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Thread: Unexpected long term complication of anterior approach for revision.

  1. #1
    Join Date
    Sep 2003

    Exclamation Unexpected long term complication of anterior approach for revision.

    As I have posted many times before I got my life back after my revision.

    In June I developed a small bowel obstruction requiring emergency surgery to remove extensive scar tissue and 1 1/2 feet of jejunum(small intestine). I almost didn't make it. My surgeon said the anterior approach caused a defect in the mesentery through which my small intestine got trapped and strangulated. My recovery was complicated by loss of blood and a wound infection. I spent 2 1/2 weeks in hospital and 5 weeks in rehab. granted being 70 years old increases the risk.

    What to take out of this? Those who've had an anterior approach be aware and seek medical attention quickly if you cannot pass gas, have a BM and have nausea/vomiting.
    Better yet: avoid the anterior approach if possible.
    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

  2. #2
    Join Date
    Jan 2008
    Karen I am very glad you are okay now.

    Thank you very much for posting that. That is extremely helpful.
    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."

  3. #3
    Join Date
    Oct 2007
    Wow. Good to have you alive and well and warning others. That is quite an unexpected complication. You take care-- and thanks for the information.
    67 and plugging along...
    2007 52į w/ severe lumbar stenosis & L2L3 lateral listhesis (side shift)
    5/4/07 posterior spinal fusion T2-L4 w/ laminectomies and osteotomies @L2L3, L3L4
    Dr. Kim Hammerberg, Rush Univ. Medical Center in Chicago

    Corrected to 15į
    CMT (type 2) DX in 2014, progressing
    NEW 10/2018 x-rays show spondylolisthesis at L4/L5 - Dr. DeWald is monitoring

    Click to view my pics: pics of scoli x-rays digital x-rays, and pics of me

  4. #4
    Join Date
    Oct 2008
    Sunshine Coast, Queensland, Australia
    Sorry to hear you've experienced this complication Karen, but glad to hear you're on the way back to good health.

    I am wondering if this sort of information is relayed back to our surgeons as well as scoli surgeons generally.
    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

  5. #5
    Join Date
    May 2010
    Indianapolis area

    That must have been really scary and also quite a burdensome recovery. I'm sorry you had to go through that, but glad you're okay! I like the suggestion to inform your scoli surgeon.

    age 48
    80* thoracolumbar; 40* thoracic
    Reduced to ~16* thoracolumbar; ~0* thoracic
    Surgery 3/14/12 with Dr. Lenke in St. Louis, T4 to S1 with pelvic fixation
    Broken rods 12/1/19; scheduled for revision fusion L1-L3-4 with Dr. Lenke 2/4/2020
    Not "confused" anymore, but don't know how to change my username.

  6. #6
    Join Date
    Jan 2012
    Yacolt, WA
    Thanks for letting us know. Hope that you are OK. If I have surgery, I will be I will ask my MD how to possibly prevemt this.
    Adult Onset Degen Scoliosis @65, 25* T & 36* L w/ 11.2 cm coronal balance; T kyphosis 90*; Sev disc degen T & L stenosis

    2013: T3- S1 Fusion w/ ALIF L4-S1/XLIF L2-4, PSF T4-S1 2 surgeries
    2014: Hernia @ ALIF repaired; Emergency screw removal SCI T4,5 sec to PJK
    2015: Rev Broken Bil T & L rods and no fusion: 2 revision surgeries; hardware P. Acnes infection
    2016: Ant/Lat Lumbar diskectomy w/ 4 cages + BMP + harvested bone
    2018: Removal L4,5 screw
    2021: Removal T1 screw & rod

  7. #7
    Join Date
    Jan 2009
    Ames, Iowa
    Oh my gosh, Karen, that all sounds frightening. So glad you are recovering now. Thanks for letting us know. 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.

  8. #8
    Join Date
    Jun 2011
    Southern CA
    Glad that you are doing so well

    Fused from C2 - sacrum 7/2011

    April 21, 2020- another broken rod surgery

  9. #9
    Join Date
    Sep 2003
    Northern California

    Glad you're OK, and sorry for the ordeal. Thankfully, most surgeons who do ALIFs are not cutting the muscle, so this will no longer be an issue except for the occasional patient who requires a thoracotomy.

    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

  10. #10
    Join Date
    May 2008

    Oh boy..... Iím so glad your ok.

    I know the feeling when the plumbing stops up as I had a stubborn ileus. I knew I was in trouble RIGHT away. I take it that you didnít waste anytime going to the hospital....

    Now Iím wondering if scar tissue grows? Did you have this obstruction since 2002, did you have any symptoms all along? Any idea what could have caused this to happen now? 10 years later?

    I remember my vascular surgeon saying that they wouldnít penetrate or open my Peritonium, they push it to the side to gain access. An anatomy lesson on the fly. 10 seconds later, I was out and being wheeled in. Was it the same for you with Boachie?

    I am especially glad you posted.

    49 yr old male, now 62, the new 63...
    Pre surgery curves T70,L70
    ALIF/PSA 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

    My x-rays

  11. #11
    Join Date
    Apr 2012
    San Jose, CA
    That is scary. Complication many years later... I hope that you are doing better, Karen.

  12. #12
    Join Date
    Jan 2006
    near Philadelphia
    Good Lord, that's terrifying. I'm so glad you're okay! Thanks for letting us know.

    I have heard that this is a potential development for anyone who has had any kind of abdominal surgery -- it happened to an acquaintance of mine who'd had surgery for a hernia years before.

    I had the same-sized anterior incision as you, so naturally this gives me significant pause.
    A/P fusion on June 19, 2007 at age 52; T10-L5
    Pre-op thoracolumbar curve: 70 degrees
    Post-op curve: 12 degrees
    Dr. Boachie-adjei, HSS, New York

  13. #13
    Join Date
    Aug 2004
    That must have been very scary! I am so glad to hear that you are OK!!!!!
    Mom to David, age 17, braced June 2000 to March 2004
    Vertebral Body Stapling 3/10/04 for 40 degree curve (currently mid 20's)

  14. #14
    Join Date
    Mar 2010
    That is SOOO scary! Do they not take the time to close the mesentery when doing anterior surgery? I understand that scar tissue can develop from any surgery. This is something that one wouldn't expect years down the road. Thanks for bringing it to everyone's attention. I'm really glad to hear that you are okay.

    Best wishes.
    Be happy!
    We don't know what tomorrow brings,
    but we are alive today!

  15. #15
    Join Date
    Mar 2008
    New Bern, NC
    Boy o Boy, you just can never tell when something can go wrong. I'm so glad you pulled through. Take good care of yourself and try not to have any more scary and crazy things happen to you.
    Diagnosed with severe lumbar scoliosis at age 65.
    Posterior Fusion L2-S1 on 12/4/2007. age 67
    Anterior Fusion L3-L4,L4-L5,L5-S1 on 12/19/2007
    Additional bone removed to decompress right side of L3-L4 & L4-L5 on 4/19/2010
    New England Baptist Hospital, Boston, MA
    Dr. Frank F.

    "In God We Trust" Happy moments, praise God. Difficult moments, seek God. Quiet moments, worship God. Painful moments, trust God. Every moment, thank God.

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