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Thread: Unexpected long term complication of anterior approach for revision.

  1. #16
    Join Date
    Apr 2012
    Location
    Harrisburg, Pa.
    Posts
    85

    Anterior Approach

    Hi Karen...I had a bowel obstruction in 1989....was very blindsighted by it. I had a bowel resection and almost didn't make it when after the surgey I had hemorrhaging and they didnt know if they would have to go back in...bleeding stopped and i have been ok since all that happened. I am replying because if you have uncontrollable diarrhea from the surgery, you will have to take what I call my "miracle medicine" Welchol Cholecystramine. I can eat anything and I dont have to worry about "dumping". Sorry for TMI but this was a life saver for me. If you have any questions, send me a PM.

    Pat
    1963 Fusion T4-L2 for congenital scoliosis. It was a bone graft and not instrumentation
    1989 to Present....Have had chronic pain. MRI's show severe neural foraminal stenosis L2-S1, rotational scoliosis lumbar spine over 40 degrees, compression of nerve roots L5-S1, Broad Based Herniations L4-L5, L5-S
    Surgery scheduled with Dr. Bridwell on December 11, 2012
    December 11, 2012 Had surgery with Dr. Bridwell. He fused L4-L5 with rods and screws.

  2. #17
    Join Date
    Apr 2012
    Location
    Harrisburg, Pa.
    Posts
    85

    Anterior Approach

    SORRY!!!!! Forgot to include in my last post that MY BOWEL OBSTRUCTION HAD NOTHING TO DO WITH MY SPINAL SURGERY IN 1963 and also I have never had an anterior revision....wanted to tell all of you so you wouldn't be concerned.
    Pat
    1963 Fusion T4-L2 for congenital scoliosis. It was a bone graft and not instrumentation
    1989 to Present....Have had chronic pain. MRI's show severe neural foraminal stenosis L2-S1, rotational scoliosis lumbar spine over 40 degrees, compression of nerve roots L5-S1, Broad Based Herniations L4-L5, L5-S
    Surgery scheduled with Dr. Bridwell on December 11, 2012
    December 11, 2012 Had surgery with Dr. Bridwell. He fused L4-L5 with rods and screws.

  3. #18
    Join Date
    May 2008
    Location
    Central NJ
    Posts
    1,956
    OMG Karen, I am so happy that you're ok. How absolutely scary. Take care of yourself.
    __________________________________________
    Debbe - 50 yrs old

    Milwalkee Brace 1976 - 79
    Told by Dr. my curve would never progress

    Surgery 10/15/08 in NYC by Dr. Michael Neuwirth
    Pre-Surgury Thorasic: 66 degrees
    Pre-Surgery Lumbar: 66 degrees

    Post-Surgery Thorasic: 34 degrees
    Post-Surgery Lumbar: 22 degrees

  4. #19
    Join Date
    Sep 2003
    Location
    NJ
    Posts
    1,291

    Lightbulb abdominal approach

    Any time the abdomen is entered scar tissue(adhesions) are a given. Once the bowel is pushed aside or manipulated this happens. Scar tissue from any abdominal surgery can later cause small bowel obstruction. This includes even a C section.

    Linda, I do not understand what you mean by "going through muscle" not being a problem. A thoracotomy, by itself, does not disturb the bowel because there are no bowels in the chest. Going anteriorly, by my right hip to the spine, involved pushing the bowel aside. There is no way to avoid going through abdominal muscle when going through the abdomen. When I had the hysterectomy the surgeon removed my appendix because it was bound up with adhesions from the anterior approach.

    Interestingly, when they released my adhesions this time, I have more room for abdominal breathing. Unfortunately, the adhesions always come back.
    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

  5. #20
    Join Date
    May 2008
    Location
    reno,nevada
    Posts
    3,531
    In this article, its 90% and up to 20 years.
    http://en.wikipedia.org/wiki/Adhesion_(medicine)

    I am understanding more about this and will be prepared. I now can see why I had to beg for my surgeries.....

    I still am very greatful for my surgeries,and pain free.

    Ed
    49 yr old male, now 58, the new 53...
    Pre surgery curves C12,T70,L70
    ALIF/PLIF 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

  6. #21
    Join Date
    Jan 2006
    Location
    near Philadelphia
    Posts
    1,260
    Karen, you're saying that adhesions and scar tissue always grow back? I would think the surgery you just had would create its own scar tissue all over again, is that right? Is there any way to see or get images of adhesions before they become dangerous?

    I gotta tell you, this whole thing freaks me out.
    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

  7. #22
    Join Date
    May 2008
    Location
    reno,nevada
    Posts
    3,531
    Chris

    Try not to freak out...its going to be alright.

    More info....

    http://www.adhesions.org/index.htm

    Ed
    49 yr old male, now 58, the new 53...
    Pre surgery curves C12,T70,L70
    ALIF/PLIF 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

  8. #23
    Join Date
    Jan 2012
    Location
    Yacolt, WA
    Posts
    1,524

    Can be > 20 years and Adhesion Barriers

    Quote Originally Posted by titaniumed View Post
    In this article, its 90% and up to 20 years.
    http://en.wikipedia.org/wiki/Adhesion_(medicine)

    I am understanding more about this and will be prepared. I now can see why I had to beg for my surgeries.....

    I still am very greatful for my surgeries,and pain free.

    Ed
    The info from wikipedia says that it can occur 20 years or more. My mom at age 87 had an intestional obstruction from intestines getting struck through a scar from her hysterectomy when she was 45. At her age [87], the surgeon gave her a 50-50 chance of surviving the surgery. She had a heart attack during the surgery which lead to congestive heart failure and she died a few months later. So, I guess that you are never completely "out of the woods".

    I will ask my surgeon about "adhesion barriers" and if he uses them. More info about the barriers is in the wikipedia cut that Ed posted.
    Susan
    Adult Onset Degenerative Scoliosis @65, 25* T & 36* L w/ 11.2 cm coronal balance; T kyphosis 90*; Severe disc degen T & L stenosis

    2013: T3- S1 Fusion w/ ALIF L4-S1/XLIF L2-4, PSF T4-S1 in 2 surgeries
    2014: Hernia @ ALIF repaired; Emergency screw removal surgery for Spinal Cord Injury at T4,5 sec to PJK
    2015: Revision 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 + prayer

  9. #24
    Join Date
    Apr 2010
    Location
    Waterloo, IL
    Posts
    1,690
    Karen,
    I'm so glad you are okay now. What a scary ordeal. We'd like to think that we wouldn't have complications so long after the surgery. Dr. Lenke does a "reach around" method to get to the anterior side of the spine so that there is no anterior incision. After reading your post, I wonder how many surgeons still have the anterior and posterior approach. . .
    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/

  10. #25
    Join Date
    Sep 2003
    Location
    Northern California
    Posts
    6,794
    Quote Originally Posted by Karen Ocker View Post
    Any time the abdomen is entered scar tissue(adhesions) are a given. Once the bowel is pushed aside or manipulated this happens. Scar tissue from any abdominal surgery can later cause small bowel obstruction. This includes even a C section.

    Linda, I do not understand what you mean by "going through muscle" not being a problem. A thoracotomy, by itself, does not disturb the bowel because there are no bowels in the chest. Going anteriorly, by my right hip to the spine, involved pushing the bowel aside. There is no way to avoid going through abdominal muscle when going through the abdomen. When I had the hysterectomy the surgeon removed my appendix because it was bound up with adhesions from the anterior approach.

    Interestingly, when they released my adhesions this time, I have more room for abdominal breathing. Unfortunately, the adhesions always come back.
    Hi Karen....

    Instead of cutting through muscle, they now split the muscle. I haven't actually seen it done, but you can read about the technique here.

    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
    ---------------------------------------------------------------------------------------------------------------------------------------------------
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