I had my 4th (and final) opinion yesterday up in NYC with Dr. Federico Girardi at the Hospital for Special Surgery. It was quite interesting to say the least. Some brief background: posterior spinal fusion 1993, revision 1995 and pain getting progressively worse from about 2004 until now. Saw 3 orthopedic spine specialists in my area - all 3 said pretty much the same thing: (1) remove L5-S1 disc, replace it with cage and bone protein; (2) remove Harrington rods/hooks; (3) fuse L1-S1 and further fuse spine to sacrum with pelvic rods going into either side; (4) osteotomies to correct Flatback. I was told 12-14 hr surgery (1 dr would do it in 2 stages 1 week apart so 2 weeks total in hospital) - HUGE risks for blood loss and nerve damage - 40% never work again (I'm an OT) - 2 yrs until fully recovered - and out of work atleast 1 yr (given the nature of my work - i do alot of patient transfers, ADL's, functional mobility, etc) - brace for 3 months - all 3 couldn't emphasize enough how "big and complex" this operation would be and all of them stressed how risky it was.
NOW, Dr. Girardi on the other hand had this to say: (1) still remove L5-S1 and put cage and bone protein in to fuse it; (2) flip me over and remove hardware; (3) fuse approximately L3-L4-L5 and that he would see once he got in there if he'd need to fuse to my sacrum or not. Having had 2 prior posterior lumbar fusions, i have bone grafting scars on either side of my iliac crest (L/R) - if the pelvic bone was brittle and thin (from the grafting) he wouldn't fuse spine to sacrum. If it was strong, he would. He would NOT do osteotomies - he said the L5-S1 fusion would fix that (?? - really ?? - i thought the osteotomies would fix it but maybe i'm wrong??) - he said a brace would be up to me (again, i thought that was strange since i had one for both surgeries before) - if i wanted a brace he'd give me one. He said the whole operation would be maybe 6 hours - that seems really short given that the other dr's said it was such a complex procedure. I'd be in hospital about 4 days then to rehab for a week or so. But the thing that REALLY surprised me was that he said although i'd not be allowed to do any lifting or bending for the first 3 months, after 3 months there would be NO restrictions - i could do basically whatever i wanted and return to work. IS HE SERIOUS?? Now i don't know about all of you, but having gone thru TWO previous spinal fusions, i can assure i was in no shape to work (let alone lift and transfer patients!) 3 months post-op! And if this surgery is bigger and more complex than the other 2, how would that even be possible??
I don't know...don't get me wrong, i was happy to hear his optimism, but realistically, is this REALLY what i should expect?? I thought i'd be 100% sure of who i'd pick after this consult but now all i can think of is "Why is his picture so much rosier than the other THREE??"
Thoughts?? Insights?? Anything to help me sort this out
NOW, Dr. Girardi on the other hand had this to say: (1) still remove L5-S1 and put cage and bone protein in to fuse it; (2) flip me over and remove hardware; (3) fuse approximately L3-L4-L5 and that he would see once he got in there if he'd need to fuse to my sacrum or not. Having had 2 prior posterior lumbar fusions, i have bone grafting scars on either side of my iliac crest (L/R) - if the pelvic bone was brittle and thin (from the grafting) he wouldn't fuse spine to sacrum. If it was strong, he would. He would NOT do osteotomies - he said the L5-S1 fusion would fix that (?? - really ?? - i thought the osteotomies would fix it but maybe i'm wrong??) - he said a brace would be up to me (again, i thought that was strange since i had one for both surgeries before) - if i wanted a brace he'd give me one. He said the whole operation would be maybe 6 hours - that seems really short given that the other dr's said it was such a complex procedure. I'd be in hospital about 4 days then to rehab for a week or so. But the thing that REALLY surprised me was that he said although i'd not be allowed to do any lifting or bending for the first 3 months, after 3 months there would be NO restrictions - i could do basically whatever i wanted and return to work. IS HE SERIOUS?? Now i don't know about all of you, but having gone thru TWO previous spinal fusions, i can assure i was in no shape to work (let alone lift and transfer patients!) 3 months post-op! And if this surgery is bigger and more complex than the other 2, how would that even be possible??
I don't know...don't get me wrong, i was happy to hear his optimism, but realistically, is this REALLY what i should expect?? I thought i'd be 100% sure of who i'd pick after this consult but now all i can think of is "Why is his picture so much rosier than the other THREE??"
Thoughts?? Insights?? Anything to help me sort this out
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