Re: Posterior approach to revision?

[Guest guest]

Thanks so much for your input.

I really appreciate hearing any info on the "Posterior only" approach to revision surgery.

I was under the impression that the only way to have a complete revision was to take out the Harrington rod, do the osteomies, do decompression, fusions etc and do this with A/P surgery only. I now see that in some cases it is possible to all this without the anterior surgery as well. All I can say is "Amen" to that. I am amazed that it is even possible to do this. I am guessing that the new hardware may have something to do with it. Also, I gather a lot depends on what we need done in our own particular medical situation and needs. One size fits all does not seem to apply with revision. I think that's why it can be so confusing trying to decide what surgical plan to go with. I had 3 different plans offered to me by 3 different doctors over the last 7 years. Now that my spine has deteriorated to the point where my pain levels and disability are unacceptable , I decided it's time to throw in the towel and go for broke. Last Monday when I went to see my revision doc in New York City-(I live within about a 30 minute drive to Manhattan.) I was pleasantly surprised to find out that my revision plan and options have changed dramatically, and for the better. Go figure. ?

So, apparently even after you pick your revision doc, and come back a few years later the surgical plan can change. I am not advocating waiting. I still think this is all pretty much a roll of the dice, but in my particular situation it has certainly paid off. My doc said I avoided a second revision by waiting till now. Just sheer luck I figure. I could use a little luck right about now. ! : ) The docs gain more knowledge with time. I am sure if I waited a few more years they will have improved even more. But I cannot wait any longer. I have finally hit my personal threshold for pain and disability. So I decided to go for it this winter and take my best shot.

I have to say that I am feeling more hopeful and optimistic than I have been in a long time.

I consider this my Christmas miracle. I will hopefully be able to walk again, have a straighter body and hopefully have decreased pain. And another fringe benefit is finally being able to go out clothes shopping and get me some new duds. I will be throwing out my entire collection of blah, drab, "bag the body" clothes that I have had to endure these past years hoping to hide my crooked stature.

So no matter what happens from here on in, I will always be grateful for this time in which I am feeling hopeful again. If nothing else, it has raised my spirits tremendously and has a wonderful placebo effect. It is giving me the needed energy to deal with this busy holiday season. That in itself is a plus.

Thanks again for your thoughts about the posterior revision surgery. It looks like it turned out to be positive for you. The docs said they will have to watch the fusion of my last remaining lumbar discs. They did mention the possibility of a "failure to heal" of the bottom fusion that would have to be addressed. They said it does happen occasionally but they will do their best to not let that happen. If it does then they would go back in at a later date and fix it. I guess I can live with that. ! Small potatoes in the scheme of things.

Keep me informed on your post revision progress. It sounds like you are doing wonderfully.

Take care

Carol

>>>>>>>>

Hi, CarolI had revision surgery in March with Dr Bridwell and he did two posterior only surgeries. He removed the Harrington rod and determined the fixation points for the new hardware in the first surgery and then he did the osteotomy and put the rest of the hardware in during the second surgery.He has not ruled out the possibility that I may need anterior surgery in the future, it will depend on how well I fuse. There is still bone on bone in the front of my lumbar spine, but so far, I am pain free.I have photos of my revised spine at . I am unable to post them here.You may recall that I was also a big procrastinator about getting revised. I think it took me about seven years after first finding out about flatback.

[Guest guest]

I am very happy to be feeling so much better. I had tried everything

to avoid surgery, but when I found myself thinking that I could not

continue to live with ever increasing pain, I finally decided that

the risks of surgery were preferable to the finality of suicide.

I am so glad I had surgery with Dr Bridwell! Not only do I stand up

straight for the first time in 34 years, but I am also pain free! I

can walk for hours instead of minutes and I can stand in line! Not

bending, leaning or twisting is a very small price to pay.

I had been fused to S1 in my original surgery, but the fusion was not

solid at that level and I had developed grade 2 spondololithesis. Dr

Bridwell thought I might have had a laminectomy, but it turned out

that my spine had not completely formed at that level - he called it

bifid. I had one huge osteotomy at L3 and I had an area of non-

fusion around T10.

Originally, Dr Bridwell would have planned anterior surgery for me,

but he said that I had too many previous anterior scars. At least

that is what he told me in person. When I had yet another anterior

procedure for some ovarian tumors that were found in the pre-op CT

scan of my pelvis, that surgeon told me that my interior was

amazingly scar free and it should not present a problem for

additional anterior surgery. When I requested a copy of my written

records from Dr Bridwell, I found out that he was not willing to do

anterior surgery because he felt that I was too fat and that it would

be too risky. Immediately after reading that, I signed up at

sparkpeople.com and started eating more healthily and tracking my

calories. I have lost 65 pounds and that is no longer an obstacle.

I tripped and fell while walking at the mall a couple of weeks ago,

so I had a local doctor do some xrays and make sure everything was

ok. He said my lower spine appears to be fusing very well and he

could see no evidence that anything has moved. It was a relief to

hear that everything is looking good!

Dr Bridwell's nurse had told me that he packed a lot of fusion

material in there, so everything is looking good so far.

Most of my friends have been amazed at the changes! I cut off most

of my hair before surgery, lost weight, and now I stand up straight

and smile more. It has definitely been a lot of changes for the

better. I changed jobs in August and my coworkers tell me that I am

looking better all the time! Imagine if they had known me before!

>

> Thanks so much for your input.

> I really appreciate hearing any info on the " Posterior only "

approach to

> revision surgery.

> I was under the impression that the only way to have a complete

> revision was to take out the Harrington rod, do the osteomies, do

> decompression, fusions etc and do this with A/P surgery only. I

now see

> that in some cases it is possible to all this without the anterior

> surgery as well. All I can say is " Amen " to that. > Thanks again

for your thoughts about the posterior revision surgery. It

> looks like it turned out to be positive for you. The docs said

they will

> have to watch the fusion of my last remaining lumbar discs. They

did

> mention the possibility of a " failure to heal " of the bottom

fusion that

> would have to be addressed. They said it does happen occasionally

but

> they will do their best to not let that happen. If it does then they

> would go back in at a later date and fix it. I guess I can live

with

> that. ! Small potatoes in the scheme of things.

>

> Keep me informed on your post revision progress. It sounds like you

are

> doing wonderfully.

> Take care

> Carol

>

>