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Thread: Flexible fusion surgery/motion preservation surgery

  1. #1
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    Aug 2012
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    Flexible fusion surgery/motion preservation surgery

    Well, I'm going to do some serious research on this type of new spinal surgery.

    When I had my first Scoliosis surgery, I was told that it would never be possible to remove the rods because my fusion would break. I was also told that the rods couldn't be causing me pain. But ten years after my surgery I was told that yes, the rods could be removed, and that yes, they often caused people pain. So medical opinion changes, and so does research and medical devices. It all depends who you ask. You never know what will be invented or discovered. There are some great young spinal researches out there. And the internet is amazing for research.

    For years I have wondered why they couldn't make a flexible spinal rod. I was told it would never be possible. And yet now spinal surgeons have finally done just that - invented a flexible rod. They don't seem to be using it for adult Scoliosis yet, but they are using it for lumbar vertebrae degeneration. Since I have now been diagnosed with collapsed L 4 and 5 as well as every other degenerative condition below my fusion, I am going to try to get this new surgery done instead of a standard fusion. I will NOT lose what little flexibility I have left in my spine without a fight. It may come to that, but at least I will have tried.

    I have also been told by spinal surgeons that it is not possible to undo or break a fusion, but then again it depends who you ask, since a spinal surgeon recently refuted this to me. So maybe someday people who are fused to the sacrum will be able to be unfused and refused with flexible rods.

    Fusion surgery effects us all differently, just as pain does; it's all subjective and depends on the individual. For me, flexibility is very important. The loss of it bothered me from the moment I woke up after the first surgery and continues to bother me. And there are thousands of people who had Harrington Rod/long fusion surgeries like me, and who are now disabled from lumbar pain and degeneration. In my opinion, we need to demand some good research and cutting edge technologies for our lumbar revisions.

    I will be doing many hours of research on this in the next six months. I'm disabled from the pain, and I have the time. I won't be posting often on this site because I'm not looking for medical or other advice; I need a clear, unbiased head to approach this research. However, if anyone has any specific research articles or links on flexible fusion lumbar surgery for patients that have already been fused for scoliosis, I'd be grateful. I will post at the end of my research for those who might be interested. i know there are many silent voices on this site.

    Thanks and best regards,
    Last edited by Tableone; 07-15-2013 at 03:45 AM.

  2. #2
    Join Date
    Mar 2010
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    2,646
    Tableone,
    I haven't seen you here before, so welcome. I am interested in what you find, as well. Although the words flexible and fusion might not help your search. Fusions aren't flexible. But, if you find something about flexible rods or the such I'd be glad to hear it.

    I also have DDD at L5/S1 and, yes, it can be very painful. One of my doctors offered me a new disc. They have moveable artificial discs now. Maybe that could be something you look into rather that trying to find flexible rods. The reason the rods are stiff is to keep the spine from recurving. Yes, they can remove them. Yes, your curve can progress after rod removal due to bone remodeling. Anyway, I thought I might point you in the direction of the artificial disc since they have them in the U.S., which is the last place to get anything.

    Good success to you!
    1985 - Dx w/ painful AIS at 16 with 39* upper LEFT thoracic single curve.
    2000 - 41*
    2010 - 46* (T1 - T6) 38* (T6-L2) Now a double thoracic
    2012 - Dx w/ Cervical Muscle Dystonia.
    DDD L5/S1 with left nerve impingement
    Left SI joint dysfunction

  3. #3
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    Aug 2012
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    35

    Flexible fusion clarified

    The previous poster seems unclear about what I posted, and I'd hate for anyone else to be similarly confused. I apologize if I was not clear before.

    To clarify: There is indeed something called "flexible fusion surgery," and it is for spinal fusions. That's why it's called "fusion." It is usually done for degenerative cervical or lumbar conditions (not Scoliosis.) In my case, the spine below my fusion (for Scoliosis) has degenerated due to my long Scoliosis fusion (T2 -L3) This degenerative area is not curved, and there is no Scoliosis. It is, however, collapsing with stenosis, disc buldge and dessication, osteophytes, etc. I know that many other people are in a similar situation. I should add that my Scoliosis fusion is stable and in good shape, (even though I had the hardware removed) and I have no loss of lordosis, and no flatback.

    The conventional treatment would be to fuse the remaining vertebrae to the sacrum with unbending metal rods as so many others on this site have gone through. However, the new trend in treatment is the flexible fusion surgery with bendable instrumentation. I will be investigating whether someone who has had Scoliosis fusion surgery on the upper spine might be a candidate for this.

    If I can find some spinal surgeon researchers interested in operating on me, it might be a step forward in advancing Scoliosis surgery to eventually include some flexibility. It might be too late for those of us already fused, but at least the next generation could benefit.

    And those thousands that are suffering from degenerative lumbar conditions due to Harrington Rod surgery could certainly benefit by not having to have their remaining spine fused.

    My doctor will be helping me approach spinal researchers. I will post more as my research continues.

    Thanks and best regards,
    Last edited by Tableone; 07-16-2013 at 12:54 AM.

  4. #4
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    May 2009
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    3,597
    patients with scoliosis can NOT have just disc replacement...
    believe me, i asked...i wanted just disc replacement for my DDD...
    nope....every surgeon...plus Linda Racine...told me it cannot be done...
    you do anything to scoliotic spine, you gotta fuse it...
    cannot JUST mess with the discs...
    wish you could....i would be first in line!!!

    my husband is convinced, for some reason, that a flexible rod should be
    possible...
    sooooo...i asked EVERY surgeon i saw...and they all said, nope, won't support
    the spine...couldn't be done...nope, not gonna happen...not even 50 years from
    now...nope...not gonna see it...


    jess...and Sparky
    Last edited by jrnyc; 07-16-2013 at 04:59 PM.

  5. #5
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    Dec 2012
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    I don't think any of us can say for sure what will be possible in 50 years. Please let us know what you find out!

  6. #6
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    May 2009
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    i truly hope you are right...
    i haven't had surgery yet...to sacrum...
    the idea of rods in my spine is something i cannot wrap my
    head around...
    flexible rods that supported the spine would be great....
    a dream come true!
    especially for anyone who needs a long fusion!!!
    maybe they could just do it in sections...
    ???

    jess...and Sparky

  7. #7
    Join Date
    Sep 2003
    Location
    Northern California
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    Tableone...

    Are you referring to dynamic stabilization or something else? I work in the UCSF Spine Center. No one there is using dynamic stabilization, but we've seen several patients who had this type of surgery elsewhere, and who have come to UCSF for revision.

    --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

  8. #8
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    May 2010
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    Indianapolis area
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    What is dynamic stabilization? Is it done on scoli patients?
    age 41
    80* thoracolumbar; 40* thoracic
    Reduced to ~16* thoracolumbar; ~0* thoracic
    Surgery 3/14/12 with Dr. Lenke, T4 to S1 with pelvic fixation
    Not "confused" anymore, but don't know how to change my username.

  9. #9
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    Sep 2005
    Location
    Gold Coast Australia
    Posts
    48
    Quote Originally Posted by jrnyc View Post
    patients with scoliosis can NOT have just disc replacement...
    believe me, i asked...i wanted just disc replacement for my DDD...
    nope....every surgeon...plus Linda Racine...told me it cannot be done...
    you do anything to scoliotic spine, you gotta fuse it...
    cannot JUST mess with the discs...
    wish you could....i would be first in line!!!

    my husband is convinced, for some reason, that a flexible rod should be
    possible...
    sooooo...i asked EVERY surgeon i saw...and they all said, nope, won't support
    the spine...couldn't be done...nope, not gonna happen...not even 50 years from
    now...nope...not gonna see it...


    jess...and Sparky
    I have an artificial disc (Maverick) at L4/5 which is at the bottom of my as yet unfused scoliosis. It was done for my advanded DDD at that level. It's done regularly here in Australia.
    Cathy

  10. #10
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    Sep 2003
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    Northern California
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    Hi Cathy...

    As far as I know, the only evidence that artificial discs (TDR) work in patients with scoliosis, is rare and anecdotal. I hear far more anecdotal evidence of TDR failing in patients with scoliosis. This is, I believe, done only outside the U.S.

    --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

  11. #11
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    Apr 2012
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    San Jose, CA
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    This is just a lay person opinion - wouldn't a flexible rod curve along a scoliotic spine? I would think that the forces that curve our spines will force any flexible rod to curve along the spine too. May be this is why every doctor says it's impossible?
    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

  12. #12
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    Oregon
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    The purpose of the hardware is to hold the vertebrae still while bony fusion occurs (internal fixation). Broken rods occur because bony fusion fails to occur, allowing continuous motion between two vertebrae. Eventually the metal rods suffer from metal fatigue and fracture. This happened to me at two levels and I had to have a huge revision to fix it.

    I do not think a flexible rod would achieve the purpose of holding the vertebrae still over a period of months (internal fixation) while bony fusion occurs. Bony fusion by definition means joining two or more vertebrae together into one bone. We all know that a solid bone is not flexible or bendable. So I do not see how the biomechanics of fusion can possibly go together with flexibility.

    It seems like you are hoping for some version of dynamic stabilization, as Linda suggests. There is some info about this on Pubmed.

    Good luck in your search. I will be curious to hear what you find out.
    Gayle, age 46
    Boston brace as a teen for AIS
    Oct 2010 fusion T8-sacrum w/ pelvic fixation, TLIF at L4/5.
    Feb 2012 major A/P revision for broken rods


    mom of Leah, 12 y/o, diagnosed Jan '08 with 26* thoracic JIS (age 6)
    4/08 26 degrees, brace 16 hrs/day
    9/08 17 deg. OOB - brace discontinued
    9/09 30 deg, resuming brace
    5/10 VBS Dr Luhmann Shriners St Louis
    5/14 stable 4 yrs post-op, 14* T

    also mom of Torrey, 9 y/o son, 12* T, decreasing spontaneously (from 19*)

  13. #13
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    Jan 2008
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    NC
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    Whatever is involved in the flexible "fusion", it can't involve fusion because that would be inflexible. It's a conflict in terms.

    I suspect this flexible system is disc replacement with some type of support that is NOT fusion.
    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."

  14. #14
    Join Date
    Dec 2012
    Posts
    19
    Actually if you just type into google "flexible fusion" you come up with plenty of info on it. UCFS, where the moderator of this site works, is not doing it. But plenty of other medical schools are and there has been much success with it, at least in people who have not had scoliosis surgery. I hope the original poster will let us know what else he finds out about this.

  15. #15
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    Northern California
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    Notice that it's always in quotes. If you're talking about permanent fusion of two bones together, it's not flexible. Flexible fusion devices take the place of fusion, but are not fusion. As far as I know, it's never an option for people with big scoliosis curves. Lastly, as I've mentioned previously, we see some of these patients... after they've had surgery elsewhere, and come to UCSF for revision surgery.
    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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