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Thread: Fusion last year; Thoracoplasty this year!

  1. #1
    Join Date
    Aug 2006
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    46

    Fusion last year; Thoracoplasty this year!

    Hi everyone,

    I had a spinal fusion last summer (late June to be exact) and although the correction was great, I have opted to have a thoracoplasty this summer (May 20th to be exact). I know there a lot of threads about thoracoplasties, but every case is different and they aren't really fully answering the questions I have. Of course I have spoken to my surgeon about this, and will ask him any last minute questions, but any insight from experience would help a lot!
    My surgeon didn't think I would need a thoracoplasty last year when he did my spinal fusion, so he did not do it. I healed well and the recovery was quite fast. I had it in late June and was ready to start my third year of college after 2 short months. I'm 20, so I'm glad I opted to do this while I'm young. For some reason, it seems like my rib hump has gotten bigger after the surgery. Does anyone else feel this way as well? From research I'm guessing that it is normal because muscles are relaxing again..? I just know that my rib hump was really reduced after my fusion, and now it is becoming more and more noticeable. Also, for the women--do you feel as though your rib hump is more noticeable during your menstrual cycle? Is there any connection between that? Because that's when I notice mine the most.
    I want the thoracoplasty because from my understanding, the rib hump will be gone (although not completely) and won't come back since my spine will not have any chance of rotating due to the fusion and the rods. I'm correct in this, right?
    I'm having the surgery on May 20th, and hope to be back and ready for my senior year of college by mid-August. My surgeon said recovery isn't as bad as the spinal fusion, and it's a different type of pain that I'll be feeling. I know it will be weird/painful to breathe for a while. For anyone who has had the surgery- what kind of pain, exactly? Can you breathe normally and just have a hard time taking deep breaths? I would love some insight into this, and what your recovery process was like, what you could/couldn't do, etc.
    I'd be happy to answer any questions about the fusion!

    Thanks everyone!

  2. #2
    Join Date
    Jan 2009
    Location
    Ames, Iowa
    Posts
    1,250
    Hi--
    I was really interested in your post since I don't see this area addressed much. I have the same thing but am much older than you so I doubt I could do anything about it. Likewise, mine seemed so much better than before surgery. Then, about 3 months ago I thought the right hump was getting bigger. The whole back area looks worse with such a big dip in the middle and caved in left side. I asked about it at my appt. last week and Dr. Lenke said it could have "popped up" a bit but he didn't think it would get any worse. He doesn't seem inclined to do thoracoplasty due to lung function problems. I'll be interested to see how you do with this. Good luck! Janet
    Janet

    61 years old--57 for surgery

    Diagnosed in 1965 at age of 13--no brace
    Thoracic Curve: 96 degrees to 35 degrees
    Lumbar Curve: 63 degrees to 5 degrees
    Surgery with Dr. Lenke in St. Louis--March 30, 2009
    T-2 to Pelvis, and hopefully all posterior procedure.

    All was posterior along with 2 cages and 6 osteotomies.

  3. #3
    Join Date
    Sep 2006
    Posts
    143
    Janet, Would you still say that your back looks better than before surgery?

  4. #4
    Join Date
    Sep 2003
    Location
    NJ
    Posts
    1,291
    After surgery the back is very swollen for many months. When the swelling goes down I wonder if the hump becomes more noticable/
    Original scoliosis surgery 1956 T-4 to L-2 ~100 degree thoracic (triple)curves at age 14. NO hardware-lost correction.
    Anterior/posterior revision T-4 to Sacrum in 2002, age 60, by Dr. Boachie-Adjei @Hospital for Special Surgery, NY = 50% correction

  5. #5
    Join Date
    Aug 2006
    Posts
    46
    Karen, I never could tell that my back was swollen after surgery, but I was expecting it to be that way from what I had heard.
    My back looks better than it did pre-op, but the rip hump is still noticeable and it is still uncomfortable sitting across a straight backed chair.

  6. #6
    Join Date
    Jan 2008
    Posts
    111
    Hi, I had two thoracoplasty operations at ages 39 and 43. The first involved 6-7 ribs and the second 3 ribs on the right side. I had previous fusion without rods at age 17. The surgeon was unable to straighten my spine during a reconstruction attempt and then did the thoracoplasty. I recovered well and did not have any problem with shortness of breath. I did have a pleural effusion in the hospital and responded well to breathing treatments. At home, I was very sore for about 1-2 months, but was thrilled with the cosmetic results. Moving my right arm caused soreness as my muscles were tender. All the soreness eventually went away. I think that by August you should be fine to return to school. Be careful lifting and carrying heavy books. Use a book carrier on wheels if need be. In spite of low lung volumes later in life, now age 65, I would make the same decision again because of the significant change the surgery made in my self esteem and in my social and work functioning. I wish you the very best.

  7. #7
    Join Date
    Jan 2008
    Posts
    111
    Oh, just adding. I do have shortness of breath on exertion issues now at age 65. Just wanted to give the full picture.

  8. #8
    Join Date
    Apr 2010
    Location
    Waterloo, IL
    Posts
    1,690

    rib hump reduction following surgery

    Do most people have a significant reduction in their rib hump following fusion just by the derotating of the spine? I don't think Dr. Lenke likes to do thoracplastic surgery, but since I'm going to be in pain anyway, I am going to bring it up at the post operative appointment. I hate the looks of the rib hump and want it gone but naturally the decision will be Dr. Lenke's.
    Karen

    Surgery-Jan. 5, 2011-Dr. Lenke
    Fusion T-4-sacrum-2 cages/5 osteotomies
    70 degree thoracolumbar corrected to 25
    Rib Hump-GONE!
    Age-60 at the time of surgery
    Now 66
    Avid Golfer & Tap Dancer
    Retired Kdgn. Teacher

    See photobucket link for:
    Video of my 1st Day of Golf Post-Op-3/02/12-Bradenton, FL
    Before and After Picture of back 1/7/11
    tap dancing picture at 10 mos. post op 11/11/11-I'm the one on the right.
    http://s1119.photobucket.com/albums/k630/pottoff2/

  9. #9
    Join Date
    Jan 2009
    Location
    Ames, Iowa
    Posts
    1,250
    Joyfull--Yes, it looks better than before surgery mostly because I've been stretched out and it took away the squished rolls, etc. I'm sure initially swelling covered up some of the imbalance. But it was at about 10 months that I really noticed it being bigger and lop-sided compared to the other side. I too have a lot of discomfort sitting back on any hard surface. It wasn't so much a few months before that. Janet
    Janet

    61 years old--57 for surgery

    Diagnosed in 1965 at age of 13--no brace
    Thoracic Curve: 96 degrees to 35 degrees
    Lumbar Curve: 63 degrees to 5 degrees
    Surgery with Dr. Lenke in St. Louis--March 30, 2009
    T-2 to Pelvis, and hopefully all posterior procedure.

    All was posterior along with 2 cages and 6 osteotomies.

  10. #10
    Join Date
    Mar 2009
    Location
    Sacramento, CA area
    Posts
    189
    Quote Originally Posted by curvycakes View Post
    For some reason, it seems like my rib hump has gotten bigger after the surgery.
    Hi,
    That is why I am planning on having a thoracoplasty at the same time as my fusion. I have heard that the hump can be reduced significantly just with the fusion/rods alone but I am extremely uncomfortable (physically as well as emotionally) about my back rib hump. My surgeon has a lot of experience doing them and has seen excellent results. I hope you have excellent cosmetic results from your surgery!
    Laurie
    Age 57
    Posterior fusion w/thoracoplasty T2-L3 Oct 1, 2010
    Thoracic curve corrected from 61* to 16*
    Lumbar curve, unknown measurement
    Disfiguring back hump GONE!!
    Dr Munish Gupta
    UC Davis Medical Center, Sacramento, CA

  11. #11
    Join Date
    Oct 2008
    Posts
    10
    Hi curvycakes,

    I had my fusion about two years ago and I too feel very uncomfortable with my appearance. I would like to get a thoracoplasty at some point but do not know which surgeon to even go to. I can't seem to find a lot of information on the web. The surgeon that did my surgery was uncomfortable with doing thoracoplasties so looking back on it, I probably should have gone to someone else in the first place. He told me I wouldnt need it anyways bc he could get a good correction without it. Anyhow, I still have a significant hump and my shoulder blade sticks out and bothers me. I can't wear tanktops or tight shirts. It's also uncomfortable sitting in hard chairs since only my right side rests on the chair. Can you keep me updated on ur journey? Thanks so much

    Pooh

  12. #12
    Join Date
    Mar 2010
    Location
    Midwest
    Posts
    106

    Revision for adolescent

    Hope all goes well fro you al.

    l Thanks for all the past support.

    Now that my daughter has begun to recover from her third and second revision surgery, I can calm down. She seems to be doing very well -looking and acting healthy so much better than between the 2 and 3 rd surgeries when the infection was brewing. It is a puny infection but loves to be around metal and plastic. Despite the wait time, she had no ill effects!!!!!!!!!!!!! We had all hoped it would be over but her back has gone back maybe worse than it was prior to the first surgery.

    We were going to get second opinions and go out of state but she wasn't feeling like she wanted to go through more medical exam rooms ect.
    So we have a visit the end of the month. She wants to have it done, timing is the only issue. I don't think her doctor who has a good reputation and who we like despite some bumps along the hospital road realized this would be happening. He acted very surprised and almost shocked as she laid out her reasons for a 4th surgery. She is pretty medically aversive. Hates drains,blood draws, and in the beginning never talked. Her back did change from one week to another from discharge to the day at the office. I am afraid that the doc will consider us "bad news". It would be wonderful to have the girls have the same back again. Anyone think this should be a concern or am I overthinking it all?

  13. #13
    Join Date
    Mar 2010
    Posts
    2,755
    I think you are being a mom. Your daughter is very brave to be wanting a 4th surgery with all of the problems she has had. She must have very good reasons for wanting this done. I guess all you can do is support her, unless for some reason you don't want her to go through with it. If she is determined to have it done, she will recover much easier now than if she waits until she is an adult. I wish your family the very best outcome. You have very specail daughters. I'm just so sad to hear that things went so badly for the one. I'm sure she will be fine being in the hands of a doctor with a good reputation. I'm sure he will be EXTRA careful for the 4th procedure.

    Best Wishes

  14. #14
    Join Date
    Oct 2009
    Location
    PA
    Posts
    798

    humps and insurance coverage; appearance in "older women"

    Did any of you have difficulty getting insurance coverage for your thoracoplasties?
    I can see an argument being made that it is a largely cosmetic procedure, especially if it causes functional problems, if only in later life?

    One surgeon I specifically spoke to about reasons for fusions, etc (I have a hump and brought it up) said that cosmesis - appearance - was NO reason to have the surgery. Maybe he was specifically referring to women my age (64) or maybe he meant, in general. (I have noticed a number of doctors blowing off concerns with appearance in women my age. NOT that appearance would be the only reason I'd want the surgery).

    Anyhow, back to the insurance question. I can see MEDICARE objecting especially if it compromises pulmonary function, and in fairness there IS a difference in changing appearance in a young woman in her twenties as opposed to one in her sixties.

    Still, I'm not out of the game left, and frankly, as a single, I find men tend to look first and only find inner beauty later! It's hard enough to meet "good men" when you're older without adding this problem. I am fairly attractive and youthful for my age, except for the scoliosis which has caused poor posture, shrinkage and the hump. (Also, to be holistic, I'm sure it changes my expression too, as I'm often in pain.). Until this developed I was usually taken for a woman a decade or more younger. Not any more!

    I don't want to take any really dumb medical risks without a good reason, but I think appearance and the self confidence that results, matter at every age.
    Not all diagnosed (still having tests and consults) but so far:
    Ehler-Danlos (hyper-mobility) syndrome, 69 - somehow,
    main curve L Cobb 60, compensating T curve ~ 30
    Flat back, marked lumbar kyphosis (grade?) Spondilolisthesis - everyone gives this a different grade too. Cervical stenosis op'd 3-07, minimally invasive

  15. #15
    Join Date
    Aug 2006
    Posts
    46
    Back-out---The insurance matter is a really good question, one that I also have been wondering. When I talked to my surgeon about it, he didn't mention anything out of the ordinary about the insurance issue. In all fairness, I do have pain associated with the hump. However, another main reason I am going through with it is because of the cosmetic deformity. Couldn't a case be made for the mental health issue regarding the matter? Psychologically benefiting since the disease can effect you psychologically? I don't know. I understand your reasons for wanting to go through with it though! I'm sorry you're facing the things you are regarding this. Hang in there!

    Pooh, I cannot find a lot of information either. Every time I type "thoracoplasty" it tells me the word is not located in the dictionary and there is a little red squiggly under the word as if it's mispelled! No information anywhere! Haha, it's a little discomforting. I didn't know who to go to either because I didn't think my orthopedic surgeon performed thoracoplasties since he was so against it during the time of my fusion. I understand his reasons for not liking to perform this type of surgery though. Anyway, when I went to talk to him about this a few months ago he was hesitant, but understood my reasons for this. So he's going to do it. I would feel most comfortable with him performing it anyway since he did my fusion. So maybe you can go back to your original surgeon and talk about your reasons? I will definitely keep you updated though!

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