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Thread: pelvic fixation--separate incision or same?

  1. #16
    Join Date
    Dec 2009
    Location
    Bakersfield
    Posts
    80
    Aug.17,09 Anterior
    Aug.20,09 Posterior
    Fused T-10 to Sacral Pelvis
    Cedars-Sinai
    Dr.Pashman

    Sheri 47 years young
    Husband married 30 years
    3 kids 29,28,25
    4 grandkids 10,8,5,3

  2. #17
    Join Date
    Oct 2009
    Location
    PA
    Posts
    798
    First of all, your films look great for all I can evaluate!

    However, am I wrong in reading them to show that the pelvic fixation was only done on one side - Left?
    If so, is this usual?
    Also, how does this feel to you?

    Oops! I see the one-sidedness is the whole point of your posting the Xray links. Hmmm. You certainly are right that it's one side (left). And I guess you explained earlier that you had a special anatomic reason for having it done unilaterally.
    Guess that only leaves me with the one question - how it feels? Funny, I'd think this would make for an uneven pull. I assume with your age and bone density, that's not a problem.

    Best!
    Last edited by Back-out; 07-14-2010 at 05:38 PM.
    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

  3. #18
    Join Date
    Aug 2008
    Location
    Indianapolis, IN
    Posts
    416

    Wink Pelvic Fixation

    There is no separate incision for pelvic iliac screws. All done via the posterior incision. And you cannot feel them except for some hip aching during the initial recovery period. They are placed for extra stability.
    May 2008 Fusion T4 - S1, Pre-op Curves T45, L70 (age 48). Unsuccessful surgery.

    March 18, 2010 (age 50). Revision with L3 Osteotomy, Replacement of hardware T11 - S1 , addition of bilateral pelvic fixation. Correction of sagittal imbalance and kyphosis.

    January 24, 2012 (age 52) Revision to repair pseudoarthrosis and 2 broken rods at L3/L4.

  4. #19
    Join Date
    Jan 2008
    Location
    Oregon
    Posts
    1,162
    Thanks to all for the interesting comments and replies! The reason I originally asked was I read -somewhere- that separate incisions were required. So I am relieved to hear only one is needed.
    Gayle, age 50
    Oct 2010 fusion T8-sacrum w/ pelvic fixation
    Feb 2012 lumbar revision for broken rods @ L2-3-4
    Sept 2015 major lumbar A/P revision for broken rods @ L5-S1


    mom of Leah, 15 y/o, Diagnosed '08 with 26* T JIS (age 6)
    2010 VBS Dr Luhmann Shriners St Louis
    2017 curves stable/skeletely mature

    also mom of Torrey, 12 y/o son, 16* T, stable

  5. #20
    Join Date
    Sep 2003
    Location
    Northern California
    Posts
    6,801
    In most cases, fixation to only one side of the pelvis is adequate to do the job. I think it's just a matter of surgeon preference.

  6. #21
    Join Date
    Sep 2003
    Location
    Northern California
    Posts
    6,801
    Quote Originally Posted by sheri66 View Post
    Linda,I only have bolts on left side where the second incision is.On previous post I said right but meant left side.
    You still haven't changed my mind. I believe that your pelvic screw was put in through the main incision. It has to be connected to the main construct, so it seems to me that a separate incision would not make it any easier.

    Ask Dr. Pashman the next time you have a chance, and let me know.

    Regards,
    Linda

  7. #22
    Join Date
    Aug 2007
    Location
    florida
    Posts
    9
    My revision and the repair of L5-S1 (ALIF) was through the previous incisions
    LSH

  8. #23
    Join Date
    Mar 2010
    Location
    Ottawa, Canada
    Posts
    21

    incisions and sacral fixation

    In response to the thread regarding additional fixation beyond the standard perdical screws in the lumber vertebrae, I am very interested in the experiences.

    You may recall that the surgeon in my case felt my situation was not so bad that I could wait. Wait till I actually am in pain! But the surgery if and when would include sacral fixation.

    Any comments on life after that - activity, stiffness, pain. It seems such a drastic measure.

    On another note - just to say that some of the messages are really informative and I have been impressed by the knowledge that many of you have.

    Great social network
    ps a short article in the local paper on scoliosis - maybe becoming a little more "visible"
    [FONT="Comic Sans MS"]
    Spinal fusion 1961
    HR 1981 T3-L4
    Thoracic curve 75Cobb; post 40
    Present: Thoracic 60Cobb Lumber?
    [FONT]

  9. #24
    Join Date
    Dec 2009
    Location
    Bakersfield
    Posts
    80
    Linda,I had my 1 year appointment with Dr. Pashman he said everything looks good and Im all fused and released meI asked him about my separate scar and he said he put that screw in that incision not main incision.
    Aug.17,09 Anterior
    Aug.20,09 Posterior
    Fused T-10 to Sacral Pelvis
    Cedars-Sinai
    Dr.Pashman

    Sheri 47 years young
    Husband married 30 years
    3 kids 29,28,25
    4 grandkids 10,8,5,3

  10. #25
    Join Date
    Sep 2003
    Location
    Northern California
    Posts
    6,801
    Thanks for the follow-up. When I see him next, I'll find out about the technique.

    --Linda
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Dilbert
    I'm sarcastic... what's your super power? --Unknown
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation
    ---------------------------------------------------------------------------------------------------------------------------------------------------
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  11. #26
    Join Date
    Jun 2010
    Posts
    52
    I saw Dr. Pashman and he said that I would have to fuse from T2 to Pelvis with fixation. He said it would be both posterior and Anterior, so it's the center back and the horizonal in the front, as described on his website. He did not mention any side incision was needed.
    62/75 (T4-T9 68 degree & T11 - L4 80 degree) 10/19/2010
    45/50 year 2000
    36 yrs old
    Considering, researching surgery for the first time
    S. California
    http://s1210.photobucket.com/albums/...ashionista889/

  12. #27
    Join Date
    May 2009
    Posts
    3,745
    i saw Dr Pashman's fellow surgeon at Cedars Sinai, Dr Anand, last January...though i need T4-pelvis, we agreed to T10 to pelvis, as did all other surgeons i consulted with on east coast...using minimally invasive approach...side and back "pokes," kinda' like incisions, but smaller and spares muscles somewhat...
    so, in the case of minimally invasive, both back and side are used...

    now, if i could just make up my mind!! i have, actually...many many times!!
    then i "unmade" it!

    jess
    Last edited by jrnyc; 11-11-2010 at 04:17 PM.

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