Posterior only vs. A/P?

[jrnyc]

one has a choice based on which surgeon one chooses..some do minimally invasive...some do not...
also..my surgeon gave me a choice of metals...and also is willing to try to stop at sacrum if i so wished...would go to pelvis if he thought it was unavoidable...

however, if i have the surgery..and i know it would be with him...i would take his word on metal and take his word on where to stop...i trust him....i like him....or i wouldnt have surgery with him...that's it.

jess

[titaniumed]

The anterior surgeries are complicated surgeries and they do these "releases" due to better access to the spine. Usually this is reserved for large lumbar curves. Some surgeons feel that the success rates for fusion are better by doing this.

I had an Ileus, which is an abdominal shutdown and happens when the intestines are touched. So, I was NPO, which means nothing through the mouth, and had an NG tube. They feed you through this tube, and ended up with large gall stones a year later and lost my gall bladder. This was due to the "superfood" they feed you in the hospital. Please remember that these things don’t happen too often, but can happen. They are called "complications", which everyone should be aware of before having scoliosis surgery.

My posterior was done 2 days after my anterior, so a 2 day stage. One of the things I would like to know is, how do surgeons decide the length of the stage? I don’t think I would like to wait too long, to get it over with. If I remember correctly, Doodie (Julie) had a long stage. I was awakened for 2 minutes by my surgeon for "permission" to continue on with my posterior, otherwise I was out in intensive care till my posterior.

Anterior surgeries also take longer to heal from....

I had no choice, had major degeneration, diseased bone, multiple herniations, and couldn’t control my pain effectively anymore. After 34 years, it was a battle I just couldn’t keep fighting.

Be sure to let us know what happens. The interview process or "hiring" can be quite a process..... Its nice to have multiple surgeons in agreement on the procedure, and many will give a second opinion. That’s why its nice to have digital x-rays to e-mail.
Ed

[Back-out]

Ed

If I remember correctly, Doodie (Julie) had a long stage. I

It's her surgeon I'm seeing at the end of June!

Boy, you've fought a long battle, Ed. Now you're bringing hope to so many with your results and attitude.

Appreciated!

You seem to take it so lightly, but it's clear all your successes were hard-won. Didn't know about your gallbladder surgery*, for instance.

Best,

*Er, how long was it after the spinal surgery, and is this a certainty after use of a N-G tube? How long was it in? Maybe better in a PM as it's unusual, I hope. You must have had a whole different specialty evaluate you for it, right?

[ADMoul]

Just to throw another factor in...I had a previous abdominal surgery years ago. Dr. Lonner did not indicate an a/p procedure for me which surprised me due to my large lumbar curve. I think there was concern about scar tissue from the old surgery making an anterior approach more difficult. I know if he has to do any follow-up surgery it would be from the front and he would bring in another doc to deal with moving organs. My corrections were not as dramatic as some, but am very happy with how I look and feel and just as glad not to have had an anterior approach. So surgical history can be another variable in this decision, too.

[Confusedmom]

Thanks for all the feedback!

I went back to see surgeon No.1 yesterday and got this explanation for A/P:

I have a stiff, 67 degree thoracolumbar curve with peak at L1. To get more flexibility down there, they need to take out discs. They have to do this from the front, although it can be done minimally invasively. In my case, though, he doesn't think mini invasive will work because he needs to get in there and pack bone where he takes the discs out. He says he thinks packing bone from both the front and back will help fusion and correction and I will get a better long-term outcome. So, the anterior part will be done just in the lumbar spine and the posterior will go from T4 to L4.

He also said he would do this in a single day, 12-hour operation. Reason is to reduce stress for me between surgeries. His partner splits it into 2 surgeries three weeks apart to reduce the "single load" stress.

All this makes sense to me, but I'm still going to get a third and fourth opinion!

Thanks again,
Evelyn

[titaniumed]

Evelyn

If you can get your surgeons assistants e-mail addresses, you can address specific questions easily. Phone calls do not work. This way they can answer at leisure. Give them a few days.

Ask where he will get the bone from for the grafts? If from the hip, will I have pain in that location?

Is leaving one level unfused really that beneficial? How much mobility will I gain? Would it be better to fuse all the way down to the pelvis? Will the unfused level give me problems 10 years down the road? What are the chances of a future revision surgery?

Will the anterior cut be vertical, or along my waistline?

What are some of the complications that can happen?

This will be the most important decision of your life, it deserves a few questions and some serious thought. Surgery is irreversible. You do have some time.

Ed

[Confusedmom]

Ed,

Thank you so much for taking the time to think through questions for me! You are so kind, and these are good questions. Believe me, I am giving it serious thought.

Just thought I would mention to you that my surgeon told me Thursday that he would like to use titanium with me. So I'm thinking that after my surgery I'll change my user name to "TitaniumEv." What do you think?!

Evelyn

[Debra JGL]

Hi Evelyn,
I was curious who is scheduled to be the surgeon for the 9/15 date, or what approach is planned? Also, what did doc #2 recommend? Sorry, if you already answered these questions in another post - I'm trying to keep up. It's great you are going to get some additional recommendations. It seems each approach carries with it different benefits and risks, and finding the one from a doctor you trust that you feel most comfortable is key. You may want to ask to how much additional correction would be gained, and how important is the anterior approach to a good fusion for you. Also, asking about any additional risks of increased operating time.

Just thoughts,
Debra

[titaniumed]

Evelyn

Your welcome. After all I've been through, I feel that I need to help when I can. Lately, I've been very busy at work, sometimes I cannot take the time to read so much anymore. I'm recovered now, and pain free.

LOL! We have threads here about user names for scolis, and there can only be one titaniumed or titaniumev. If you choose to change, I'm fine with it, I will change my user name to Rod Stewart! LOL

"Do you like my posture, do you like my balance, come on sugar, let me know"

That was pretty bad, I know. The disco period of the late 70s was a desperate period in music.

If you look at my x-ray, you will understand.
Ed titaniumed@hotmail.com

[Leanna]

Thanks for all the feedback!

I went back to see surgeon No.1 yesterday and got this explanation for A/P:

I have a stiff, 67 degree thoracolumbar curve with peak at L1. To get more flexibility down there, they need to take out discs. They have to do this from the front, although it can be done minimally invasively. In my case, though, he doesn't think mini invasive will work because he needs to get in there and pack bone where he takes the discs out. He says he thinks packing bone from both the front and back will help fusion and correction and I will get a better long-term outcome. So, the anterior part will be done just in the lumbar spine and the posterior will go from T4 to L4.

He also said he would do this in a single day, 12-hour operation. Reason is to reduce stress for me between surgeries. His partner splits it into 2 surgeries three weeks apart to reduce the "single load" stress.

All this makes sense to me, but I'm still going to get a third and fourth opinion!

Thanks again,
Evelyn

My doctor also said he would be doing my A/P in a single day which since I have found out I have been stressing about it. Not that it is a good thing at all... but Im glad to hear someone else shares his point of view. I was worried he may have lost his marbles Keep us informed what your other opinons state.

[Vali]

Evelyn, I had both A and P done on the same day. Mine took 6 and 1/2 hours to complete. I did not go to ICU as the recovery team said i came out of anaesthesia really well.

PS..My name on the Aussie forum is 'Rodverta Braefusion'!!!!!!

[Leanna]

Evelyn, I had both A and P done on the same day. Mine took 6 and 1/2 hours to complete. I did not go to ICU as the recovery team said i came out of anaesthesia really well.

PS..My name on the Aussie forum is 'Rodverta Braefusion'!!!!!!

Vali, this is really good to hear. I think my stress level just came down a notch or two

[jrnyc]

Hi Vali
wow..6 and a half?! my quotes for my surgery were more like 10 hours plus... i dont know if you had the disc "cleaning out" i need...but if you had cages, i'm sure you did..

glad you are doing well!

jess

[Vali]

Hi Jess, i have two cages at L4/5-L5/S1, (Should put that in my signature!)so i'm guessing they did the cleanup routine. The other thing is that my incision is like a caesarian cut, maybe smaller, as i can only invision that only a bubs head could come out and nothing more, so maybe time was saved there. Also, my surgeon was assisted by another Scoli surgeon. They help each other out when they have to do these big surgeries.

[jrnyc]

thanks, Vali...
the estimate for 10 plus was with A/P...now that it is to be minimally invasive side/back, i wonder if it would reduce the time by a few hours...or not..?
there's a question for the surgeon...who was waiting for my call last month!

jess