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Thread: Looking for a surgeon

  1. #1
    Join Date
    Apr 2012
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    Florida
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    Post Looking for a surgeon

    I am 60 had Harrington Rods t4-L4 at age 27, then a revision L4-5. I continue to have radicular pain through my right SI joint radiating down my right leg.
    What about all this laser surgery, and pain management. I would prefer not to have another surgery.
    Who should I see. I live in Florida but will travel to find the answer.

  2. #2
    Join Date
    May 2009
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    3,745
    hi Betty
    welcome to the forum....
    there is much support here from good people...

    i do not understand what you wrote...laser surgery is still surgery....
    so i don't understand if you are really looking for a surgeon or just a good pain managent doctor...

    i have a pain management doctor in NYC...
    i also had a pain management doc in CT, where i live now...he gave me SI joint injections that gave me
    a lot of pain relief...however, the shots he gave me in January were too much steroid all at once...
    as a result, i now have severely low cortisol...it is one side effect of steroid injections...
    i am not having any more shots, and am getting more blood work done mid month, to see if my
    cortisol is improving at all...
    low cortisol causes EXTREME exhaustion....

    but...that is not to say that shots shouldn't be considered...i got wonderful pain relief from the SI joint
    injections, and nothing else ever worked for me...not epidural injections, nor facet block, nerve
    ablation, or any other of the shots they tried with me...
    i should mention that i have not had spinal surgery...ever...yet....
    and no doctor could figure out why the SI joint shots worked...i was just glad that they did...
    i expect the pain to return now that i will not be repeating the shots....

    best of luck...i hope you find a pain management doctor who can help you...they are not all
    surgeons...i had one who is an anesthesiologist...
    there is a chance that you do need a surgeon for revision surgery....perhaps you need to see
    both a surgeon and a pain management doctor....

    jess

  3. #3
    Join Date
    Apr 2012
    Location
    Florida
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    Post

    Quote Originally Posted by jrnyc View Post
    hi Betty
    welcome to the forum....
    there is much support here from good people...

    i do not understand what you wrote...laser surgery is still surgery....
    so i don't understand if you are really looking for a surgeon or just a good pain managent doctor...

    i have a pain management doctor in NYC...
    i also had a pain management doc in CT, where i live now...he gave me SI joint injections that gave me
    a lot of pain relief...however, the shots he gave me in January were too much steroid all at once...
    as a result, i now have severely low cortisol...it is one side effect of steroid injections...
    i am not having any more shots, and am getting more blood work done mid month, to see if my
    cortisol is improving at all...
    low cortisol causes EXTREME exhaustion....

    but...that is not to say that shots shouldn't be considered...i got wonderful pain relief from the SI joint
    injections, and nothing else ever worked for me...not epidural injections, nor facet block, nerve
    ablation, or any other of the shots they tried with me...
    i should mention that i have not had spinal surgery...ever...yet....
    and no doctor could figure out why the SI joint shots worked...i was just glad that they did...
    i expect the pain to return now that i will not be repeating the shots....

    best of luck...i hope you find a pain management doctor who can help you...they are not all
    surgeons...i had one who is an anesthesiologist...
    there is a chance that you do need a surgeon for revision surgery....perhaps you need to see
    both a surgeon and a pain management doctor....

    jess
    Thank you for your reply. I am not sure what I am looking for I just want the pain to stop. I have had multiple injections in the SI joint about 13 years ago, they did not help. Since then the pain radiates down my entire leg. I was considering the epidural injections or a nerve facet block. About 10 years ago a myleogram was attempted but after an hour it was not possible to get through my scarr tissue. This makes me wonder if I would be a candidate for other pain injections.
    Thank you for warning about the cortisone levels

  4. #4
    Join Date
    Sep 2003
    Location
    Northern California
    Posts
    6,801
    Hi Betty...

    Laser surgery will not help you. It isn't (or at least, shouldn't) be used in deformity surgery. I just met a patient last week who had laser surgery in Florida. Her insurance wouldn't pay for it, as it is not indicated for deformity. The surgery destabilized her spine further than it had been, and she is going to have to have a major reconstruction.

    I know how hard it is to make the decision to have more surgery, but I can tell you from first-hand experience that it can be super effective. After having surgery a year ago, I now have no lower back or leg pain.

    There are some really good revision surgeons around the U.S. Where are you located?

    Regards,
    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
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    If you've signed up and are having trouble posting, please check your spam folder. An email was sent to the email address which you subscribed. You have to follow the instructions in that email. Done that and still having trouble posting? Contact Joe O'Brien at jpobrien@scoliosis.org.

  5. #5
    Join Date
    Apr 2010
    Location
    Waterloo, IL
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    1,690
    Welcome to the forum. I was 60 when I had my first surgery and certainly hope it is the last, but i am pleased with the results and have no regrets. Good luck in whatever you decide to do to relieve your pain. I know that many have had revision surgery and are happy with the results. I would never consider spinal surgery unless I had one of the best surgeons in the country because think it makes a huge difference in one's outcome.
    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/

  6. #6
    Join Date
    Apr 2012
    Location
    Florida
    Posts
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    Post Laser surgery?

    Linda, thank you for your reply. My problem is coming from the two levels below my rods and fusion that is why I was wondering of laser might work on the last two levels. As you know they take a lot stress with the 12 above being fused.
    I am located in south west Florida but would travel for a good out come.

    Quote Originally Posted by LindaRacine View Post
    Hi Betty...

    Laser surgery will not help you. It isn't (or at least, shouldn't) be used in deformity surgery. I just met a patient last week who had laser surgery in Florida. Her insurance wouldn't pay for it, as it is not indicated for deformity. The surgery destabilized her spine further than it had been, and she is going to have to have a major reconstruction.

    I know how hard it is to make the decision to have more surgery, but I can tell you from first-hand experience that it can be super effective. After having surgery a year ago, I now have no lower back or leg pain.

    There are some really good revision surgeons around the U.S. Where are you located?

    Regards,
    Linda

  7. #7
    Join Date
    Apr 2012
    Location
    Florida
    Posts
    12

    Post Great pictures

    Dr. Lenke is now on my good list. You look great!!!!

    Quote Originally Posted by golfnut View Post
    Welcome to the forum. I was 60 when I had my first surgery and certainly hope it is the last, but i am pleased with the results and have no regrets. Good luck in whatever you decide to do to relieve your pain. I know that many have had revision surgery and are happy with the results. I would never consider spinal surgery unless I had one of the best surgeons in the country because think it makes a huge difference in one's outcome.

  8. #8
    Join Date
    May 2009
    Posts
    3,745
    if you read some of the posts in the revision section of this forum,
    you will find people who had their surgeries redone years later, with successful results...
    perhaps it is time for you to ask a surgeon what can be done for you...
    a top scoliosis surgeon might have answers for you....
    pain management for scoliosis related problems is usually just temporary...

    best of luck...
    jess
    Last edited by jrnyc; 04-09-2012 at 09:01 AM.

  9. #9
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    Northern California
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    Quote Originally Posted by Betty B View Post
    Linda, thank you for your reply. My problem is coming from the two levels below my rods and fusion that is why I was wondering of laser might work on the last two levels. As you know they take a lot stress with the 12 above being fused.
    I am located in south west Florida but would travel for a good out come.
    Unfortunately, laser surgery would still be of no help to you. Beware of the Florida surgeons who are advertising it as a solution to just about every back problem.

    When I had revision surgery in Jan 2011, I also had the 2 levels below my fusion that had gone bad. Nate Lebwohl, in Miami, does revision surgeries. Also, Khaled Kebaish at Johns Hopkins has a great reputation. If you don't mind traveling, New York has an abundance of surgeons who specialize in revision surgery.

    --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
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    If you've signed up and are having trouble posting, please check your spam folder. An email was sent to the email address which you subscribed. You have to follow the instructions in that email. Done that and still having trouble posting? Contact Joe O'Brien at jpobrien@scoliosis.org.

  10. #10
    Join Date
    Apr 2012
    Location
    Florida
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    Post Great references

    Linda thank you so much for the great references. Perhaps I will start wtih Nate Lebwohl in Miami it would certianly make life easier, it is a 3 hour ride from my home.


    Quote Originally Posted by LindaRacine View Post
    Unfortunately, laser surgery would still be of no help to you. Beware of the Florida surgeons who are advertising it as a solution to just about every back problem.

    When I had revision surgery in Jan 2011, I also had the 2 levels below my fusion that had gone bad. Nate Lebwohl, in Miami, does revision surgeries. Also, Khaled Kebaish at Johns Hopkins has a great reputation. If you don't mind traveling, New York has an abundance of surgeons who specialize in revision surgery.

    --Linda

  11. #11
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    Apr 2012
    Location
    Harrisburg, Pa.
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    Yacpatty

    Hi Betty...I am also 60...had a bone fusion in 1963 T4-L2 at the age of 13. I have been in chronic pain for the past 26 years and am at my wit's end. What exactly did they do when they did the revision surgery on L4? Also, do you have neural foraminal stenosis and did you have surgery for that?

  12. #12
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    Apr 2012
    Location
    Florida
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    Post surgical history + more

    Quote Originally Posted by yacpatty View Post
    Hi Betty...I am also 60...had a bone fusion in 1963 T4-L2 at the age of 13. I have been in chronic pain for the past 26 years and am at my wit's end. What exactly did they do when they did the revision surgery on L4? Also, do you have neural foraminal stenosis and did you have surgery for that?

    yacpatty:
    I was pretty good from 1979 to 1990, then I got terrible pains deep in my left calf. I hav a L4-5 partial hemilaminectomy, medial facetectomy and forminotomy for nerve root decmopression with disc removal. I was only in the hosital two nights and pretty good after 6-8 weeks. However, about 1998 I started getting pain in my right SI joint, now it radiates through my thigh and calf. my thigh feels like the muscle is having a spasam and the calf feels like it has a tight blood pressure cuff on it. Good days bad days. I can not be more specific about your question as I had to pull out my surgal report and copy what I typed.
    I just made an appointment with a physician in Miami. http://srs.execinc.com/edibo/PublicDirectory this is a web site I have been hunting for doctors on as well as ones that got good references from people on the forum. Be careful as I think any one can join the foundation, it does not mean they are good at what they do.

  13. #13
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    Northern California
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    Quote Originally Posted by Betty B View Post
    http://srs.execinc.com/edibo/PublicDirectory this is a web site I have been hunting for doctors on as well as ones that got good references from people on the forum. Be careful as I think any one can join the foundation, it does not mean they are good at what they do.
    This is the Scoliosis Research Society, and membership is relatively exclusive. For physicians to be members, at least 20% of their surgeries have to be for spinal deformity.
    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
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    If you've signed up and are having trouble posting, please check your spam folder. An email was sent to the email address which you subscribed. You have to follow the instructions in that email. Done that and still having trouble posting? Contact Joe O'Brien at jpobrien@scoliosis.org.

  14. #14
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    San Francicsco Bay Area
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    [QUOTE=Betty B;137696]yacpatty:
    I was pretty good from 1979 to 1990, then I got terrible pains deep in my left calf. I hav a L4-5 partial hemilaminectomy, medial facetectomy and forminotomy for nerve root decmopression with disc removal. I was only in the hosital two nights and pretty good after 6-8 weeks. However, about 1998 I started getting pain in my right SI joint, now it radiates through my thigh and calf. my thigh feels like the muscle is having a spasam and the calf feels like it has a tight blood pressure cuff on it.

    Betty: I am interested that you had a disc removal surgery plus the other procedures in the area below your fusion. From what you say, it seems like it gave you relief for several years. Could you please let us know where you had it done? Also, how do you know that the pain is from your SI joint? I'm trying to figure out where my pain is coming from. Thanks.

  15. #15
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    Apr 2012
    Location
    Florida
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    somewhat successful

    Glad to offer my experience:
    I had a discectomy @ L4 and left laminectomy in 1991-good outcome. Later right leg problems May 2013 I went to University of Miami Spine Institute. I saw Mark Brown, a semi-retired surgeon, researcher who diagnoses and sends you to the right surgeon in the group. He had me see Seth Williams who mainly does Lumbar work. He was the only one who would do a laminectomy on L-4. It leaves an unstable joint but would bide time. I was only 60 at the time so I wanted to postpone another fusion as long as possible. Anyhow I was thrilled and had NO pain for months after. Unfortunately as predicted it did not last. Since then I have had multiple injections at a pain clinic. Including an epidural- no help- nerve ablasion - no help. The last two sets of shots were at the nerves coming out of the facets and SI joint. I am doing well for now.
    I would go back to Dr. Seth Williams when time comes for more surgery.

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