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Unexpected long term complication of anterior approach for revision.

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  • Unexpected long term complication of anterior approach for revision.

    As I have posted many times before I got my life back after my revision.

    In June I developed a small bowel obstruction requiring emergency surgery to remove extensive scar tissue and 1 1/2 feet of jejunum(small intestine). I almost didn't make it. My surgeon said the anterior approach caused a defect in the mesentery through which my small intestine got trapped and strangulated. My recovery was complicated by loss of blood and a wound infection. I spent 2 1/2 weeks in hospital and 5 weeks in rehab. granted being 70 years old increases the risk.

    What to take out of this? Those who've had an anterior approach be aware and seek medical attention quickly if you cannot pass gas, have a BM and have nausea/vomiting.
    Better yet: avoid the anterior approach if possible.
    Original scoliosis surgery 1956 T-4 to L-2 ~100 degree thoracic (triple)curves at age 14. NO hardware-lost correction.
    Anterior/posterior revision T-4 to Sacrum in 2002, age 60, by Dr. Boachie-Adjei @Hospital for Special Surgery, NY = 50% correction

  • #2
    Karen I am very glad you are okay now.

    Thank you very much for posting that. That is extremely helpful.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

    Comment


    • #3
      Wow. Good to have you alive and well and warning others. That is quite an unexpected complication. You take care-- and thanks for the information.
      71 and plugging along... but having some problems
      2007 52° w/ severe lumbar stenosis & L2L3 lateral listhesis (side shift)
      5/4/07 posterior fusion T2-L4 w/ laminectomies and osteotomies @L2L3, L3L4
      Dr. Kim Hammerberg, Rush Univ. Medical Center in Chicago

      Corrected to 15°
      CMT (type 2) DX in 2014, progressing
      10/2018 x-rays - spondylolisthesis at L4/L5 - Dr. DeWald is monitoring

      Click to view my pics: pics of scoli x-rays digital x-rays, and pics of me

      Comment


      • #4
        Sorry to hear you've experienced this complication Karen, but glad to hear you're on the way back to good health.

        I am wondering if this sort of information is relayed back to our surgeons as well as scoli surgeons generally.
        Surgery March 3, 2009 at almost 58, now 63.
        Dr. Askin, Brisbane, Australia
        T4-Pelvis, Posterior only
        Osteotomies and Laminectomies
        Was 68 degrees, now 22 and pain free

        Comment


        • #5
          Karen,

          That must have been really scary and also quite a burdensome recovery. I'm sorry you had to go through that, but glad you're okay! I like the suggestion to inform your scoli surgeon.

          Best,
          Evelyn
          age 48
          80* thoracolumbar; 40* thoracic
          Reduced to ~16* thoracolumbar; ~0* thoracic
          Surgery 3/14/12 with Dr. Lenke in St. Louis, T4 to S1 with pelvic fixation
          Broken rods 12/1/19; scheduled for revision fusion L1-L3-4 with Dr. Lenke 2/4/2020
          Not "confused" anymore, but don't know how to change my username.

          Comment


          • #6
            Thanks for letting us know. Hope that you are OK. If I have surgery, I will be 66-67....so I will ask my MD how to possibly prevemt this.
            Susan
            Adult Onset Degen Scoliosis @65, 25* T & 36* L w/ 11.2 cm coronal balance; T kyphosis 90*; Sev disc degen T & L stenosis

            2013: T3- S1 Fusion w/ ALIF L4-S1/XLIF L2-4, PSF T4-S1 2 surgeries
            2014: Hernia @ ALIF repaired; Emergency screw removal SCI T4,5 sec to PJK
            2015: Rev Broken Bil T & L rods and no fusion: 2 revision surgeries; hardware P. Acnes infection
            2016: Ant/Lat Lumbar diskectomy w/ 4 cages + BMP + harvested bone
            2018: Removal L4,5 screw
            2021: Removal T1 screw & rod

            Comment


            • #7
              Oh my gosh, Karen, that all sounds frightening. So glad you are recovering now. Thanks for letting us know. Janet
              Janet

              61 years old--57 for surgery

              Diagnosed in 1965 at age of 13--no brace
              Thoracic Curve: 96 degrees to 35 degrees
              Lumbar Curve: 63 degrees to 5 degrees
              Surgery with Dr. Lenke in St. Louis--March 30, 2009
              T-2 to Pelvis, and hopefully all posterior procedure.

              All was posterior along with 2 cages and 6 osteotomies.

              Comment


              • #8
                Glad that you are doing so well
                Melissa

                Fused from C2 - sacrum 7/2011

                April 21, 2020- another broken rod surgery

                Comment


                • #9
                  Karen...

                  Glad you're OK, and sorry for the ordeal. Thankfully, most surgeons who do ALIFs are not cutting the muscle, so this will no longer be an issue except for the occasional patient who requires a thoracotomy.

                  Regards,
                  Linda
                  Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
                  ---------------------------------------------------------------------------------------------------------------------------------------------------
                  Surgery 2/10/93 A/P fusion T4-L3
                  Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

                  Comment


                  • #10
                    Karen

                    Oh boy..... I’m so glad your ok.

                    I know the feeling when the plumbing stops up as I had a stubborn ileus. I knew I was in trouble RIGHT away. I take it that you didn’t waste anytime going to the hospital....

                    Now I’m wondering if scar tissue grows? Did you have this obstruction since 2002, did you have any symptoms all along? Any idea what could have caused this to happen now? 10 years later?

                    I remember my vascular surgeon saying that they wouldn’t penetrate or open my Peritonium, they push it to the side to gain access. An anatomy lesson on the fly. 10 seconds later, I was out and being wheeled in. Was it the same for you with Boachie?

                    I am especially glad you posted.

                    Ed
                    49 yr old male, now 63, the new 64...
                    Pre surgery curves T70,L70
                    ALIF/PSA T2-Pelvis 01/29/08, 01/31/08 7" pelvic anchors BMP
                    Dr Brett Menmuir St Marys Hospital Reno,Nevada

                    Bending and twisting pics after full fusion
                    http://www.scoliosis.org/forum/showt...on.&highlight=

                    My x-rays
                    http://www.scoliosis.org/forum/attac...2&d=1228779214

                    http://www.scoliosis.org/forum/attac...3&d=1228779258

                    Comment


                    • #11
                      That is scary. Complication many years later... I hope that you are doing better, Karen.
                      I am stronger than scoliosis, and won't let it rule my life!
                      45 years old - diagnosed at age 7
                      A/P surgery on March 5/7, 2013 - UCSF

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                      • #12
                        Good Lord, that's terrifying. I'm so glad you're okay! Thanks for letting us know.

                        I have heard that this is a potential development for anyone who has had any kind of abdominal surgery -- it happened to an acquaintance of mine who'd had surgery for a hernia years before.

                        I had the same-sized anterior incision as you, so naturally this gives me significant pause.
                        Chris
                        A/P fusion on June 19, 2007 at age 52; T10-L5
                        Pre-op thoracolumbar curve: 70 degrees
                        Post-op curve: 12 degrees
                        Dr. Boachie-adjei, HSS, New York

                        Comment


                        • #13
                          That must have been very scary! I am so glad to hear that you are OK!!!!!
                          mariaf305@yahoo.com
                          Mom to David, age 17, braced June 2000 to March 2004
                          Vertebral Body Stapling 3/10/04 for 40 degree curve (currently mid 20's)

                          https://www.facebook.com/groups/ScoliosisTethering/

                          http://pediatricspinefoundation.org/

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                          • #14
                            Karen,
                            That is SOOO scary! Do they not take the time to close the mesentery when doing anterior surgery? I understand that scar tissue can develop from any surgery. This is something that one wouldn't expect years down the road. Thanks for bringing it to everyone's attention. I'm really glad to hear that you are okay.

                            Best wishes.
                            Be happy!
                            We don't know what tomorrow brings,
                            but we are alive today!

                            Comment


                            • #15
                              Karen,
                              Boy o Boy, you just can never tell when something can go wrong. I'm so glad you pulled through. Take good care of yourself and try not to have any more scary and crazy things happen to you.
                              Sally
                              Diagnosed with severe lumbar scoliosis at age 65.
                              Posterior Fusion L2-S1 on 12/4/2007. age 67
                              Anterior Fusion L3-L4,L4-L5,L5-S1 on 12/19/2007
                              Additional bone removed to decompress right side of L3-L4 & L4-L5 on 4/19/2010
                              New England Baptist Hospital, Boston, MA
                              Dr. Frank F. Rands735.photobucket.com/albums/ww360/butterflyfive/

                              "In God We Trust" Happy moments, praise God. Difficult moments, seek God. Quiet moments, worship God. Painful moments, trust God. Every moment, thank God.

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