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Drs. in MD and VA

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Hi Kelley,

I live in northern VA and have never heard this name before. I would

definitely ask to talk to 3 people that have had revision with him.

My first surgeon at Hopkins was very nice and explained everything

but once things went wrong - Hopkins was awful. Like you, I trusted

this man. There is a Dr. Lauerman at town and he does do

revision. Have not heard much either way about him. The surgeon

should do more than a couple of these a year - that is what I have

always been told. It's hard to believe this whole area is so out of

it in regards to revision.

Good luck!

from VA

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Hi ,

I have to call the office on Monday to get those patient's names from

Dr. 's nurse. It is strange that their seems to be a void in

" revision specialists " , but then again who puts those nametags on

doctors? I mean really any surgeon that knows any of the separate

procedures required to complete a revision could do one, so in that

regard we could be going down the wrong track completely when

discounting some of these guys that aren't so " well known " . I'm sure

not everyone who has scoliosis needed subsequent surgery from previous

fusions chime in on these Internet forums. As a matter of fact,

probably a good many that really suffer with this condition are disabled

and not in a financial position to allow for a computer and/or Internet

access.

I'm just trying to consider it all... I certainly don't want to NOT

consider Dr. because no one here has heard of him; on the other

hand, I don't want to deny myself the chance to get other opinions on a

very serious surgery. We were VERY impressed with Dr. and I've

seen quite a few ortho specialists in my time (10 surgeries to date).

Then again, I trusted my last surgeon to do a good job and it turned out

to be failed. Of course, that's not really totally fair since

psuedarthrosis is beyond their control and that seems to be my main

nemisis.

Like my husband put it: " We go to great lengths to check out contractors

to do work on our home and insist on referrals and check their

credentials, I think that's the least we can do when talking about your

health " ! He really is so supportive and will go anywhere and pay

anything so that I can have the best of care - I'm so lucky in that

regard.

We'll see how it goes... ~ Kelley

>

> Hi Kelley,

> I live in northern VA and have never heard this name before. I would

> definitely ask to talk to 3 people that have had revision with him.

> My first surgeon at Hopkins was very nice and explained everything

> but once things went wrong - Hopkins was awful. Like you, I trusted

> this man. There is a Dr. Lauerman at town and he does do

> revision. Have not heard much either way about him. The surgeon

> should do more than a couple of these a year - that is what I have

> always been told. It's hard to believe this whole area is so out of

> it in regards to revision.

> Good luck!

> from VA

>

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Kelley - Good point below, re: finances and disabled sufferers we dont

even know about. About 10 surgeries, you poor baby! I can't imagine

being strong enough or brave enough to keep on trying after all that.

I admire you! And about that hubby -hugs to him and you for realizing

watcha got! Have a wonderful evening, Marty

---<kelleymoore@...> wrote:

....As a matter of fact, probably a good many that really suffer with

this condition are disabled and not in a financial position to allow

for a computer and/or Internet

access.

.... We were VERY impressed with Dr. and I've seen quite a few

ortho specialists in my time (10 surgeries to date). Then again, I

trusted my last surgeon to do a good job and it turned out to be

failed.

.... " I think that's the least we can do when talking about your

health " ! He really is so supportive and will go anywhere and pay

anything so that I can have the best of care - I'm so lucky in that

regard. We'll see how it goes... ~ Kelley

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Oh no! Marty, thank you so much for your nice comments, but I don't

feel like a " poor baby " at all. Quite the contrary, I feel blessed that

this is the worst thing in my life that I face; there are so many more

people worse off than I am! I am also blessed with having a wonderful

supportive family and husband and it has helped me so much to get

through it all and helps me keep a good disposition about life. Thanks

again... ~ Kelley

> ...As a matter of fact, probably a good many that really suffer with

> this condition are disabled and not in a financial position to allow

> for a computer and/or Internet

> access.

> ... We were VERY impressed with Dr. and I've seen quite a few

> ortho specialists in my time (10 surgeries to date). Then again, I

> trusted my last surgeon to do a good job and it turned out to be

> failed.

> ... " I think that's the least we can do when talking about your

> health " ! He really is so supportive and will go anywhere and pay

> anything so that I can have the best of care - I'm so lucky in that

> regard. We'll see how it goes... ~ Kelley

>

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Kelley,

You said that " psuedarthrosis is beyond their control " ....and yes, in

some regards it has to do with the patients body's ability to

mend.....but there are different techniques that seem to yield higher

solid fusion rates. It is a subject you should question the doctors

you are considering on. Personally, after reading the Pubmed articles

I wanted all of the bells and whistles...I wanted an a/p procedure, I

wanted BMP, I wanted a bone growth stimulator, and I wanted to have a

brace at discharge so I could use it in the early healing. Of course,

I am not a smoker and didn't have any other markers making me believe

that this was gong to be an issue....but I did not want to roll the

dice, and interestingly, the insurance company never blinked.

Take Care, Cam

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Cam,

Dr. insisted on harvesting bone from me (although my last surgeon said that I didn't have any left because of all the fusions I've had) and using a bone growth stimulator for the fusions. I know the medical community is learning more all the time about this technology and I believe they now understand that cadaver (allograft) bone just doesn't graft as well as autologous bone. I am also a non-smoker in otherwise excellent health, so everything should be in my favor for optimal bone grafting, but... :o)

Its interesting that you bring up the A/P approach to this type of surgery. Dr. is the first to mention that he didn't think it was necessary (in my case). That contradicts what other surgeons have told me so we specifically asked him to elaborate on that.

His plan is to put me in a post-op brace for 3-4 months. He mentioned the brace would have "thigh cuffs". I have no clue what those are and it didn't hit me until the drive home (of course!), so that is one of the questions I presented to him in my email. I wore a post-op brace after my 1999 revision and a magnet therapy bone growth stimulator (I'm not sure of the medical name for this device.).

Hoping for a good outcome this time around... ~Kelley>> Kelley,> > You said that "psuedarthrosis is beyond their control"....and yes, in > some regards it has to do with the patients body's ability to > mend.....but there are different techniques that seem to yield higher > solid fusion rates. It is a subject you should question the doctors > you are considering on. Personally, after reading the Pubmed articles > I wanted all of the bells and whistles...I wanted an a/p procedure, I > wanted BMP, I wanted a bone growth stimulator, and I wanted to have a > brace at discharge so I could use it in the early healing. Of course, > I am not a smoker and didn't have any other markers making me believe > that this was gong to be an issue....but I did not want to roll the > dice, and interestingly, the insurance company never blinked.> > Take Care, Cam>

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Hi Kelley,

Just wanted to say it's partly personal preference of the surgeon as to whether they go anterior or not. There's a lot of factors that affect it, but a surprising amount of " anterior " work can be done from a posterior incision. In my case they didn't have a lot of choice, as I already had an anterior rod in the way making an anterior incision a more tricky proposition, so it was easier to do it all from the posterior incision. That said, QMC are apparently favouring a posterior only approach, including for lumbar fusions, where it's possible, because in cases where the patient would otherwise have had anterior and posterior, it's less traumatic and also leaves more scope to the future (I'm not sure of the exact complications or reasons, but I have read/heard that opening an anterior incision multiple times isn't a great idea). It's rather a case by case basis, and the doc I spoke to regarding this said that if you've got particularly bad disc collapse and need that re-spaced, anterior would probably be done, but anyway - this is a major teaching hospital in the UK where I am treated, so it's definitely not an off the wall idea to go posterior only even for revisions and osteotomies.

titch-- The wages of sin are death, but by the time taxes are taken out, it's just sort of a tired feeling - a Poundstone

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titch and kelley,

I concur, I had anterior work in April but it was because respacing

work had to be done. The second day surgery the posterior approach was

used.

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---Cam,,

Remember how much I whined about the bone growth stimulator early

on?? Well I now can sleep with it on..!!! I put it on when I go to

bed and when it beeps after 4 hours, I hear it, wake up and take it

off....it is amazing what we get used to after a few months!!! ,PA

In , " kmrevised " <kelleymoore@...>

wrote:

>

>

> Cam,

>

> Dr. insisted on harvesting bone from me (although my last

> surgeon said that I didn't have any left because of all the fusions

I've

> had) and using a bone growth stimulator for the fusions. I know the

> medical community is learning more all the time about this

technology

> and I believe they now understand that cadaver (allograft) bone just

> doesn't graft as well as autologous bone. I am also a non-smoker in

> otherwise excellent health, so everything should be in my favor for

> optimal bone grafting, but... :o)

>

> Its interesting that you bring up the A/P approach to this type of

> surgery. Dr. is the first to mention that he didn't think

it

> was necessary (in my case). That contradicts what other surgeons

have

> told me so we specifically asked him to elaborate on that.

>

> His plan is to put me in a post-op brace for 3-4 months. He

mentioned

> the brace would have " thigh cuffs " . I have no clue what those are

and

> it didn't hit me until the drive home (of course!), so that is one

of

> the questions I presented to him in my email. I wore a post-op

brace

> after my 1999 revision and a magnet therapy bone growth stimulator

(I'm

> not sure of the medical name for this device.).

>

> Hoping for a good outcome this time around... ~Kelley

>

> >

> > Kelley,

> >

> > You said that " psuedarthrosis is beyond their control " ....and

yes, in

> > some regards it has to do with the patients body's ability to

> > mend.....but there are different techniques that seem to yield

higher

> > solid fusion rates. It is a subject you should question the

doctors

> > you are considering on. Personally, after reading the Pubmed

articles

> > I wanted all of the bells and whistles...I wanted an a/p

procedure, I

> > wanted BMP, I wanted a bone growth stimulator, and I wanted to

have a

> > brace at discharge so I could use it in the early healing. Of

course,

> > I am not a smoker and didn't have any other markers making me

believe

> > that this was gong to be an issue....but I did not want to roll

the

> > dice, and interestingly, the insurance company never blinked.

> >

> > Take Care, Cam

> >

>

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Kelley,

I didn't mean to imply that the posterior only approach wan't

completely appropriate for some...and I think Titch has laid out a

few other reasons why the anterior surgery is not a choice. In my

case, and I did have 2 cages placed, DrRand never even suggested it

and DrBoachie said in my case it was possible to do the work

posteriorly only, but it was much more challenging and would have

signifigantly greater blood loss and he didn't advise it. So I

didn't really feel it was an option for me but I know of others who

have had surgery with DrLaGrone and have had very happy outcomes

posterior only.....I think it depends on each individuals case.

I was lucky that there ended up being such abundant bone growth on

the old fusion that no further harvesting of bone was required...all

me and BMP.

Those bone cuff braces don't sound like much fun. I think our friend

CA is enjoying one now! I guess they prevent you from

inadvertantly putting too much strain on the lumbar area while it

heals...but they are mighty restrictive as I understand it.

I am hoping for a good outcome for you too!

Cam

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