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Anyone heard of 3 incisions?

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  • Anyone heard of 3 incisions?

    Hi, I am new at posting but have been reading for over a year now. After advancing 3 more degrees in the past year (I'm now at 75 *-thoracolumbar) I've decided the fear of being doubled over in 10 more years scares me more than this huge surgery! Plus at 54, the odds of staying healthy are diminishing! Anyway, my surgery is scheduled for 8/5/08 (after my son's wedding in June) with Dr. Shelokov in Plano, TX.

    Has anyone had 3 incisions with their surgery? They are proposing the left flank, the back (of course) and the lower abdominal area, all for better access to the vertebrae. He will be fusing T-9 to the sacrum, so maybe that's why. I didn't really ask him, but I need to.

    Reading everyone's experiences has helped so much already.

    Thanks,
    Betsy
    Betsy

    Age 54, Scoliosis diagnosed at age 13, never treated (curve minimal, surgery was not recommended)
    Thoracolumbar curve now 75 degrees, advanced 18 degrees in past 10 years
    A/P surgery, with fusion from T-9 to Sacrum, scheduled for 8/5/08 with Dr. Shelokov/Plano, TX

  • #2
    Hi Betsy,

    Your curve appears quite similar to mine. One of the surgeons I consulted last year proposed A/P fusion from T2 to the sacrum with iliac bolts and an added anterior lumbar interbody fusion (ALIF). That would have meant three incisions – the anterior, the posterior and an incision above the pubic bone for the ALIF procedure. My curve is now at 80º and when I saw a comparison of my film from one year to the next, there was a very noticeable progression. Like you, even though I still have only minimal discomfort from time to tome, I fear my fate 10 years from now if I remain untreated. Good luck to you.

    Chris

    Comment


    • #3
      Becky I was fused from T4 to the sacrum in December. They only used a posterior approach and they used the bone harvested from my spine as well as BMP so they didn't need to harvest from my hip. I think you will have 3 incisions because they are going in from an anterior approach, a posterior approach and my guess the 3rd incision is to harvest bone from your hip. You might ask your surgeon if they can use bone harvested from your spine instead of your hip. One less incision and one less injury to have to heal. Just a thought.

      I have been told that sometimes surgeons just do what they are familiar with, so both anterior and posterior....just posterior...hip bone harvesting..etc. One isn't necessarily better than another, just what they are used to doing. I would at least ask about not having bone harvested from the hip if it isn't necessary.
      Good Luck,
      Alicia
      Geish
      47 years old, dx at 13
      +30* to the right, +60* to the left, +30* to the right
      Surgery 12-13-07 - fusion from T4 to sacrum.


      http://www.scoliosis.org/forum/attac...tachmentid=267 Pre surgery
      http://www.scoliosis.org/forum/attac...tachmentid=268 Post surgery
      http://i156.photobucket.com/albums/t...s/DSC01091.jpg Xray from the side
      http://i156.photobucket.com/albums/t...1089-1-1-1.jpg Xray from the back

      Comment


      • #4
        Hello Fellow Texan,

        I can't help you with the 3 incisions, just wanted to say hi. I have also been to Dr. Shelekov for an opinion/consult. He proposed posterior only because my structural curve is high thoracic. I have also been reading for a while and just started posting. I am still at the stage of trying to figure out who(doctor) and when. I haven't taken that next leap of faith to make a decision and book it. This forum has been so helpful as I head down this path. Good luck to you and I wish you well.

        Mary
        64-T
        40-L
        Mary
        T-64
        L-40
        Wore Milwaulkee brace from 6th grade until 11th grade. Surgery was scheduled Oct. 1983, did not go through with it.

        Comment


        • #5
          Yep, Thats what they're planning for me. Anterior done 1st. 2 incisions 1 from side 1 in front, that is with ALIF at L2-3, L3-4 and L4-5. Second surgery would be posterior T3 or 4 to sacrum. I think it really depends on the condition of your discs and degree of curves along with what your Dr is most comfortable with.
          2 60* curves, DDD, left trunk shift, some rotation, rib and lumbar humps, annular tear at L5-S1
          surgery 5/08 planning fusion T3 or T4 to sacrum with iliac fixation
          Dr. Anderson at Rothman Institute
          5/16/08 ALIF L1-L5
          5/23/08 fused T2-sacrum w/fixation and I'm all Titanium
          6/4/08 open all back up to clean out for Staph infection
          (left open with just clear dressing)
          6/6/08 recleaned and closed
          3/30/2012 revision planned, broken rod and removal of iliac bolts

          Comment


          • #6
            I still can’t help wonder though if some surgeons get overly zealous in an attempt to fix our spines. Or is it precautionary so we don’t have to make a return trip to the OR every couple of years or so.

            Chris

            Comment


            • #7
              The more i read on this forum, the more i think i might have been a guinea pig for this surgeon. ..... I had 3 different surgeries, with 3 days in between each of them. The first one i had done "endoscopically" on my thoracic area from T4 down.... I had 5 incisions under my right arm... they went in between the ribs, deflating my lung and working on the discs from the front. Also i had an incision on my right front pelvic area where bone was harvested. The second surgery was in my abdominal area from 2 inches above my belly button down to pubic bone and another bone harvesting incision on the left side this time. The third surgery was the long posterior incision the whole length of my back extending even into my ( I don't know any other way to put this that's not embarrassing)... crack ... BOY those metal staples there HURT!!! And yet another incision on the front right for more bone harvesting..... 10 incisions all together... plus the incision in my neck for the main line IV.... Hubby said i rivaled Frankenstein... and walked like him too for quite a while. ... I thought more like Filet of fish...

              Both the nurses at the hospital and the surgeon's office nurses said they had never had anything like that before....
              Last edited by JoAnn5; 02-24-2008, 10:24 AM.

              Comment


              • #8
                Originally posted by JoAnn5
                The more i read on this forum, the more i think i might have been a guinea pig for this surgeon...
                The third surgery was the long posterior incision the whole length of my back extending even into my ( I don't know any other way to put this that's not embarrassing)... crack ... BOY those metal staples there HURT!!! (
                I have to tell you my incision goes all the way down too! My surgeon used 2 stitches total on a 22 inch incision. I was glued back together! I had one stitch at the top and another at the bottom. They were both removed before my 2 week check up by the visiting home nurse. No metal staples. 10 incisions seems insane. I just can't imagine having that many incisions. I'm so sorry you had to go through so much.
                Alicia
                Geish
                47 years old, dx at 13
                +30* to the right, +60* to the left, +30* to the right
                Surgery 12-13-07 - fusion from T4 to sacrum.


                http://www.scoliosis.org/forum/attac...tachmentid=267 Pre surgery
                http://www.scoliosis.org/forum/attac...tachmentid=268 Post surgery
                http://i156.photobucket.com/albums/t...s/DSC01091.jpg Xray from the side
                http://i156.photobucket.com/albums/t...1089-1-1-1.jpg Xray from the back

                Comment


                • #9
                  Dear JoAnn5,

                  I cannot imagine how you manage to log roll with so many areas to protect or what you choose to hold first when you have to cough or sneeze. Double high 5's to you for being such a surgical trooper! I had no staples and feel like a total whiner for ever complaining about my incisions -- the posterior T6-S1 that was opened twice and extends to my "crack" and the anterior which extends from the navel to the pubis. I am the first to tell people how beautiful I think my incisions are and how very grateful I am to only have the two of them to deal with. You are probably eligible for some special kind of NSF Forum Award for "The Most Incision Lines"! Sorry that you became eligible for the award. I hope you heal quickly and with invisible lines.

                  Linda W.
                  Linda
                  Two-stage A/P fusion T6-S1 with lumbar implants June 12 & June 27, 2007 at age 57
                  S curve 75+ degrees with kyphosis
                  Now 45 degrees and standing 3 inches taller!
                  Dr. Frank Rand, New England Baptist Hospital, Boston

                  Comment


                  • #10
                    Originally posted by JoAnn5
                    the long posterior incision the whole length of my back extending even into my ( I don't know any other way to put this that's not embarrassing)... crack(
                    When you require a fusion clear down to the sacrum, does that mean you're laying on the operating table with your whole butt exposed? Ugh!

                    Comment


                    • #11
                      Originally posted by CHRIS WBS
                      When you require a fusion clear down to the sacrum, does that mean you're laying on the operating table with your whole butt exposed? Ugh!
                      My surgeon joked that he left his initials tattooed on my butt! I would assume it was out there for the whole surgery team to see.
                      Geish
                      47 years old, dx at 13
                      +30* to the right, +60* to the left, +30* to the right
                      Surgery 12-13-07 - fusion from T4 to sacrum.


                      http://www.scoliosis.org/forum/attac...tachmentid=267 Pre surgery
                      http://www.scoliosis.org/forum/attac...tachmentid=268 Post surgery
                      http://i156.photobucket.com/albums/t...s/DSC01091.jpg Xray from the side
                      http://i156.photobucket.com/albums/t...1089-1-1-1.jpg Xray from the back

                      Comment


                      • #12
                        looked it up...

                        JoAnn--I looked it up, and the technical term for "crack" is "gluteal cleft." But hey, hardly anyone would know what you're talking about if you refer to it that way! My incision is 20" long, from T2-L4--and goes all the way down to my "gluteal cleft" (ha ha ha...) I had wondered about you gals fused to the sacrum... now I know! Ouch!

                        Chris--I believe they drape you and just leave the area they are working on exposed. So yes and no. Part of your butt would be exposed, but not all of it. And if you looked at Pam's pictures of her surgery, your skin is all painted up and you have clamps and things, so it's not like it looks "normal"-- plus there are just OR staff looking and they are watching for things other than how your particular butt looks... so it doesn't really matter.
                        71 and plugging along... but having some problems
                        2007 52° w/ severe lumbar stenosis & L2L3 lateral listhesis (side shift)
                        5/4/07 posterior fusion T2-L4 w/ laminectomies and osteotomies @L2L3, L3L4
                        Dr. Kim Hammerberg, Rush Univ. Medical Center in Chicago

                        Corrected to 15°
                        CMT (type 2) DX in 2014, progressing
                        10/2018 x-rays - spondylolisthesis at L4/L5 - Dr. DeWald is monitoring

                        Click to view my pics: pics of scoli x-rays digital x-rays, and pics of me

                        Comment


                        • #13
                          I can remember being wheeled into the OR just before that 3rd surgery on my backside.... The goofy juice must not have kicked in all the way yet... I remember seeing the table with the pillows / pad / whatever-you-call-it that i knew i would soon be draped over... and i said to the dr. " I want you to promise me one thing...." He said, "What is that hon?" I said, "That you all won't laugh at me with my big old butt stuck up in the air...." He said, "We never laugh at anybody"..... and then i faded out.... and couldn't have cared less!! lol.

                          Thanks for that technical term, Susie.... I must remember it for the next time my plumber comes to work under the sink.... hehehe..

                          Linda, thank you for your compassion!! It was 2 and 1/2 yrs ago now... and i've fully recovered... even had a revision surgery 5 months ago to remove the hardware, but it was nothing... only the long incision on my back again from top to 'gluteal cleft' and very quick recovery. That first one, though, was pretty rough for sure! The surgeon's nurse told me that i won a prize for having the most staples she'd ever removed at one time...lol..

                          Alicia, I sure wish my doc had used superglue!! lying on those metal staples and sitting on them..... whew.... not fun!!

                          Comment


                          • #14
                            Thanks, everyone, for your input! I do believe my disc degeration in the lower lumbar area is the reason for the lower abdominal incision. He didn't talk of harvesting from my hip, only my ribs. I've read and heard hip harvesting is definitely more painful and a longer recovery. It was just interesting because last year he only mentioned 2 incisions and this year it's 3. I guess every year they find ways to improve on their procedure. I just don't want to get up to 10 incisions, JoAnn! It's great to know you've done so well. I don't really even care about the scarring at this point, just the pain of being sore everywhere while trying to recover!

                            Good luck, MaryF and Chris, with your decisions. It is such a very tough one. On most days, I'm happy I've made the decision to get it done.

                            Thanks,
                            Betsy
                            Betsy

                            Age 54, Scoliosis diagnosed at age 13, never treated (curve minimal, surgery was not recommended)
                            Thoracolumbar curve now 75 degrees, advanced 18 degrees in past 10 years
                            A/P surgery, with fusion from T-9 to Sacrum, scheduled for 8/5/08 with Dr. Shelokov/Plano, TX

                            Comment

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