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Thread: New info on more fusion leads to more questions

  1. #1
    Join Date
    Mar 2017
    Location
    Ohio
    Posts
    5

    New info on more fusion leads to more questions

    Appreciate all of the replies to my earlier thread and now have some progress to report as well as new questions. Now I have talked to 3 different surgeons and even though they all agree on fixing my flat back, they really vary in their approaches and this is confusing to me.

    One wants to piggy-back new instrumentation on my Harrington rod. Another wants to do an ALIF, but not do anything with the old rod. The third surgeon wants to also do an ALIF, but also take out all of the old hardware in the process. I have no issues with the old rod. Does anyone know any advantages to removing the old rod, especially if it hasn't caused any problems?

    Would really appreciate any advice I could get on any of this.

    Thanks all!

  2. #2
    Join Date
    May 2008
    Location
    reno,nevada
    Posts
    3,551
    I would guess that the complete removal of the old Harrington would have to do with re-balancing you from the side.....If they mention osteotomy, they will re-establish or increase lordosis in your lower spine. The balancing of the spine and having a proper plumb is what scoliosis surgeons do, they are experts at balancing us. You don't want to end up leaning in any direction. You want to be standing up straight after your are done. You need an experienced scoliosis revision surgeon or surgeons.

    2 out of 3 recommend ALIF. If they are doing an ALIF, they will also instrument from the back for your lower levels. I am assuming they are taking it to the pelvis.

    ALIF for problem lumbar cases seems to works well judging by the testimonials here. They insert a spacer, pack it with graft or BMP and its the compression that works so well for the fusion process.

    ALIF is also serious surgery.....there are things that can happen, but they do have good results and will use a vascular surgeon for this procedure. Please be aware of complications.

    I have no problems at all with my lumbar spine. None at all.

    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

  3. #3
    Join Date
    Sep 2003
    Location
    Northern California
    Posts
    6,797
    Quote Originally Posted by OhioSwimmer View Post
    Appreciate all of the replies to my earlier thread and now have some progress to report as well as new questions. Now I have talked to 3 different surgeons and even though they all agree on fixing my flat back, they really vary in their approaches and this is confusing to me.

    One wants to piggy-back new instrumentation on my Harrington rod. Another wants to do an ALIF, but not do anything with the old rod. The third surgeon wants to also do an ALIF, but also take out all of the old hardware in the process. I have no issues with the old rod. Does anyone know any advantages to removing the old rod, especially if it hasn't caused any problems?

    Would really appreciate any advice I could get on any of this.

    Thanks all!
    We can't possibly know what's right for your specific situation. I would do a little research on each of the surgeons. Where did they attend medical school? Did they do an adult spine fellowship? Once you're comfortable with one of the surgeons, trust that they're going to do what is best for you. I have a decent amount of experience in deformity surgery issues, but I can't possibly know as much as an experienced spine surgeon.

    --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
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    If you've signed up and are having trouble posting, please check your spam folder. An email was sent to the email address which you subscribed. You have to follow the instructions in that email. Done that and still having trouble posting? Contact Joe O'Brien at jpobrien@scoliosis.org.

  4. #4
    Join Date
    Mar 2017
    Location
    Ohio
    Posts
    5

    Appreciate it and helpful

    Quote Originally Posted by titaniumed View Post
    I would guess that the complete removal of the old Harrington would have to do with re-balancing you from the side.....If they mention osteotomy, they will re-establish or increase lordosis in your lower spine. The balancing of the spine and having a proper plumb is what scoliosis surgeons do, they are experts at balancing us. You don't want to end up leaning in any direction. You want to be standing up straight after your are done. You need an experienced scoliosis revision surgeon or surgeons.

    2 out of 3 recommend ALIF. If they are doing an ALIF, they will also instrument from the back for your lower levels. I am assuming they are taking it to the pelvis.

    ALIF for problem lumbar cases seems to works well judging by the testimonials here. They insert a spacer, pack it with graft or BMP and its the compression that works so well for the fusion process.

    ALIF is also serious surgery.....there are things that can happen, but they do have good results and will use a vascular surgeon for this procedure. Please be aware of complications.

    I have no problems at all with my lumbar spine. None at all.

    Ed
    Thanks much Ed for those details. This makes sense and helps me to understand. Yes, I understand that the surgeons want to restore lordosis and balance.

    Something that I didn't make clear is that all three surgeons want to do an ALIF with a posterior fusion. Yes, I understand that this is big procedure, which is why I feel it is important for me to be educated about it.

    Also, so glad to hear that you have done so well!

  5. #5
    Join Date
    Mar 2017
    Location
    Ohio
    Posts
    5

    Comfort level important

    Quote Originally Posted by LindaRacine View Post
    We can't possibly know what's right for your specific situation. I would do a little research on each of the surgeons. Where did they attend medical school? Did they do an adult spine fellowship? Once you're comfortable with one of the surgeons, trust that they're going to do what is best for you. I have a decent amount of experience in deformity surgery issues, but I can't possibly know as much as an experienced spine surgeon.

    --Linda
    Thanks Linda and great idea on doing some research on the surgeons. I agree that it is worthwhile finding out info on their training and having a very high comfort level with them. For me, patient education is also really important and that includes understanding more about the procedure. I realize that is not the case with everyone.

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