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  1. #1
    Join Date
    Jun 2017
    Posts
    11

    Question Revision surgery with Dr. Arlet

    Hello,

    This is the first time posting here. I have a revision surgery set with Dr. Vincent Arlet on 07/17. This will be from T4-L2. I am 26 and had my first surgery when I was 12 years old. My curve is now at 65 degrees to the left thoracic and with a prominent rib hump when bending over. The curvature is expected to increase at 1 degree per year and therefore I would like to put this behind me while I'm young, healthy and in relatively good shape.

    My questions is does anyone know of anyone having surgery done with Dr. Arlet? From my research he seems to be well appraised but I have not seen much mention of him on this site.

    Also from experience does anyone know what sort of curvature correction I may receive along with any reduction in the rib hump? Dr. Arlet advised there could be a 40% correction but I am not sure that is feasible. He also mentioned there could be a reduction in the rib hump but did not want to perform a thoracoplasty.

    Any thoughts or feedback would be great.

  2. #2
    Join Date
    May 2008
    Location
    reno,nevada
    Posts
    3,551
    Welcome to the forum, nice to see younger folks posting...

    I am not understanding, what levels did you have fused when you were 12? and what will be revised? Do you have any x-rays you could post?

    Its impossible to say what curve correction you will have, in general, adult corrections are usually in the neighborhood of 50%

    I was told I could be fused "as is" since many questions get answered after they get in. Expecting no correction as the worst outcome prepared me and when the nurse brought my x-rays in to see, I was pleasantly surprised with what I saw and I am quite happy...I still have a small thoracic hump, this being corrected by the de-rotational abilities of modern hardware systems. Thoracoplasty is a rare thing here in the states....there are not many members here that have had thoracotomy done. I have read that open thoracotomy is especially painful, and for pain, its in first place. Its something I would have trouble begging for. Our surgeries are hard enough as it is.

    There were a few posts about Dr Arlet a few years ago......from what I am seeing, he looks like he has been on the scene for many many years....

    How much pain are you in?

    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
    Jun 2017
    Posts
    11
    Hey Ed,

    I am not sure exactly what levels were fused previously. Basically Dr. Arlet will be fusing more levels to hopefully correct some of the curve and then prevent it from curving in the future.

    I'm in pretty good shape , I go to the gym 3-5 days per week, I lift weights and do cardio when I am at the gym. I would say my pain is sparatic but it has never stopped me from going to work or being out and about.

    My main reasoning for moving forward would be to prevent the curve from getting worse and to hopefully increase the cosmetics of my back / rib hump. Dr. Arlet himself appears to know what he is doing but hasn't been to transparent in explaining what to expect and what not. I could just be having last minute jitters knowing that I'm going from a pretty active and social lifestyle to the opposite.

  4. #4
    Join Date
    Jan 2008
    Location
    NC
    Posts
    8,903
    Hi.

    I had the same question that Ed had about what operation you had when you were 12. I am not clear on why that didn't stabilize your curve unless you have adding on or something where you have other curves that weren't fused originally that are progressing.

    Knowledge is power and you deserve to know exactly what was done and what will be done. If you ask Arlet he will tell you. I suspect you are not sure what to ask to I am going to throw questions out there you can use if you want...

    1. What levels were previously fused?

    2. Why do I need a second operation? Did other curves develop or did my original fusion not take?

    3. Are you removing hardware? If you want it ask him for it. He will likely give it to you.

    4. Am I a candidate for vertebral body tethering either of the original curve or any new curve? Tethering is an experimental technique that is showing promise. It is better than fusion in sparing motion... it preserves front to back motion but you will still lose some side to side and twisting.


    Revisions are generally easier than original surgeries per the testimonials I have heard.

    Assuming nothing else is going on, with a T4-L2 fusion I suspect you will have no restrictions on physical activity beyond bungee jumping and such. Both my daughters are fused T4-L1 and have no restrictions other than bungee jumping. They claim they feel normal and the one I asked didn't even realize she didn't have a normal range of motion bending side to side. People don't bend through the thorax much so her ROM is less than an unfused person but not much less. I think it will be similar to you. Even with tethering the bending to the side is restricted because of the tether. The tether mainly preserves front to back bending per that one study I saw.

    Good luck. At 26 I suspect you will recover like a teenager which means weeks versus months before you feel better.
    Last edited by Pooka1; 07-07-2017 at 12:09 PM.
    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."

  5. #5
    Join Date
    Jun 2017
    Posts
    11
    So I was able to look at my records online and the prior surgery was a fusion from t8-t11 with the use of a Harrington rod. The X-ray noted scoliosis from t6-l2 which would seem to make sense as to why the surgery will be t4-l2. Do you know what type of rods are used now ? From my readings on here it appears the Harrington rod is obsolete so to speak.

    Thanks !

  6. #6
    Join Date
    Jan 2008
    Location
    NC
    Posts
    8,903
    Yes you will receive a modern segmental construct. Because you are not being fused too far into the lumbar, trying tethering may not be worth it. Most people don't bend very much through the thorax to the point that my daughter who has a fused thorax didn't realize she had lower ROM than unfused people until I showed her me bending to the side. Most people don't bend to the side which is which she didn't realize it.
    Last edited by Pooka1; 07-07-2017 at 11:34 AM.
    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."

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