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Thread: Screw very close to aorta!

  1. #1
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    Dec 2004
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    Question Screw very close to aorta!

    Hi everyone! I had scoliosis surgery 6 years ago for my 60 degree curve. It was 10 after surgery. I recovered fast and everything has gone good. I have pain in the upper part of my spine where the rod is.
    To get to what i was wanting to say was that about a year ago i went to my scoliosis doctor and had routine x-rays done. I thought he was going to tell me everything looks good and come back in 2 years but he told me that one of my screws is a millimeter away from my aorta! A MILLIMETER?? Do you realize how close that is?? I'm just wondering if anyone has experienced this problem and could tell me what you have had to do about it.
    Thanks!

  2. #2
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    May 2004
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    16
    anterior instrumentation? what does your surgeon recommend?

  3. #3
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    Hi Linzylou...

    I've heard about a case where the surgeon actually hit the aorta, and the patient almost died. I think it's very rare. In patients with thoracic scoliosis, the aorta is positioned differently than in people with a normal spine.

    I'm curious, is the surgeon who told you about the problem the same one who performed the surgery?

    Regards,
    Linda

  4. #4
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    The surgeon that did my surgery is the one that told me. But he also had told me that nobody has ever had their rod removed but when i got on here i read about people who have had their's out. I haven't been since then and i have been pretty frightened at the idea that my spine could move a mm and be touching or puncturing my aorta! I don't know what to do

  5. #5
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    Hi LinzyLou...

    It's entirely possible that there's no danger, but I'd love it if you could get a second opinion. I see that you're in Kansas City. Who was your surgeon?

    Regards,
    Linda

  6. #6
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    Dr. Roger Jackson was my doctor

  7. #7
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    Hi LinzyLou...

    I realized that I don't really know which surgeons treat adults in your area. You might try Marc Asher. If not, and you don't mind travelling, you might want to try Keith Bridwell in St. Louis. I'm sure he treats adults.

    I hope you'll let me know what you find. In the meantime, I'll see if I can get an answer to whether it's something about which one should worry.

    Regards,
    Linda

  8. #8
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    my mom made me an appointment for a specialist in st. louis. i can't remember his name right now. But it is scheduled for the 10th of january and in the meantime i have to go get an MRI so i can take it with me. I hope i don't have to have surgery again but if i do then i might as well do it while i'm still young enough to handle the pain well.

  9. #9
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    Hi Linzylou...

    It seems to me that the worse case scenario would be removal of the screw, which would probably be a fairly simple surgery. I've known people who had spine screws removed on an outpatient basis.

    Regards,
    Linda
    Last edited by LindaRacine; 12-14-2004 at 06:31 PM.

  10. #10
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    Hi LinzyLou...

    I asked Dr. Serena Hu at UCSF about the screw, and this was her response:

    "Was this just from xrays I would guess? He would have a hard time knowing for sure without a CT scan. But if that screw has been there for 10 years I'm sure she's fine. If he said come back in 2 years, I'm sure he's not worried."

    Hope that helps.

    Regards,
    Linda

  11. #11
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    I have my medical records from when i went to the doctor last...here's what he said"

    1/24/03-- Thoracic CT scan, dated 1-21-03 was reviewed. The study was done from T6 to T12. The tip of the T7 screw seems to be adjacent to and behind the aorta. The tip of this screw is the closest to the aorta of all of the screws imaged. I feel that this situation should be monitored and that a repeat CT scan should be done in a year or two. We will discuss the finding with the patient. In summary, it does not appear that the tip of the screws are significantly impinging against the aorta.

    1/27/03-- Phone conversation with Lindsay and her mother regarding the findings on her recent outpatient CT scan of the thoracic spine. I informed them that the second from the top screw was close to the back of the aorta and that the tip of the screw may be impinging somewhat on the aorta. The ramifications of this were carefully outlined with them. I told them that if they wanted to get a second opinion, we would support that, or if they watned to see a chest heart surgeon, that could be arranged as well. I recommended that this condition be followed closely and that she be seen again if she starts to develop any new symptoms regarding chest pain. Otherwise she should have another x-ray taken in a year or tow, and perhaps a repeat CT scan should be done at that time.

    7/25/03-- 5 years postop, came back early because she fell off of a trampoline one week ago. She reports having pain in the interscapular area as well as the mid lumbar area, as outlined in her pain drawing. No radiating arm or leg pain.

    I recommended that she give it more time and take some soma. I also recommended Ultram. She is going to decide which of these works better for her. Her mother asked about implant removal due to the fact that one of the screw tip is close to the aorta. I suggested that this be followed along further at this time and that next summer another CT scan of the thoracis spine be done to see if there is any dilation or asymmetry in the shpae of the aorta. I also suggested that they might want to get a second opinion regarding this issue. I recommended Dr. Lawrence Lenke in St. Louis.

    That's the last time i have been to him but my mom went ahead and made an appointment with the doctor you recommended to us because she also saw that Lawrence Lenke is in the same practice. Thank you for checking up on everything for me. I appreciate it alot. I can't believe that you can have screws removed in outpatient! That sounds unbelievable.. i guess i will see what happens but until then there isn't much i can do about it.

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