Considering a T8-L5 fusion

[ladare]

Hi, my name is Lisa, I'll very soon be 49, and I have idopathic scoliosis with a a lumbar curve of 46 degrees. The curve was increasing at the rate of about 1.5 degrees for 10 years, then it increased 8 degrees just in last year. The pain I experience has become debilitating. I can only stand or walk for about 10 minutes before the pain is excruciating. This pain is in my left buttocks, and my thigh gets numb and weak, and I get pins in needles in my lower leg. Sitting is becoming difficult also. Bending is nearly impossible due to the pain it causes at the apex of the curve. I also have arthrtis in my back, a slipped vertebra, and bone spurs. I'm on Tramadol, but is doesn't even touch the pain, but it does improve my outlook on life. The surgeon has been able to answer a lot of the procedure questions I have, but I still have questions about functionality after the surgery, so I'm hoping somebody with a fusion similar to T8-L5 can share with me what fuctional challenges they have had after surgery. To be honest, one of my biggest concerns is how well I'll be able to take care of myself after toileting. (I'm glad these blogs are basically anonymous... I'd also be interested in any other comments anyone has. This is such a huge decision.

Thanks!

Lisa

[Singer]

Hi Lisa,

My fusion is similar to the one you're thinking about (I'm almost 53). I was able to take care of all my toileting by the time I left rehab (20 days post-op). In terms of overall functionality, I'm not where I want to be yet -- I still can't touch my feet or tie shoes. I'm very stiff and feel just generally clunky (for want of a better word). I had a lot of trouble with the anterior portion of my surgery and it seems to me that people who have a posterior approach only seem to fare better overall. I DID get a great correction, but at what price?

It is a very tough decision but in terms of your pain levels and rate of progression it sounds like you are definitely a candidate for surgery.

[ladare]

Chris, I made a mistake - my fusion will be the same as yours T10-L5 (not T8 - I hear that is very bad place to end a fusion). But mine will be posterior only, which I know is much better than A/P. Thanks for your feedback. What do you think keeps you from touching your toes, the lack of mobility, or problems with the anterior surgery? I'm sorry to hear you are not where you want to be yet and wish you much progress soon!

Lisa

[sparklegirl59]

hello lisa

hi i'm val. i don't know, but it seems like your going to need God. He will help you through it all. just pray, and i will be praying too.

you will feel better knowing that God is in control. feel free to pm me anytime you would like too. (i'll be there if you wanna talk. ) God bless you, ~*val*~

[CHRIS WBS]

and it seems to me that people who have a posterior approach only seem to fare better overall.

But for how long? Checking Dr. Pashman's web site yesterday, here's what he says: "The anterior and posterior combination increase the surgical success rate dramatically."

[dolores a]

hi Ladare

Sounds like you are at the same stage and have the same questions as I do, though you appear to be much more knowledgeable of your condition then I am. I am waiting for my chart from my doctor so I can understand more, all I do know is that I have a 48* lumber curve, and a smaller Thoracic Curve and was told I need the surgery also. It seems that almost everyone has this sciatica thing going on also. I have the same symptoms you described. Did your doctor say at what point you would need surgery, mine said that I should have the surgery before I get into my sixties as the bones might not support such a surgery then. I guess my biggest question is which will be worse, not having the surgery deal with the pain, which I know will get worse, or have the surgery and deal with the unknown of how long it will be to recover.
_________________
Doloresa

[txmarinemom]

But for how long? Checking Dr. Pashman's web site yesterday, here's what he says: "The anterior and posterior combination increase the surgical success rate dramatically."

I think I'd need to see more evidence than one doctor's statement.

We all know surgeons have different views, and that statement is non-contextual without the TYPE of surgery he means, anyway.

To lend any validity whatsoever to *his* opinion, you'd need several MORE opinions - and more detail.

Regards,
Pam

[CHRIS WBS]

He was addressing surgical treatment of the lumbar spine.

[Susie*Bee]

Chris WBS

Your mailbox is full... I got interrupted in my way too long PMs to you!

(BTW--not related to this thread at all...)

[Geish]

I am willing to share my story. I am fused from T4 to the sacrum so it doesn't get a whole lot worse. I had issues toileting for the first few weeks. I just couldn't reach anything by myself. The Occupational Therapist brought me a tool at about 2 weeks post op and I was finally able to take over toileting by myself. Up to that point I had to have one of my daughters (ages 15 and 20) help me. Let me tell you it is very humbling. After about 2-3 weeks using the tool I had regained enough flexibility to be able to meet all of my needs with out the tool. I think it was sheer determination on my part! I will say that this whole experience has made me a better person and I know it has been a growing experience for both of my girls. I couldn't be prouder of them if I tried. I would be happy to answer any questions you may have. Really nothing you can ask is too personal, just send me an email or PM.
Alicia

[txmarinemom]

He was addressing surgical treatment of the lumbar spine.

And again ... that's one doctor's view.

[debbei]

Thank you Lisa for asking this question

it's one that didn't occur to me yet. SHEESH how humiliating, but I guess I'll have to get over it.

[txmarinemom]

it's one that didn't occur to me yet. SHEESH how humiliating, but I guess I'll have to get over it.

LOL, Debbe ... I have no doubt it just hadn't occurred to you ... yet .

[Singer]

Lisa -- to answer your question, it's my limited mobility that keeps me from touching my toes. I'm very stiff and inflexible around L5 (I have a ton of hardware there) but it may loosen up with time and PT. Some people with fusions to the sacrum are more flexible than I am, so I'm not sure what the deal is. I plan on asking Dr. B. about it at my one-year checkup next month.

[loves to skate]

loves to skate

Hi Lisa,
Welcome to the forum. In some respects, I'm glad I didn't find out about this forum before I had my surgery because toileting would be one more thing I would have worried about. I was fused from L2 to S1, both posterior and anterior. I had the same symptoms you are talking about prior to surgery for about 4 years. Unfortunately I only found out it was caused by a scoliosis 2 years ago, but that's another story. I had trouble toileting for about two weeks after the posterior surgery. After that it was OK. I can tie my shoelaces if I prop one leg over the opposite knee. I was able to cut my own toenails at about 2 1/2 months post-op by sitting on my bed and bringing my foot up onto the bed (I was so surprised I could do it).
Chris, you just posted while I was in the middle of my post. That is very interesting that some of us fused to the sacrum would be more flexable than those fused to L4,L5. Let me know what Dr. B says.
Doloresa, The bones of a 60 year old plus will support a fusion so long as you don't let osteoporosis take over. The problem at this age is that the Dr. won't be able to get much of a correction.
Pam, You can add Dr. Rand to your list of one who says that he can obtain a much stronger fusion using both anterior and posterior approach for a lumbar fusion, which I believe means less chance for failure. I don't know if age has anything to do with it.
For what it is worth, Sally