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thoughts on long fusion

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  • #16
    I'm pretty sure Anya's fusion is T4-L3. I think she just did a typo. She has a long fusion-- she sent me her before and after back pics for my scrapbook, so I know from looking that it's not T12.

    OK, Ed, so it's not related to how high the fusion goes with not being able to lie down on your stomach. But it makes sense to me... I think that may be my problem anyway. My bed feels comfy, so that's not the problem. (Although I do like it firm...) Let us know what your doctor says.
    71 and plugging along... but having some problems
    2007 52° w/ severe lumbar stenosis & L2L3 lateral listhesis (side shift)
    5/4/07 posterior fusion T2-L4 w/ laminectomies and osteotomies @L2L3, L3L4
    Dr. Kim Hammerberg, Rush Univ. Medical Center in Chicago

    Corrected to 15°
    CMT (type 2) DX in 2014, progressing
    10/2018 x-rays - 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

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    • #17
      Long fusions are done for many reasons like a double curve, big C-curve etc...But what you have to remember is that if you are fused to L-4, then eventually L-5 will degenerate since it carries all the stress of the fused levels. I am fused from T-3 through S-1 and you get used to it. I still ride my horse. There are a lot worse things that can happen to a person in life (Just my philosophy) and my fusion is just an inconvenience. If a surgeon of Dr. Boachie's reputation and skill recommends that length of fusion, then that is what is best for you in the long run.

      Comment


      • #18
        Wow, thats a lot of responses!!
        I have been fused now for 10 years...you learn to live within you means really. It hasn't stopped me from doing much. I can bend over and touch the floor just fine. I do get lots of comments on my great posture
        26 year old female
        wore a brace in junior high
        fusion of T4-L4 at 15 years old
        broken hardware at 23 due to failed fusion
        November 10, 2008 hardware removal and fusion of L3-L4

        Comment


        • #19
          Hi Debra,
          I'm fused T-10 through L-5 which probably isn't considered a long fusion but it's low so I thought I'd throw my 2 cents in. I'm only 6 weeks post-op so I don't really have a feel of what my flexibility will be in the long run. But, for me, the flexibility or lack-thereof really wasn't a factor when I was making my decision on whether to have surgery or not. For the last 2 years or so, I have been in enough pain that I didn't do a lot of bending or twisting anyway. My quality of life was rapidly declining and by the time I scheduled my surgery date, I was just excited about the prospect of being rid of at least some of the pain.

          I can tell you that at this point, I haven't noticed any problems reaching down. I can shave my legs (but I do have long gorilla arms), tie my shoes and I even cut my toenails by myself this morning. It's a little scary thinking that maybe I shouldn't be able to do those things but I can.

          I guess what I'm saying is everybody has different priorities. Flexibility just wasn't a big enough issue to even weigh-in on the decision. I needed less pain and more quality, and I have to say it appears I've gotten both.

          I wish you peace in making your decision. This has to be one of the toughest parts of the whole process. Don't forget that we're here for you!
          Becky, 46 years old
          Diagnosed at 13 with mild scoliosis
          Ignored until 448/07
          Left thoracic 49* T5-T11
          Right thorocolumbar 60* T11-L4
          Surgery Monday, June 9, 2008 Oklahoma Spine Hospital
          Fused T-10 to L-5
          14 titanium pedicle screws
          Corrected to approx. 10* YEA!!!
          Email

          Comment


          • #20
            Susie*Bee,

            The only way I can lay on my stomach comfortably is when I have a massage done. They drop the head rest down for me. I think it might have to do with how big of a lordosis curve you have. Dr. LaGrone gave me a larger lordosis curve than what I had before and it is a little easier to lay on my stomach. Still not comfortable, can only do it for a couple of minutes and cannot have a pillow.....whereas before this last surgery....not at all. Like others have said, felt like my spine was being really stressed.
            Theresa

            April 8 & 12, 2004 - Anterior/Posterior surgery 15 hours & 7 hours
            Thorasic - 79 degree down to 22
            Lumbar - 44 degree down to 18
            Fused T2 to sacrum
            June 2, 2005 - Pedicle subtraction osteotomy @L3 7 hours
            MAY 21, 2007 - Pedicle subtraction osteotomy @ L2, extended the fusion to S2 and added pelvic instrumentation 9 hours

            FUSED T2 - SACRUM 2

            Comment


            • #21
              I have a question for those of you "older" patients (ha ha, I'm actually older than many of you posting here). How many of you had longer fusions some time ago, then, years later experience problems at the bottom of your fusion any way?

              My daughter is now 13, was fused last August from T2-T11 with curves of 61T and 53L, the lumbar curve was thought to be compensating. However, the lumbar curve did not correct as much as we had hoped, it is now at 36. It does not appear to be worsening (in fact, from Feb-May it actually improved slightly), but, the doctors don't give us much hope that it will continue to reduce. In Feb, her surgeon said he may want to further fuse to L2, "because she should look better after all she's been through". A second opinion said she should be fused to L3 or L4 soon, so that she would still have growth left after the long fusion. He said that he would predict back problems in middle age if we don't correct now. He also stated that this correction would purely be cosmetic at this time. Neither doctor believes that this curve will continue to get worse.

              She is having no pain at this time, the lumbar curve is noticeable to me (although the rest of my family doesn't think that it is). The doctor's report (I just got) says there is noticeable trunk shift to left, and, her hips are asymetrical at this time (shoulder blades are even), top looks good. Although he also said he'd do a thoracoplasty, but, that's another story.

              I am struggling with what to do for her. I question whether doing a long fusion now wouldn't just put stress further down the spine, and in middle age she would still have problems regardless. I see many comments about the stress on the back below the fusion, I can't help but feel that if she were fused to L4 now, the stress would go to L5, like someone above has said.

              Would you have rather had a long fusion earlier in life, with the loss of mobility...vs having waited until later when you may or may not have begun to have back problems? And, do you think that had you been fused longer earlier in life that this would have prevented the back problems in the first place?

              I know everyone's situation is different, I would just like to hear what others would have wanted for themselves if they could have chosen. My daughter has no complaints at this time (physically or appearance), and gives me no opinion either way. It's a tough decision to be making.

              Comment


              • #22
                Flexibility

                Hello All! I am fused T2-sacrum and it has been 2 years now since my last surgery(4 surgeries). I had A & P with cages, osteotomies, and they added a third rod via triple-rod technique. I cannot lay on my stomach unless I'm in physical therapy and my belly/hips are supported with a pillow and my neck in a donut tilted down. As far as flexibility goes with a longer fusion yeah you loose some but it out weighs the reward, and you would be surprised how your body accomodates and you learn how to move as a unit. I have a question for "Theresa". How much lordosis did Dr. LaGrone give you? I was curious! I had 16 degress pre-op and 74 degress post-op. but that is now creating problems for me b/c I have too much. Was this your first surgery and surgeon? I would appreciate any info. you can provide. Thanks!

                Amanda 30 yrs. old from St. Louis MO
                1st surgery 2002- Dr. Bridwell STL. fused posteriorly T4-L4 (he didn't do the anterior staged portion so I developed severe flatback)

                2nd surgery 2005- NC. 13 hr. A&P surgery. T2-sacrum with cages, osteotomies, laminotomies, and laminectomies.

                3rd surgery 2005- NC. Revision of lumbar spine for failed fusion and removal of T12 screw that was bothering me (woke up with no rods from T2-T11 and there was never any mention of this by him or my permission to do so).

                4th surgery 2005- NC. After progression of T-spine curve after rod removal he agreed to re-istrument them in and to explore the lumbar spine. Woke up with extensive work done in lumbar spine, more osteotomies, and a triple rod. Did not put my thoracic rods back in. Immediately after surgery my right foot was in a contracted equinovarus position and could not actively move foot, it was limp. Was in a wheelchair and still am for long distances. Had to have 2 foot surgeries as a result of this.

                Currently seeking opinions for thoracic spine to be re-fused straight and rods to be re-instrumented. Know of any other great drs.? They all seem to be in NY or MD.

                Hanging in there...
                Last edited by acubfan; 08-03-2008, 09:36 PM.

                Comment


                • #23
                  Why didn't you go back to Dr. Bridwell? Dr. LaGrone did my third surgery. My other doctor said it was okay with him since that was Dr. LaGrone's specialty....dealing with prior fusions and flatback. He did over correct me some but that is because as you heal you lose some of the correction. I don't know what the degree is. Somewhere in here I posted my x-rays after the first surgery and after the third surgery. You can see on the side views the big difference in my lordosis curve. Dr. LaGrone was very nice and you can get some pretty good prices on Southwest Airlines to Amarillo. I do not recommend driving back after the surgery! For us it was 9 hours so we did it in two 4 1/2 days. The first day was okay, but the second day was really rough. But if you can, you should really go out to see him before making any decisions. When you looked at my x-rays clinically I was corrected. But when you saw me in person, you could tell something wasn't right. Let us know what you do.
                  Theresa

                  April 8 & 12, 2004 - Anterior/Posterior surgery 15 hours & 7 hours
                  Thorasic - 79 degree down to 22
                  Lumbar - 44 degree down to 18
                  Fused T2 to sacrum
                  June 2, 2005 - Pedicle subtraction osteotomy @L3 7 hours
                  MAY 21, 2007 - Pedicle subtraction osteotomy @ L2, extended the fusion to S2 and added pelvic instrumentation 9 hours

                  FUSED T2 - SACRUM 2

                  Comment


                  • #24
                    Originally posted by emma12
                    I have a question for those of you "older" patients (ha ha, I'm actually older than many of you posting here). How many of you had longer fusions some time ago, then, years later experience problems at the bottom of your fusion any way?
                    I guess I qualify, my sugery was 25 years ago when I was 12. I'm fused T2-L4, and yes I have problems now. It started about 10 years ago, but didn't hamper me in any way, until recently. I am having nerve pinching that I believe is from disc degeneration, I am currently going, slowly, through doctors trying to get them to treat the problem not the symptoms. I don't regret having my surgery at all, I literally would not be here if I didn't.

                    However there was no talk of exercises when I did my surgery, and at that time they weren't even looking at the long term effects of fusions. Now they do, and they have exercises to help keep the muscles in your back strong, which will give you long term help.

                    It is a tough decision, one you need to talk with your doctor about, and your daughter. But get as much info as possible before making the decision.

                    Brad
                    Surgeries July 26th & August 3rd 1983 (12 years old)
                    Still have 57 degree curve
                    2 Harrington rods
                    Luque method used
                    Dr David Bradford
                    Twin Cities Scoliosis Center
                    Preop xray (with brace on)
                    Postop xray

                    Comment


                    • #25
                      I wouldn't consider myself older, but I have had my fusion for 10 years.

                      I do have problems now, but we are crossing our fingers that it is due to failed fusion and broken hardware, and not degenerative discs.

                      I agree with Brad, I think you should talk with the doctor and your daughter. See what will happen if you don't fuse now, what could that result in. I was never given an option for how long the fusion could be, but I do not regret my surgery.
                      26 year old female
                      wore a brace in junior high
                      fusion of T4-L4 at 15 years old
                      broken hardware at 23 due to failed fusion
                      November 10, 2008 hardware removal and fusion of L3-L4

                      Comment


                      • #26
                        Long Fusions

                        Theresa,

                        I didn't go back to Dr. Bridwell b/c after two years of going back for post-op. visits and keeping him updated with letters of how physical therapy, facet injections, poor posture, and terrible pain he just continuously ignored it and passed it off that my hip flexors were tight. I also have spasticity from my original injury so there aren't many drs. who can actually understand how the spasticity plays into my case. I talked with Dr. L's office yesterday and they recommended that patients traveling from out of state should send all of their x-rays, diagnostics, and a brief history. I will also get a current MRI since things have changed since my last one 2 years ago. I agree with you, it looks like my lordosis is good but my sagittal balance is off with C7 sitting way in front of L5-S1 when dropping a plumb line. When you look at me I look awful. I still lean forward and my cervical spine is hyperlordotic, I also lean to my left side when looking at me from an AP view on x-ray or in person. L's office will review my stuff and then contact me to let me know if he can help me out. I sure hope so. It gets very expensive traveling to drs. out of state to find out that it's too involved for them. I commend L's office for really thinking about the expense involved for a patient and their family and not making them travel to TX. unless something can be done. I'll let you know what I find out in the next few weeks. I just want some relief...

                        Amanda
                        Last edited by acubfan; 08-03-2008, 09:40 PM.

                        Comment


                        • #27
                          Amanda,

                          That is basically what was happening for me after my first two surgeries! After the 2004 surgery they did another surgery consisting of an osteotomy at L3. They had actually thought about doing is during the first surgery but due to issues that came up they decided to get out and see what would happen. The osteotomy was a great success but I still leaned forward and decompensated to the left. Also from the first surgery I now have intercoastal neuralgia (sp) in my right rib area and continually pain at the bottom of my spine. When dr LaGrone saw my digital x-rays my plumb line was only like 2 cm off. According to the textbooks that should be an acceptable amount to be off. I think it was like up to 4 cm max. Dr. LaGrone prefers the full x-rays (the real long ones). That showed I was alot more that just 2 cm off! When he did the osteotomy at L2 he also cut deeper into the left side to balance me better and did alot of manipulations while he was in there. Also due to having a partial vertabra in the lumbar sacrum area is why he fused further down to S2. He was including that partial in the fusion because there was some movement to it. When I picked up my hospital reports when we went for my 1 year checkup I found out how bad off I was and why I had to spend 3 days in CCU. My family told me my lungs had been filling up with fluid and my heart had swelled up. But they didn't want me to be worried about it so it was talked about as it was something little. It was probably a good idea to do that since I have aniexty problems. The doctors mentioned in their reports while I was in CCU I was having aniexty issues. Now I understand why my family could only see me every 4 hours for just a few minutes. I didn't understand why they couldn't see me more. Oh yeah, I was also told I have hip flexion contractures by both doctors. I think you'll really like Dr. LaGrone. Keep me informed on how it goes.
                          Last edited by Theresa; 07-25-2008, 12:51 AM.
                          Theresa

                          April 8 & 12, 2004 - Anterior/Posterior surgery 15 hours & 7 hours
                          Thorasic - 79 degree down to 22
                          Lumbar - 44 degree down to 18
                          Fused T2 to sacrum
                          June 2, 2005 - Pedicle subtraction osteotomy @L3 7 hours
                          MAY 21, 2007 - Pedicle subtraction osteotomy @ L2, extended the fusion to S2 and added pelvic instrumentation 9 hours

                          FUSED T2 - SACRUM 2

                          Comment


                          • #28
                            Thank you to you all for your kind, understanding, and honest responses! I still feel uncertain, but ALL your responses play an important part of my decision. I know the right choice that I will feel good about will become clear to me. My main concern is for the future and progression, as many of you said, with my lung function possibly declining and the condition of my spine worsening and increasing pain and decreasing surgical options. But I must weigh this against not being in too much pain now, having no limmitations to what I can do, my children being fairly young (I got a laugh from the person who pointed out the difficulty in looking for things under the couch), and potential future advances. I do feel good though about Dr. Boachie. The prospect of correcting these curves is so exciting to me but I know I have to feel good about the procedure. I have not spoken to Dr. B about my concerns yet, I called but the office said he would talk to me after the MRI was done and he wrote his report up on me. Hopefully this coming week I'll get to speak to him. I'll keep you posted.

                            I happened to be in a Wawa the other day and in front of me I noticed a lovely young woman with a beautiful figure with a scar down her back (compliments of summer attire). She told me she was fused down to her sacrum 4 years ago and said, with a twinkle in her eye, it was the best thing she ever did. She reminded me of many of you with your encouraging stories, and warm, understanding hearts.

                            Thank you to you ALL again!!
                            Debra
                            Debra
                            Age 45
                            Pre - surgery Thoracic 69, Lumbar 48
                            Post-surgery Thoracic 37, Lumbar 39 (unfused)
                            Fused T4-T12
                            Milwaukee braced, 11 years old to 15 yo
                            Surgery Sept. 1st, 2010 Dr. Boachie

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