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Thread: Having fusion to the sacrum January 7th

  1. #1
    Join Date
    Aug 2012
    Location
    San Francicsco Bay Area
    Posts
    127

    Having fusion to the sacrum January 7th

    Well I am finally having fusion to the sacrum surgery on January 7th at UC Davis in Sacramento. My surgeon is Dr. Rolando Roberto. He's an interesting surgeon in that he does not have a God-complex like the other surgeons I consulted, and he is willing to work with his patients as to the different ways of doing surgery, which I appreciate. For instance, I have requested no BMP (Bone Morphogenic Protein). Instead, he will take bone from my illiac crest. He may also use cadaver bone. Of course I will pay for this with increased hip pain, but after research I decided I was not comfortable with the BMP. I am not putting BMP down, I know it is excellent for fusing; this was just a personal decision. He is also doing a posterior-only approach, which I appreciate. I did tell him to do anterior if necessary, but he says that as he doesn't have to open the disc spaces that much (my flatback is not that bad) that he is comfortable doing posterior-only. This was a great relief to me.

    I've put this off for four years but at this point I can honestly say I am ready for it. I am tired of living in pain and want to go on with my life. I wish everyone here the very best.

    T1
    1st surgery: Fused T1-L3 in 1987 with contoured Harrington Rods. Rods broke at top.
    2nd surgery: Re-done two weeks later; fused C7-L3. Left in chronic pain.
    3rd surgery: Hardware removal 1997, but still pain for 30 years.
    4th Surgery: Fused to the sacrum in 2016. Came out of surgery with left foot paralysis. (Drop Foot) Can't walk on my own.
    I'm blessed to have found my peace and reason to live not from a husband or kids (I have none) but from God and within myself.

  2. #2
    Join Date
    Jan 2012
    Location
    Yacolt, WA
    Posts
    1,527
    I know that you are looking forward to finally getting your back revised so that you can become more active. I am glad that you found a surgeon that you can work with.

    I wish you the best!

    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

  3. #3
    Join Date
    Oct 2007
    Location
    Indiana
    Posts
    1,974
    It is so hard to set that date and go for it! Now you have a definite hope and goal, and that seems like a pretty good Christmas gift. I'll be praying for a very successful surgery and for your recovery. Thinking of you now and sending you all my best. Have a blessed time over the holidays and I'm looking forward to your reports (when you are able) in the new year.
    66 and still heartbroken...
    2007 52 w/ severe lumbar stenosis & L2L3 lateral listhesis (side shift)
    5/4/07 posterior spinal fusion T2-L4 w/ laminectomies and osteotomies @L2L3, L3L4
    Dr. Kim Hammerberg, Rush Univ. Medical Center in Chicago

    Corrected to 15
    2014 DXd w/CMT (type 2)

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

  4. #4
    Join Date
    Aug 2015
    Location
    Midlands, UK
    Posts
    13
    Wishing you all the best!
    Juvenile Idiopathic Scoliosis diagnosed aged 6/7
    Milwaukee brace 1980 - 1984, Fused T2 - L3 with Harrington Rod 1984, 10 rib costoplasty 1999, artificial disc at L3/L4 2003, extended fusion to L5 2006.
    2015 - Sagittal plane imbalance correction by insertion of 30 degree hyperlordotic cage at L5/S1 level (anterior approach) with fixation to pelvis (posterior approach) now fused T2 to sacrum.

  5. #5
    Join Date
    Aug 2012
    Location
    San Francicsco Bay Area
    Posts
    127
    At my pre-op visit my surgeon walked into the room, slapped a form down and said "sign here." When I read the handwritten part about what type of surgery I was having, I noticed that instead of the three level surgery he had been telling me I was going to have for the past six months, I am in addition having "segemental? - can't read his handwriting - instrumentation from T10 to S1 with illiac bolts bilateral." Does anyone know anything about this segment type of hardware that will go up to T10? This is significantly more surgery than I had been told, and I would like to know more about it. Unfortunately, when I tried to ask my surgeon a question he said: "Now's when you start trusting me. Sign it or we'll call the whole thing off." I think he was having a really bad day; his God complex (which I did not think he had) was way up there, and he's actually the most human of all the deformity surgeons I've met. He really intimidated me, (I was alone) and I burst into tears after he left. One does not expect to have your surgeon, whom I have always been on good terms with, be like that.
    Anyway, if anyone can tell me about the segment instrumentation and what that feels like going up to T10 from S1, I'd be grateful. I previously had Harrington rods, and those never felt comfortable in my thoracic.
    Thank you,
    Last edited by Tableone; 12-28-2015 at 12:09 AM.
    1st surgery: Fused T1-L3 in 1987 with contoured Harrington Rods. Rods broke at top.
    2nd surgery: Re-done two weeks later; fused C7-L3. Left in chronic pain.
    3rd surgery: Hardware removal 1997, but still pain for 30 years.
    4th Surgery: Fused to the sacrum in 2016. Came out of surgery with left foot paralysis. (Drop Foot) Can't walk on my own.
    I'm blessed to have found my peace and reason to live not from a husband or kids (I have none) but from God and within myself.

  6. #6
    Join Date
    Jan 2008
    Location
    Oregon
    Posts
    1,162
    This surgeon sounds like a real prize. If a surgeon ever talked to me like that, it would be the last time I saw him.
    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

  7. #7
    Join Date
    Mar 2005
    Location
    Ukiah CA
    Posts
    891
    he was probley having a bad day because being the chief spine orthopedic surgeon and vice chair of the department of orthopedic surgery is stressful
    Kara
    25
    Brace 4-15-05-5-25-06
    Posterior Spinal Fusion 3-10-10
    T4-L2
    Before 50T
    After 20T

  8. #8
    Join Date
    Dec 2008
    Location
    illinois
    Posts
    766
    Bad day???who cares. You have the absolute right to have your questions answered even if you ask the same thing more than once. There is no way you should go through this type of surgery without understanding everything that is planned for you.
    I don't know the answer to your question but maybe Linda or ed will.
    T10-pelvis fusion 12/08
    Fractured t-9 six days out of surgery
    C5,6,7 fusion 9/10
    PJK at t-9
    T2--T10 fusion 2/11
    Removal of left side t6-t10. 8/14
    C 4-5 fusion 11/14
    Right scapulectomy 6/15
    Right pectoralis major muscle transfer to scapula
    To replace the action of Serratus Anterior muscle 3/16

  9. #9
    Join Date
    Jan 2012
    Location
    Yacolt, WA
    Posts
    1,527
    There is never an excuse for rudeness or arrogance. Now you need to decide if you want to go back and ask for an explanation of the procedures or if you are going to dump him and start with a new surgeon.

    So sorry that you are going through this.
    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

  10. #10
    Join Date
    May 2010
    Posts
    345
    I AGREE WITH SUSAN!!!! You should not ever put up with that kind of rudeness!! Hope you get an answer to you question. I know you don't want to start over, looking for a surgeon, but that is uncalled for!! GoodbLuck dear~~~
    Linda Brozik~~60 yrs. old at time of Lenke's first surgery. 62 now!
    Surgery 2006 L3/4 L4/5 double fusion/ instumentation/ With 2 cages
    This started adult onset scoliosis
    July 1st, 2010/ surgery ~~fused T10 to pelvis (long rods/ screws)
    Oct.20th 2010, extended rods to T4 / did osteotomy at L3
    Oct. 29th 2012 Dr. Lenke St. Louis Mo. T4 to sacrum osteotomy anterior cage L3/4 titanium rods
    May 30th 2013 revision
    May 8th cervicle surgery 2016
    May 31st Dr. Gupta revision 2017

  11. #11
    Join Date
    Mar 2005
    Location
    Ukiah CA
    Posts
    891
    i get your guys point but surgeons can get stress as well
    Kara
    25
    Brace 4-15-05-5-25-06
    Posterior Spinal Fusion 3-10-10
    T4-L2
    Before 50T
    After 20T

  12. #12
    Join Date
    Jan 2012
    Location
    Yacolt, WA
    Posts
    1,527
    Quote Originally Posted by kennedy View Post
    i get your guys point but surgeons can get stress as well
    Kennedy, I cannot even begin to imagine the stress that a spine surgeon must feel. My point was that his behavior and the way that he interacted with his patient, no matter the reason be it "stress" or whatever is never acceptable. Each of us needs to figure out how to handle stress in a way that is not hurtful either physically or emotionally, angry, or in the case of someone that is seen as an authority figure (like a doctor, parent, religious leader, teacher, etc) as a power-play or a dominance move.

    A surgeon that throws down a consent on the table and says, "Here is when you start trusting me". "Sign it or we will call the whole thing off", does not to me convey the trust that I believe is all important in a doctor/surgeon to patient relationship. I trust that my surgeon respects me. That behavior does not appear to be respectful.

    Susan
    Last edited by susancook; 01-03-2016 at 01:53 AM.
    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

  13. #13
    Join Date
    Dec 2008
    Location
    illinois
    Posts
    766
    We do need to trust our care team. But they must act in a manner that gives us the confidence to do so. If he is having a bad day, he knows from his experiences that the surgery patient is going to have some really bad days.
    This is a big deal!
    T10-pelvis fusion 12/08
    Fractured t-9 six days out of surgery
    C5,6,7 fusion 9/10
    PJK at t-9
    T2--T10 fusion 2/11
    Removal of left side t6-t10. 8/14
    C 4-5 fusion 11/14
    Right scapulectomy 6/15
    Right pectoralis major muscle transfer to scapula
    To replace the action of Serratus Anterior muscle 3/16

  14. #14
    Join Date
    Aug 2012
    Location
    San Francicsco Bay Area
    Posts
    127
    Thanks for the support, everyone. I have decided to call his nurse and ask about this additional surgery; what the segment instrumentation is, how is it different from Harrington rods, and what impact it will have on my current thoracic pain. Also if the surgery will be longer than the original six hours I was told and if the recovery will be longer. If he considers these questions to be inappropriate and decides to fire me, then so be it. I will go down to LA instead for surgery and see someone else. I will NOT be operated on from a position of fear and intimidation, nor of ignorance. Unfortunately, many of these deformity surgeons do indeed have God-complexes and do not like questions. What I mean is, what we consider totally appropriate questions might seem to them as not trusting them or questioning their authority. They get away with acting like Gods because they can. Believe me when I say this guy was the least God-complex out of the five I have seen. So, I risk him canceling my surgery on Thursday when I ask these questions. I will keep everyone posted. I am hoping for the best.
    Thanks again for the support.
    T1
    1st surgery: Fused T1-L3 in 1987 with contoured Harrington Rods. Rods broke at top.
    2nd surgery: Re-done two weeks later; fused C7-L3. Left in chronic pain.
    3rd surgery: Hardware removal 1997, but still pain for 30 years.
    4th Surgery: Fused to the sacrum in 2016. Came out of surgery with left foot paralysis. (Drop Foot) Can't walk on my own.
    I'm blessed to have found my peace and reason to live not from a husband or kids (I have none) but from God and within myself.

  15. #15
    Join Date
    Dec 2008
    Location
    illinois
    Posts
    766
    Go for it. Your questions are very important. I know this godlike attitude exists. I was recently treated at a major Chicago hospital. On my first visit the nurse explained there "speak up policy". It encourages the patient to ask questions and ask for explanations until you are satisfied with your treatment. My surgeon there(not spine) is listed as one of the top 100 doctors in Chicago.
    T10-pelvis fusion 12/08
    Fractured t-9 six days out of surgery
    C5,6,7 fusion 9/10
    PJK at t-9
    T2--T10 fusion 2/11
    Removal of left side t6-t10. 8/14
    C 4-5 fusion 11/14
    Right scapulectomy 6/15
    Right pectoralis major muscle transfer to scapula
    To replace the action of Serratus Anterior muscle 3/16

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