Hi there,

I need reinstrumentation with osteotomies in my thoracic spine. I have progressive deformity through a solid fusion. I electively had my rods removed to qualify for a public health service fellowship 10 yrs ago. Over the past 10 yrs I have lost 15-20 degrees of correction and have so much pain I have to wear a brace to stand any length of time. I am considering Dr. Lawrence Lenke at Columbia in NYC and Dr. Baron Lonner at Mount Sinai in NYC. I have listed my view of their pros and cons. I would like any members to respond with their thoughts or advice on who I should choose. I'd really appreciate it. Thanks

Marie

Dr. Lenke - PROS

1. Known as best adult scoliosis surgeon in the world
2. Believes there is less than 1% chance of parament paralysis
3. Feels confident he can reduce my curve from 35 degrees to between 10-15 degrees using the least risky osteotomies (smith-peterson).
4. Done over 1000 similar surgeries as mine
5. On a scale of 1 to 10 challenging level with 1 being easy and 10 being extremely difficult, he rates my surgery a 2.

Dr. Lenke - CONS

1. Believes there is a 50% chance I will need a blood transfusion. They would get this blood from their hospital blood bank. There is no self donation before surgery because it weakens your system.
2. Will need to extend my fusion 1 or 2 levels. One of the levels will be the L1 level which is the start of your lumbar spine. This will make my surgery more complex because not only will he have to break my original fusion to do the osteotomies, he will also be lengthening the fusion. I will have to grow new bone at the L1 level not just heal the existing fusion. Also I will have no flexibility at that level anymore which is important because there is a lot of movement in your lumbar spine compared to your thoracic. My thoracic spine is where my fusion currently is.
3. I will need to do another full spine CT which is a lot of radiation. I just had one done a little over a year ago and nothing has changed about my back but his protocol is that I have a new one.
4. Has a number of bad reviews however he does surgery on some of the most complex difficult cases in the world.
5. The surgery will be a 2 man job and Dr. Lenke's 2nd surgeon working on me will be a fellow in training. A fellow in training is in their last year of training before becoming a practicing surgeon. A fellow is a rookie.
6. Anytime I have a question pre or post surgery I have to go through his nurse.

Dr. Lonner - PROS

1. Believes there is a less than 1% chance of permanent paralysis
2. Has technology to drastically lower my risk of needing a blood transfusion. He estimates my risk is under 5%.
3. At the end of my surgery a plastic surgeon will come in and use a special stitching technique so my scar can heal to as minimally visible as possible.
4. He is the sole operating physician. A resident may assist him but the resident will NOT be doing any of my surgery.
5. The CTs I submitted to him are adequate for him therefore he is not requiring me to get anymore high radiation scans pre-surgery.
6. He will not need to lengthen my fusion. Therefore my lumbar spine will not be messed with and my fusion will stay confined to my thoracic spine.
7. Has very few bad reviews.
8. On a scale of 1 to 10 challenging level with 1 being easy and 10 being extremely difficult, he rates my surgery a 3.5.
9. Any time I have a question I get to directly contact Dr. Lonner through email and he answers me directly. I do not have to go through nurses.

Dr. Lonner - CONS

1. Has done approximately 100 surgical cases similar to mine. Dr. Lenke has done over 1000.
2. He believes there is a good chance that he can reduce my curve from 35 degrees to between 15-20 degrees using the least risky osteotomies (smith-peterson). However he says it is possible I won't have much movement and in order to get my curve corrected to between 10-20 degrees he may have to do a riskier type of osteotomy. Dr. Lenke feels I have enough anterior disk space and he will not have to resort to a more invasive osteotomy.