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Thread: Pedicle subtraction osteotomy option

  1. #1
    Join Date
    Jul 2014
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    Pedicle subtraction osteotomy option

    I have the Harrington rod put in 1979, did great for a LONG time. till 3 yrs. ago. Now I have very painful flat back syndrome. First the PSO surgery was only option. Now a lesser of two evils surgery is offered. My bottom few vertibre's are gone. Thus the pain. They are saying go in and repair the bottom part only. All of the damage is below the rod. The recovery time is half. I work full time and Ill be honest if I have the PSO surgery with a year recovery time I will never return back to my job. My job will not be held. I am thinking hard what to do. My insurance is thru my job also. I will have to pay it on my own. The doctor has also said it is important to know that the PSO might still be needed later on if I do not get the pain relief. But they think I have a good chance. Anything you can tell me would ne helpful. Thanks.

  2. #2
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    Jul 2014
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    They said make no mistake still a not a walk in the park. but so much less complicated than the PSO surgery, going in the front and back. Major blood loss they said.

  3. #3
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    Oct 2014
    Location
    Arizona
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    Did they tell you that you would be off work a year? That seems like a really long time. What kind of work do you do? I'm having a T-4 to sacrum with pelvic fixation in January with both anterior and posterior surgery and my doc seems to think it would be reasonable for me to be back to work in 3-4 months, but I really don't think I'll be back in 3 months. I have a desk job and will probably take the bus for a while instead of driving, but I, too, really need to get back to work in a reasonable amount of time. While I have both short and long term disability, it makes me uneasy to stay away too long. My employer allows you to come back PT if desired and this would be a good option as if I work at least 20 hours, they pay for my insurance and at least I know my job is still mine.

    Whatever you decide to do, I would go for the permanent rather than short term fix.
    Before 39* lumbar at age 18, progressed to 74* lumbar and 22* thoracic age 55
    ALIF Jan 13, 2015, PLIF Jan 15, 2015 with Dr William Stevens, Honor Health
    Fused T-7 to S-1 with pelvic fixation

    After 38* lumbar

    Xrays
    Before: http://www.scoliosis.org/forum/attac...7&d=1414268930

    After: http://www.scoliosis.org/forum/attac...6&d=1424894360

  4. #4
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    Jul 2014
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    28
    I have a desk job too. A small family ran business. I am not family ,but most are. No family leave or anything like that. They cover a portion of my insurance. My husband is on mine, and that is changing in Feb. I am taking him off. One less thing to worry about. Yes, they said a year recovery.

  5. #5
    Join Date
    Dec 2008
    Location
    illinois
    Posts
    804
    Yes it a year recovery but you can do many things before the year. So you could return to work with certain restrictions for the first 6 months or so. I returned at 7 weeks but it was too soon.

  6. #6
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    Jul 2014
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    Please tell me how it was? when could you drive? Did you have both the front and back incisions made? Can you feel the hardware in you as I have read others complain so much about?

  7. #7
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    Jul 2014
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    Sorry. I just saw that you have not had the surgery yet.

  8. #8
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    Jul 2014
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    Lizard: You have not had the surgery yet? Correct? Jackie, you have had the surgery already?

    Lizard: Do you have flat back syndrome? Did you have the Harrington rod from before? What is leading you to surgery?

    Jackie: What was your main pain from? Did you have success? Did you have both the anterior and posterior surgery? Please tell me about it.

  9. #9
    Join Date
    Oct 2014
    Location
    Arizona
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    Quote Originally Posted by sheila C View Post
    Lizard: You have not had the surgery yet? Correct? Jackie, you have had the surgery already?

    Lizard: Do you have flat back syndrome? Did you have the Harrington rod from before? What is leading you to surgery?

    Jackie: What was your main pain from? Did you have success? Did you have both the anterior and posterior surgery? Please tell me about it.
    I have not had the surgery yet, but very soon (Jan 13 & 15). Which doctor are you seeing? Since you are a revision, you want somebody with a lot of experience with revisions. Hopefully, the folks from the revision board will see your post and weigh in. From what I have read on that board, recovery from revisions is often not as difficult as they are fusing a shorter segment, but still, having anterior and posterior surgery is no picnic.

    Liz
    Before 39* lumbar at age 18, progressed to 74* lumbar and 22* thoracic age 55
    ALIF Jan 13, 2015, PLIF Jan 15, 2015 with Dr William Stevens, Honor Health
    Fused T-7 to S-1 with pelvic fixation

    After 38* lumbar

    Xrays
    Before: http://www.scoliosis.org/forum/attac...7&d=1414268930

    After: http://www.scoliosis.org/forum/attac...6&d=1424894360

  10. #10
    Join Date
    Sep 2003
    Location
    Northern California
    Posts
    6,935
    Everyone is different, but many return to work within 3 months, and I would say that most return to work within 6 months.

    --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

  11. #11
    Join Date
    Mar 2005
    Location
    east coast
    Posts
    359
    It is year recovery -- as in most ppl take a full year for spine to fully fuse and to be cleared for all activities.

    However most of us with a desk job start returning at 3, 4 months. I'm back at work and I hit the 3 month mark last Monday from day of surgery and it was my first day back at work. So far been able to stay at the office for full day without issues.
    30 something y.o.

    2003 - T45, L???
    2005 - T50, L31
    bunch of measurements between...

    2011 - T60, L32
    2013 - T68, L?

    Posterior Fusion Sept 2014 -- T3 - L3
    Post - op curve ~35



  12. #12
    Join Date
    Jul 2014
    Posts
    28
    I am going to the Southeastern Spine Institute in Mount Pleasant , SC. Seeing a team which has Doctor Poletti and 3 others who will be involved.

  13. #13
    Join Date
    Oct 2014
    Location
    Arizona
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    Quote Originally Posted by green m&m View Post
    It is year recovery -- as in most ppl take a full year for spine to fully fuse and to be cleared for all activities.

    However most of us with a desk job start returning at 3, 4 months. I'm back at work and I hit the 3 month mark last Monday from day of surgery and it was my first day back at work. So far been able to stay at the office for full day without issues.
    Just wanted to say that your after xray is amazing! Congratulations on a speedy recovery!
    Before 39* lumbar at age 18, progressed to 74* lumbar and 22* thoracic age 55
    ALIF Jan 13, 2015, PLIF Jan 15, 2015 with Dr William Stevens, Honor Health
    Fused T-7 to S-1 with pelvic fixation

    After 38* lumbar

    Xrays
    Before: http://www.scoliosis.org/forum/attac...7&d=1414268930

    After: http://www.scoliosis.org/forum/attac...6&d=1424894360

  14. #14
    Join Date
    Jan 2008
    Location
    Oregon
    Posts
    1,163
    Hi,

    One comment made me pause…your surgeon said you "should" have enough less that pain that you should be able to stand up straighter…If you have bad enough flatback you need a PSO so that you can stand up straight---it is more a matter of alignment than a matter of willpower or conscious posture. If I was in that situation I would go for the PSO and hopefully just have to do it once.

    I had a major revision about 2.5 years ago that included an osteotomy - I recovered very well and was back on seated duty at work in 14 weeks.

    Please consider a few more opinions if you have any doubt at all…having a revision is no fun, and having two, well, you get the idea!

    Good luck!
    Gayle, age 50
    Oct 2010 fusion T8-sacrum w/ pelvic fixation
    Feb 2012 lumbar revision for broken rods @ L2-3-4
    Sept 2015 major lumbar A/P revision for broken rods @ L5-S1


    mom of Leah, 15 y/o, Diagnosed '08 with 26* T JIS (age 6)
    2010 VBS Dr Luhmann Shriners St Louis
    2017 curves stable/skeletely mature

    also mom of Torrey, 12 y/o son, 16* T, stable

  15. #15
    Join Date
    Jul 2014
    Posts
    28
    How long were in the hospital? I agree with what you are saying. I am just scared to be away from work cause I know that I will not return after anything more than 4 months. My position will be taken. And I have to go to rehab afterwards also. I asked if after a week could I come home, no they said rehab for another week. What was your degree of being bent over? Mine is 15 degrees. Hubby is very afraid the longer I wait the more worse it will get thus the success of the surgery goes down. I do not know how that works. Anything you can tell me to expect I would like to know.




    Quote Originally Posted by leahdragonfly View Post
    Hi,

    One comment made me pause…your surgeon said you "should" have enough less that pain that you should be able to stand up straighter…If you have bad enough flatback you need a PSO so that you can stand up straight---it is more a matter of alignment than a matter of willpower or conscious posture. If I was in that situation I would go for the PSO and hopefully just have to do it once.

    I had a major revision about 2.5 years ago that included an osteotomy - I recovered very well and was back on seated duty at work in 14 weeks.

    Please consider a few more opinions if you have any doubt at all…having a revision is no fun, and having two, well, you get the idea!

    Good luck!

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