Second surgery months later

[trulyaries]

I would like to know if anyone has had a posterior fusion to S1 and then had an anterior fusion in the same area - not immediately but several months later. If so, why did you have to have the second surgery and what was done? I would like some feedback before I get into my situation.

[CHRIS WBS]

I know of a woman who had posterior surgery to the sacrum in April of this year by Dr. Bridwell and then went back in June to have anterior surgery. Given her age (61) Dr. Bridwell preferred to space her surgeries a few months apart. JanL is having the identical surgery by Dr. Bridwell this week, but because she is younger, her surgeries are both this week. Dr. Bridwell has pretty much backed away from performing thoracoabdominal approaches which require a chest/stomach incision. He will perform an anterior distal lumbar approach when needed which does not disrupt the rib cage or diaphragm. This is what was explained to me when I met with him in September of last year.

Chris

[trulyaries]

Thanks, Chris. My doctor explained to me that the incision would be low in the left abdomen. He would do a discectomy at L5-S1, use more of my bone and donor bone (a donut?), and affix a plate in front across L5-S1 (?). Reason for my questions: he sent me for myelogram and CTscan after my 6-month checkup because I was complaining about bending over, pain, and nerve pain whenever pressure is put on my butt, especially the left. When we reviewed the results, he said everything looked fine; the fusion was taking place except for a small spot at the bottom. He said he thought my bending over was from pain. To be fair, when I first get up in the morning, I'm standing up straight without thinking about it. But after a very short time, I'm bending over again. I'm on an NSAID for pain and gabapentin for nerve pain.) He did not mention another surgery at first, but in thinking back I may have pushed it a little because I told him if I had to have it I didn't want to wait another six months. So I'm on his calendar in February, with the agreement I would see him again in January to see if there's any improvement first.

I have been having second thoughts since my visit with him and have a million questions I didn't think to ask before. This has all been so difficult for me - I'm normally a very active person and my recuperation this time around has been tough. I don't know how to decide whether my back just needs more time or whether another surgery is the right thing to do. By the way, this doctor is quite conservative and doesn't want me to do much more than walking until the fusion heals. I can manage on the treadmill because I can hold myself upright. But I cannot keep myself upright when walking for any length of time otherwise. (My ego won't let me go outside with a walker ) Sorry for this long post. Any advice would be welcome.

[Singer]

About going outside with a walker -- if I hadn't gone for long walks outside with a walker I never would have started to heal. I was on a walker for three months after my surgery. I sure hope more surgery isn't the answer for you.

[trulyaries]

Chris:
I was half-way joking about the walker. I did use it but not immediately. As I mentioned, my doctor is conservative and didn't really want me to do too much during the first 3 months, and I wouldn't have been able to anyway since my initial recovery was tough. When I did use the walker my arms and shoulders got so sore from pushing myself upright I gave it up. It's the same with the treadmill, so I try to do it in shorter segments through the day. Believe me, I really do try to be compliant, but as we see on this website, different surgeons' instructions are all over the map, and I tire of hearing "everybody's different." I wish they could give us some for-sure guidelines: "if you do A, you get B." Wishful thinking ...

[Singer]

Got it. Didn't mean to sound like a know-it-all..... I think I still feel a little sorry for myself for HAVING to use the walker.....

And yes, wouldn't it be great if recovery was one-size-fits-all instead of having endless variations?? I find that it's the only weakness of this forum: the tendency to compare, then start worrying that we're not doing as well as the next person....!

Best,
Chris

[trulyaries]

And yes, wouldn't it be great if recovery was one-size-fits-all instead of having endless variations?? I find that it's the only weakness of this forum: the tendency to compare, then start worrying that we're not doing as well as the next person....!

Amen, I say, amen. It's constant agonizing: Did I do something wrong? Did I not do something I should have?

[CurvySAT05]

I just had an A/P revision from T2-Sacrum and anchored in the Ilium on 12/5. My surgeon did the same anterior procedure that yours is talking about (from what it sounds like). I have about a 2" incision on my lower left abdomen, just below my belly button. He removed my discs at L4-5 (because it was herniated) and L5-S1 and replaced them with bone wedges (cadaver) as well as using BMP. I have a screw to hold the bone wedges in place. (I didn't see the x-rays for very long, so I don't know if there is more than just the screw).
I had developed pseudoarthrosis from a previous fusion and had 2 loose screws at L5. I also had flatback syndrome so was walking "bent forward" all the time. By using the bone wedges, my surgeon was able to bring me back into a natural alignment and then fused it that way. I had the posterior procedure at the same time b/c of the pseudoarthrosis and other problems, but it sounds like your surgeon would use a plate in front to fuse the wedge in place. Thats my experience and guess.

[trulyaries]

Yes, that does sound like what my doc is proposing to do. I see him on January 15 to make a go/no-go decision, and I have a ton of further questions for him after having had a chance to think about it more.

Can you tell me what your symptoms were from the loose screws? I forgot to mention that he said there was a halo around one of the screws which might indicate some movement.

Thanks for your response!

[trulyaries]

4th surgery on February 11

Well, I saw my surgeon yesterday and I'm going ahead with surgery next month. Maybe not surprising, I think I'm more apprehensive about this pending surgery than ever before. So I'm on a total pity party for two days now, ever since I had a total meltdown in my doc's office. Friends and family seem indifferent, probably because they have been through this with me so many times that the novelty has worn off. I'm sure I'll get over this funk, but it's a struggle right now. Thanks for letting me vent.

[Singer]

I really feel for you. I would hate to be facing yet another surgery, as you are. BUT - if it finally does the trick for you, it will be more than worth it!!
Vent all you want -- I sure would !!!

[Susie*Bee]

Dear Trulyaries--Of course you are having a pity party! That's a lot to deal with--the disappointment of not being "through," frustrations, fears--the whole gamut of concerns and emotions when dealing with yet another surgery. I'm sorry your back-up group is acting indifferently to you, but imagine they will come through when it's clench time. Perhaps they just don't know how or what their reaction should be right now... that's when people tend to distance themselves from someone in need. Possibly (?) you are also at a super-sensitive time emotionally-- I'm sure I would be (!) and so are magnifying their reaction. Regardless, don't feel bad about having a good cry about all this--it all has to come out someway. My suggestion is to then move on by getting things ready and trying to do some enjoyable things with friends/family --or just by yourself, to occupy your time till surgery. Keep in mind that we are feeling for you and will be praying for a successful surgery and recovery. And please keep us informed of both the ups and downs you go through in the meantime. This is the place to vent! Take care!

[CHRIS WBS]

Truly,

I’m so sorry to hear that you have to go through yet another surgery. Lord knows maybe this will be my fate as well. We just don’t know what our outcomes will be from this surgery. All we can do is pray and hope for the best. I sincerely pray that this is the last surgery on your spine and all will go well for you.

Chris

[trulyaries]

Thanks for your support - you guys are great! I'm feeling better tonight and moving forward to get ready for the surgery. Ironically, my home is still pretty much in post-op mode since the last time. I think my coffeemaker now has a permanent home in my bedroom! Susie, you are right as far as my support group goes - those who are always there, always will be, and those who aren't, won't ever be. My niece, one who IS always there for me, had me laughing hard last night telling me all the things I did and said post-op that I don't remember! I just have to deal with the reality of what I'm facing and do what I have to do to get through it. I just wish I could be done with all of this back stuff ... as I said ...