that sometimes it hinders your recovery. They want me to use and rebuild my back muscles. I had alot of muscle atrophy due to being curved for so many years.

I knew from the first surgery that something just didn't seem right. I used a walker for about 4 months, then a cane for the rest of the year. When the first osteotomy was done in June 05 I felt better. But you could tell my balance was still off somewhere. It wasn't alot. My doctor was hoping it was due to muscle imbalance and in June 06 I started strengthening PT for about 7 months. It didn't help and I was getting worse.

This time, I look straight from the side. My legs are in a straight line with my head. I feel upright!!!!

Today is 2 weeks from the surgery!!!! I can't believe that only last Monday we were trying to drive home from Amarillo to Houston. It's a 9 hour trip. We did it in two 4 1/2 hour days.

Last night I cooked dinner! My husband was cleaning the carpets and we had some leftover roasted chicken from the grocery store. I had him get me a pot out, I cooked up some rice, put in the chicken with some cream of chicken soup, some celery, onion, and pepper and put it in the oven with some cheese on top. It felt good doing that. I am alot slower at doing things, like instead of 30 minutes it took be about 60 minutes to prepare because I stop and take little sit down breaks.

I also try to stay out of my bed during the day, with the first surgery I used my bed all the time for rests and eventually got to the point that when it was bedtime your body was only thinking it was going for a rest. Now I rest in my son's room and keep mine only for sleeping. In order to get through this, you need to make sure that you get at least 8 hours of sleep at night. If you are having any troubles with that, let your doctor know and they can give you a mild sleeping pill to get you back in the routine.

We are hoping that this is the last surgery so we can continue our plans to go to Hawaii. We were suppose to go on our 25th anniversary but weren't able to. We are now coming up on our 32nd anniversary and were still shooting for it. Maybe one day we can meet over there.

[berta@aloha.net]

Theresa,
Thanks for all the info. That explains a lot to me. I am lucky so far that my balance is good. At first, when I stood up straight, it felt like my butt was sticking out too far, but my surgeon said that it just FELT like that since I was not use to a correct posture. Now it feels right. He had said I was balanced with my head directly over my body, and my hips were level, etc. (he was pleased with "his work", you could tell) I'm sure we had different issues, since I had a larger curve and rotation at the lumbar area and less thoracic.
For some reason my surgeon wanted me to wear a brace for 3 months or so, to keep me from twisting or bending during the initial healing time. It's very hot to wear here in Hawaii, and I can' wait to start my weaning time. I guess he will let me know after my next x-rays in a couple of weeks.

Yes, please look me up in Hawaii if you get to the Kona side of the Big Island! It would be great to meet up and compare notes. Hope you continue to heal in a good way, and I'm glad they finally got it right!

Take care! Berta

[Linda G]

Just don't get overanxious on what you can do. I was able to start shaving my legs at about 4 months, put on and tie my shoes at about 5 months, pantihose about 5 months. As for riding in the car since I broke my hip at only two months out of back surgery it has taken me a long time to be able to ride comfortably for any distance. I have not gone further than my doctor's office which is about 15-20 miles from where I live. I sit mostly in straight back chairs as I find them much more comfortable that the recliners. It may seem like all of this takes a long time but each little thing is a BIG victory. Getting out of my brace was scary but also wonderful. That was at about 4 months. I had 6 disc replaced so I will be wearing my bone growth stimulator 4 hours/day until Sept. No biggie on that. I still get tired and can't go quite as long as I use to but I am sure my energy levels will improve as I continue to wean off the pain meds and build my walking distance up to three miles per day. As for housework, I can do the laundry, make the bed, cook meals etc. Things like scrubbing the bath and vaccumming the floors are still my husbands job. All in all I believe I am doing just great and I love my new straight look. Attitude is critical also. For me prayer was a big part of it all. If you go into this knowing that it is not an overnight fix then you will do fine.
Linda G.

[bbest]

Berta,

I agree with Linda G. Don't worry too much about what you can and can't do. I find that it isn't so much that I can't do things, it's just that I have to new ways to do them. ;)

There was an old thread on haircoloring. A bunch of us, ahem, enhance our hair color from time to time. I found it was easiest to do my own coloring at home for the first few months after surgery and rinse it off in the shower. That way there's no bending or reclining to worry about. Also, I feel naked without polish on my toes. My mom did mine for me for the first few months. I am able to do my own now although, like I mentioned earlier, I had to find a new way to do it. I sit on the edge of the toilet and prop my foot up on a stool. Works great for me!

[kardoid]

Hello everybody, well im in the works of prob. getting a fusion from T11 to sacrum, im a bit scared of the limitations it will prob. give me... but reading all this gives me hope and pushes me more to do it... I was wondering what prob. are there while getting up from bed can you sit up like u normally would or is it tougher? .... The dr. was telling me that due to the curve and how rigid my spine is there will not be too much correction so that really disappoints me.. and he also tells me that there is no guarantee that my back pain would go or that i can get better so all that makes me think.. if i should do it or not? did anyone have this same prob. and at the end go for the surgery?

ur help is greatly apreciated

thank
Ivan

[Theresa]

Hi Ivan,

When I was reading back on my first pre-op papers the doctor said my spine was pretty rigid and that I would not get much correction, only a holding correction. Once he got in there, he found my spine pretty flexible!!! You just never know until they get in there.

Getting up out of bed is different for me. I used to just sit up then get out. I now log roll to get out of bed. You roll to your side and as you swing your legs down you raise your upper half to a sitting position on the side of the bed.

Also, the doctor's can't gaurantee anything really. You could be trading one kind of pain for another. But on the other hand, you could be like alot of people on here and be pain free. So far, I am not one of the lucky ones. I am hoping as I get over this surgery that my pain will be less.

[kardoid]

Thanks Theresa for your reply, i can imagine that it takes a while to get use to but hopefully all that pain that u talk about gets better too so did u gain any height too? or is ur figure diffrent than before too?

[Theresa]

This surgery I actually did gain about an inch back in height!!!! Yes, my figure is different. With flatback your bottom is kind of tucked under. I now have a rounded bottom again. As your swelling goes down you will find that your clothes will probably fit different. A lot of my tops were to big after the surgery. I use to get them a little bigger because of the rib hump on the back. I didn't wear anything that was fitted because of it. Now I do!!!