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Thread: Questions about a fused spine

  1. #1
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    Questions about a fused spine

    I know nobody here is a doctor, but so many of you are obviously very well read and I feel it's simpler to ask questions here than bother my very busy surgeon.

    After a spine is fully fused:

    * is it impossible for osteoarthritis to set in, due to it being immobilised?
    * can discs continue to deteriorate? I'm talking about the fused area.
    * can the spine continue to rotate as opposed to curve?
    * if there is no sciatica present after fusion, is it impossible to get sciatica at a later stage? In otherwords, can anything move or change to cause it?

    Thanks in advance.
    Surgery March 3, 2009 at almost 58, now 63.
    Dr. Askin, Brisbane, Australia
    T4-Pelvis, Posterior only
    Osteotomies and Laminectomies
    Was 68 degrees, now 22 and pain free

  2. #2
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    Question fusion questions

    The discs in the fused area are removed during surgery. At least that is how mine was done. Discs below the fused area get extra work.

    The sciatic nerve runs out of the spine, down the the buttocks and down the leg. Anything that bothers the nerve after it comes out the spine, along that path, can annoy that nerve and cause sciatica.

    The purpose of the hardware is to support the spine during healing and maintain correction after healing. My original fusion in 1956 was without disc removal and hardware.That meant I spent a year in bed-not walking for the fusion to heal!!! My fusion weakened and my spine curved over the next 40 years.. The discs within the fusion area degenerated destabilizing the spine.
    Original scoliosis surgery 1956 T-4 to L-2 ~100 degree thoracic (triple)curves at age 14. NO hardware-lost correction.
    Anterior/posterior revision T-4 to Sacrum in 2002, age 60, by Dr. Boachie-Adjei @Hospital for Special Surgery, NY = 50% correction

  3. #3
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    Quote Originally Posted by Karen Ocker View Post
    The discs in the fused area are removed during surgery. At least that is how mine was done. Discs below the fused area get extra work.

    The sciatic nerve runs out of the spine, down the the buttocks and down the leg. Anything that bothers the nerve after it comes out the spine, along that path, can annoy that nerve and cause sciatica.

    The purpose of the hardware is to support the spine during healing and maintain correction after healing. My original fusion in 1956 was without disc removal and hardware.That meant I spent a year in bed-not walking for the fusion to heal!!! My fusion weakened and my spine curved over the next 40 years.. The discs within the fusion area degenerated destabilizing the spine.
    FYI--my disks were not removed during my surgery. I wasn't sure and asked specifically at my last appointment.
    __________________________________________
    Debbe - 50 yrs old

    Milwalkee Brace 1976 - 79
    Told by Dr. my curve would never progress

    Surgery 10/15/08 in NYC by Dr. Michael Neuwirth
    Pre-Surgury Thorasic: 66 degrees
    Pre-Surgery Lumbar: 66 degrees

    Post-Surgery Thorasic: 34 degrees
    Post-Surgery Lumbar: 22 degrees

  4. #4
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    Nov 2005
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    I think that removing the discs is typically only done during an anterior release procedure or anterior fusion procedure, so if you had a posterior-only fusion then you won't have had it done.

    The number of discs removed during an anterior release can be limited to the discs at the apex of the curve, or more can be removed if necessary (I had all the discs of my rodded/fused vertebrae removed during my first surgery when I was 10, in order to prevent crankshaft phenomenon).

  5. #5
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    Quote Originally Posted by JenniferG View Post
    After a spine is fully fused:

    * is it impossible for osteoarthritis to set in, due to it being immobilised?
    * can discs continue to deteriorate? I'm talking about the fused area.
    * can the spine continue to rotate as opposed to curve?
    * if there is no sciatica present after fusion, is it impossible to get sciatica at a later stage? In otherwords, can anything move or change to cause it?

    Thanks in advance.

    You really should ask these questions of your doctor.

    Assuming everything heals and fuses completely, the bones won't move. Once the bones are fused, the discs are useless. It doesn't matter if they are taken out or not. They normally function as shock absorbers and if your bones are fused completely, the stresses will be transferred to adjacent vertebrae and discs. Because of the transfer of stresses to unfused vertbrae, there is a risk of deterioration of adjacent discs.

    Fused vertebrae shouldn't ever move, unless they never completely healed.

  6. #6
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    Hi...

    Tonibunny is correct. Discs are usually removed during anterior surgery. I've been told that, over time, the discs that are within the fused area of the spine, desicate. Ideally, there would be no movement at those levels, so the discs don't really have a function.

    The spine can both curve and rotate above or below the fusion mass, but there would be little to no movement of the successfully fused spine.

    I'm uncertain about the question of arthritis and sciatica. I think that sciatica can be generated from multiple nerve roots, so sciatica could be a problem for anyone who has less than their full lumbar spine and ilium fused.

    Regards,
    Linda

  7. #7
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    Thank you to all who provided answers. I will ask the surgeon whether my discs were removed or not during my surgery. I have a vague memory that he said they were, but my surgery was all posterior.
    Surgery March 3, 2009 at almost 58, now 63.
    Dr. Askin, Brisbane, Australia
    T4-Pelvis, Posterior only
    Osteotomies and Laminectomies
    Was 68 degrees, now 22 and pain free

  8. #8
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    Karen, the surgery you had in 1956 is what I was offered at age 13. I did not have it. How did you cope with not walking for so long? Were you in hospital for the entire year? Did it have any adverse psychological effects on you?

    I recently met a woman who had that surgery at age 14. She's now badly crippled and lives with pain. She says she's inoperable.
    Surgery March 3, 2009 at almost 58, now 63.
    Dr. Askin, Brisbane, Australia
    T4-Pelvis, Posterior only
    Osteotomies and Laminectomies
    Was 68 degrees, now 22 and pain free

  9. #9
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    Apr 2009
    Location
    Queensland, Australia
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    Hi Jennifer,

    How are you?
    We are all o.k.
    Gabbys op. is scheduled for 1st December.
    Dr. Askin said he would not remove Gabbys discs and that they would only be removed in an anterior procedure.
    How are things for you these days.
    Donna.
    Mother to 14 year old daughter, Gabrielle (Gabby).
    Discovered her scoliosis on her 14th Birthday in February 2009. Due to be operated on for curves of 57 and 54 degrees (S Curve) in December 2009 with Dr. Askin in Brisbane.

  10. #10
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    Hello Donna. I was only thinking of you the other day because I knew Gab's surgery was coming up shortly. I hope you are both coping well. Thanks for that info about the discs. I am positive that Dr. Askin is going to do a top notch job for Gab. Not long now, and it will be behind you and you can look forward to watching Gab getting better every day and back to her old (new!) self.

    I'll be thinking of you December 1.

    Oh, and I'm going great thanks Donna. You've found the best surgeon for Gab!
    Surgery March 3, 2009 at almost 58, now 63.
    Dr. Askin, Brisbane, Australia
    T4-Pelvis, Posterior only
    Osteotomies and Laminectomies
    Was 68 degrees, now 22 and pain free

  11. #11
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    Wheeling, WV
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    If you have responses from both Linda R. and Karen O., you've heard from the wisest.

    All I can do is wish you all the best,
    Shari

  12. #12
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    Jennifer --
    My surgery was all posterior too but he does the "reach around" to remove the discs and also to place my 2 cages. I guess there's discs up the rest of the way too?? and they get taken out I'm sure for the bone stuff, I guess.
    When I was 13 and told about surgery it was kind of the same thing. You had to be in a body cast for 9 months! Boy, that's what a young teen wants to hear. I didn't do the brace either. I remember totally freaking out about that. Many of us have some similar back stories. Janet
    Janet

    61 years old--57 for surgery

    Diagnosed in 1965 at age of 13--no brace
    Thoracic Curve: 96 degrees to 35 degrees
    Lumbar Curve: 63 degrees to 5 degrees
    Surgery with Dr. Lenke in St. Louis--March 30, 2009
    T-2 to Pelvis, and hopefully all posterior procedure.

    All was posterior along with 2 cages and 6 osteotomies.

  13. #13
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    Hi Janet...

    Surgeons do the PLIF (posterior lumbar interbody fusion) from the back, but usually on a maximum of 2 or 3 discs. There's not a lot of benefit in doing a lot more from the back.

    Regards,
    Linda

  14. #14
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    Oct 2008
    Location
    Sunshine Coast, Queensland, Australia
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    Thanks to all for answering my questions. I don't see my surgeon until March 2010 - I'll probably have compiled another list by then.
    Surgery March 3, 2009 at almost 58, now 63.
    Dr. Askin, Brisbane, Australia
    T4-Pelvis, Posterior only
    Osteotomies and Laminectomies
    Was 68 degrees, now 22 and pain free

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