T10-Sacrum recommended-yikes

[leahdragonfly]

Hi everyone,

I have been struggling with back and left leg pain for over 2 years. I saw three surgeons 2 years ago and it was felt that I could get by with a L4-L5 fusion extension (I was previously fused L5-S1 when I was a teenager for high-grade spondylolisthesis). I had some improvement with PT and decided to try and hold off. I went back for a follow-up and new x-rays last week because PT is no longer helping, and my symptoms are progressively worse. Dr Hart at OHSU called today to say he had studied my films and MRI in detail, and he now recommends fusion T10-S1 with bilat. pelvic fixation. I have a ~40 degree lumbar curve with lots of degenerative changes as well as spondylolisthesis at L4 and lateral slippage at L3 and L2. I knew this was a possibility, but I am just staggering here at the thought of this.

This news also comes at a horrible time, since my daughter is having VBS in less than a month.

I would love to hear from anyone with a similar fusion, any encouragement you can offer, as well as info about recovery time. Also, I was told I would be on a vent overnight the first night, and I am just terrified about this, since I am a nurse and have cared for many vent patients. Does anyone have any memory of being on the vent post-op?

[Vali]

Hi Gayle, I am fused T11-S1 and at nine months post-op. I have had a real good recovery (knock on wood!). I was off pain meds at day 15 and my surgeon remarked how ell i was doing at the 8 week mark! Don't get me wrong, there were times when i struggled a bit, but overall it was very do-able. I had the same pain as you. I had been having spinal injections since December 2006. Overall, as i have said before on here, 'it's not a walk in the park but it's not that bad either'! I thank my surgeon very much for giving me , no pain, a great posture and my social life back! If you have any further questions, please ask.

[Pooka1]

Oh Gayle so sorry to hear that! What a shock!

Can I just ask if one of your symptoms was not being able to stand longer than a few minutes?

Can I also just ask if they thought some of the damage to your spine might be due to the hypermobility syndrome? Both my kids have that diagnosis for now and one had terrible pains in her hips during PE and the other is getting terrible pains in her knees withOUT being in PE. I have to wonder if their lax ligaments are allowing major damage to all their joints.

And I want to wish you and Leah well for the VBS. I bet that will pan out for her.

Best regards,
sharon

[jrnyc]

Hey Gayle
just saw my surgeon today.. (my thread-"greetings from NYC")but i've known all along i need L4-sacrum with bilateral pelvic fixation...today my surgeon agreed to do minimal invasive...side and back incisions, "poking method" in back...less muscle cutting, less blood loss, etc...
i have 42 thoracic and 61 lumbar curves...with degenerative disc disease, rotation, spinal stenosis, listhesis of L3 on L4 and L2 on L3, spinal arthritis...and now find out i need some osteotomies and lamenotomies or ectomies or whatever they're called...and a few other things i was too exhausted to listen to...i went to NYC from CT and came straight back...listening to the surgery one needs can be....draining!

i think you and i need very similar surgeries...

best of luck in whatever you decide...i've been getting pain management shots for some years now...little help, except the botox shots in thoracic...nothing is helping lumbar though...

jess

[LindaRacine]

Hi Jess...

I want to make sure you understand that your scoliosis curves are not being addressed by the surgery you described. That's not a bad thing, however. Dr. Berven at UCSF has been doing this type of surgery on some individuals for a little while. In the "older" people who would normally require long fusions, he's addressing only the segments that are specifically causing pain. As far as I know, nothing has been published on the topic. The thought is that these patients should have an easier recovery because of the much shorter fusion, and that the worse case scenario is that they end up having to have revision to fuse the same levels that they would have fused if they had done the full fusion in the first place.

By the way, I always recommend that patients bring a spouse, friend, parent, or child with them to surgeon appointments. It can be a pretty overwhelming experience, and I can't tell you how many times people haven't gotten all the facts, or have misremembered what they were told. Since you were feeling a little overwhelmed, you might want to call the office and request a copy of the dictation.

Regards,
Linda

[jrnyc]

Hi Linda
no...i am not aware of it not addressing my curves and fixing the scoli problems....since Dr Lonner would be placing rods and screws...i figured the rods will do their straightening work...i dont understand what you are describing...???
i do not need thoracic fusion...all the fusion i need is L4-sacrum and T11-sacrum...not anything higher...so how would i not be having the fusion i need? 5 scoli surgeons have all indicated the same areas in need of fusion...all are in agreement....

Dr Lonner is sending his dictation to my G.P. and to me...at my request

could you clarify...cause Dr Lonner was talking about straightening my spine...he clearly said that to the doctor visiting him....

jess

[LindaRacine]

Hey Gayle
just saw my surgeon today.. (my thread-"greetings from NYC")but i've known all along i need L4-sacrum with bilateral pelvic fixation..

Hi Jess...

You didn't mention the T11-sacrum fusion in this post. :-) L4-Sacrum is only a 3 level fusion. T11-sacrum will address your lower curve.

Regards,
Linda

[jrnyc]

oh...whoops...well, that is where the rods are supposed to go...always were...the debate was how they were gonna get there

thanks for pointing that out to me...
i got worried for a minute...never would i go thru all that surgery and not address the scoli...all or nothing i say...fix the curves, fix the discs, fix it, fix it, and try to get it one time around!

now it isnt clear "when," this will happen.... but the "if" it will happen part doesnt look quite so "iffy" right now...

thanks again...
jess

[mamandcrm]

Not knowing anything about fusion, I of course don't have any advice for you but just wanted to say I'm sorry to hear that you have to have more on your plate right now. But it sounds like there are folks here in the surgical threads who can inform and reassure you about what's ahead of you so that's good. Best, Chris

[titaniumed]

Hi Gayle

Wow, with your daughter up at bat, I guess you can only take things one day at a time right now.

The kids do so well, its amazing. Try not to worry too much, things will be fine.

I was on a ventilator for a few days, I have no memory at all about that. My surgeon woke me up once on day 2, after my anterior, to ask for permission to continue on my posterior, which is mandatory, and was awake for about 1 minute.
The ventilator wasn’t an issue at all for me.

Ed

[leahdragonfly]

Thanks for the replies!

Sharon,

I didn't remember to ask about the relation between hypermobility and my degenerative problems, but I know my physical therapist certainly thought it was the cause of my excessive spinal and neck arthritis at a young age. I will try to remember and ask this question. I unfortunately did high-level competitive gymnastics for 9 yrs as a child, which I know did not help my back!

Vali,

I was hoping you would write. I know your surgery was similar. My question to you, at what point would have been or were able to return to a light-duty job? My work will let me come back and have very light duty--sitting mostly, although able to stand and move around frequently. Is this possible at the 3 month mark do you think?

Ed,

Thanks for the info about the vent. So do you remember coming off the vent and having the ET tube removed? I know they have to let you awaken enough to breathe well on your own before they do that. Do you know what they used to keep you snowed for the several days on the vent?

Thanks,

[Vali]

Hi Gayle, sorry but i must have missed your post earlier today. I don't think you would have any problems returning to work at three months in the 'light duty' role you have explained. It's also good to read that your employer is willing to accommodate you (stand up and walk around as required etc.) The only way it could be a problem, would be if you were still on strong pain meds. I am self employed and have a home office. At 7 weeks post-op, i thought i would try to do a couple of hours work (my BAS was due July 28),
but found myself getting tired after half an hour. Make sure you do the right thing and listen to your body for the first 3 months and you should be ok. If you have more questions, just ask.

[fierceliketiger]

I have a T-10 to pelvis fusion. I was not on a vent, though it was a concern. I have asthma and have had problems coming out of anesthesia before, so it was talked about.
I mostly posted because I have ligamentus laxity, and while they said that the hypermobility could have contributed to my scoliosis getting worse, I was also able to obtain a better correction/more height because they could stretch things further than they can with most other people.