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Re: Revision questions

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Hi

I am sure others will chime in, but generally this group is

comprised of folks who had revision for flatback...and generallly

flatback came about as a result of a original surgery with the HR

which was one long straight rod, attached at only to points and/or

went deep into the lumbar vertebra (L4 or L5). So...in terms of

extensiveness...most of us only had one or two segments open between

the sacrum...

The surgery to correct flatback requires osteotomy to restore the

sagittal balance....so most anyone who had revision for flatback had

this as a part of their revision. In my case, and I believe in most

folks, one of the main complaints/sources of pain stems from nerve

root compression and decompression/laminectomy was a part of my

surgery, as was replacment of 2 discs with cages and implants to

attach my old rod to the new system/tie into sacrum. It was two days

of surgery, 6-7 hours each, in my case about a week apart. No picnic.

Some patients have similar surgery to me in one long day...avg.

around 14 hours...some have a two day scenario only 24 hours

apart..some are staged 2 to 3 weeks apart. I have never been sure of

why there is such variability, even patient to patient with the same

surgeon.

The research suggests that the key to a satisfactory outcome/surgery

for " flatbackers " has a lot to do with restoration of the sagittal

balance, and a reduction in pain. I am not sure if you will be able

to draw any comparison to your own situtation and set your mind at

ease, except to note that many of us went through big spinal

surgeries, many more than once, and got through it somehow. Very

generally, a person who has flatback is not advised to have just a

discectomy/laminectomy without addressing the saggital imbalance

because we will just be back for more surgery in fairly short order,

after having just undergone an almost identically long

recouperation...with an added risk of having a spine that will not

have the structural components for the surgeon to work with when

fusing to the sacrum...not to mention the risks of more scar tissue.

If you use the search feature and search under Edie Scrath or

Kirkaldie....about a year ago there was fairly lenghy discussion

about the pros/cons of the smaller surgery...these two members

underwent that surgery... went on to have a full revison/fusion

to the sacrum about a year later, Edie has gotten about a year out

of it and now is contemplating the same for herself next spring.

These fused spines present a challenge to any surgeon. I hope you

have selected a doctor with care and have confience in his ability

to address whatever problem you are surrently addressing, as well as

having spoken about the future and the liklihood that this will see

you through to the end of your days. I don't say this to scare

you...just to alert you to the notion that the same as they patted

us on the backside as teenagers and told us to have a nice

life...the truth seems to have been far from that, and I think in

your case it might be beneficial to at least ask how what your

surgeon proposes to do now plays into your future spinal health.

Make sense?

I hope I haven't muddied the waters,

Cam

>

> Hi everyone...I'm usually just a lurker, but am interested in

> something....many posters mention revisions, but I'm wondering

what

> kinds? How many of you have had full ostonomies (don't know if

that's

> spelled correctly, but the surgery where they realign the flatback

> spine), and how many have had smaller scale revisions like a disc

> decompression and fusion, or additional hardware? I'm just

curious

> what many mean when they say " revision " - what type of surgery,

how

> long, etc.

>

> Thanks for sharing!

> Chris

>

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Maybe I should be more clear. When I say revision, I am refering to

whatever surgery has been necessary to correct the flatback caused by

original scoliosis surgery. For some that is osteotomies, for others

fusion, replacing hardware, removing hardware. The list continues.

>

> Hi everyone...I'm usually just a lurker, but am interested in

> something....many posters mention revisions, but I'm wondering what

> kinds? How many of you have had full ostonomies (don't know if

that's

> spelled correctly, but the surgery where they realign the flatback

> spine), and how many have had smaller scale revisions like a disc

> decompression and fusion, or additional hardware? I'm just curious

> what many mean when they say " revision " - what type of surgery, how

> long, etc.

>

> Thanks for sharing!

> Chris

>

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  • 1 year later...
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All knee (and hip) revisions are different. For me I've had my knee

revised and my hip revised, and am getting ready to tackle both again this

coming year. The revisions are lasting around 10 years for each knee/hip.

Its the plastic liner that I keep wearing out <g>, guess I'm too active.

The knee liner was easy and I was up and out of there the next day and back

to normal activity in a week. The hip liner was a bit harder (but nothing

like the original surgery!!) since they had to remove the cup, insert a

mega amount of bone grafting, insert a thicker liner and a new ball.

Overall tho, these revisions for me were a piece of cake compared to the

original surgeries. Mine are the old style, as the first knee was done 26

years ago.

One thing to find out is exactly " what " will be revised - what part of the

prothesis. It does make a difference surgery/recovery wise.

tanya

TACHANKA SIBERIANS

" All Four Paws Rolling "

wenatchee, wa

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Margaret

My RTHR was revised in June 2004 and it was by far easier than the

original. I feel so bad for you because you have a rough time. I

was in an auto accident in August 2002. That caused the stem to

loosen and in May 2004 they finally noticed it on xray. I had the

surgery the next month and was home the next day. Only the stem was

redone and it was cemented like the original. The stem is longer.

The poly cup was fine.

My 1997 LTHR is starting to show wear in the poly cup. That THR is

an older version of the cup and stem. The OS said it should last

another 10 years. I have no symptoms and the OS saw it on xray at my

annual " tune-up " . The revised hip looks fine on xray and feels good

too.

The OS did say that non-cemented stems were harder to get out because

the bone grows into the stem. I guess my cement loosened and the

stem came out without any bone loss or cutting to get it out.

But after 16 total surgeries in my 51 years, I am not looking forward

to any operations!

Sue

>

> On Friday I was listening to a client tell another client that her

> doctor has said her second knee needed revising.

>

> She had the first revised a few months after I had my hip revised.

I

> remember at the time thinking she was doing so much better than me

and

> thought she managed ok. I used to feel guilty that this old lady

had

> coped much better than I had.

>

> Can you imagine how surprised I was to hear her say that she was not

> going to have it revised because she had such a rotten time with the

> other knee when it was revised.

>

> So for those with revisions I have some questions:

>

> Are revisions always tougher than primary ops?

>

> Have you had a really tough revision to be followed by another

> revision that was not so tough?

>

> Has anyone needing a revision made the decision not to have it? If

so

> what were the consequences of doing that?

>

> Aussie Margaret

> LTHR 1990 revised 2004

>

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Thanks everyone for your replies

Is there anyone out there who decided NOT to have a revision done, and

what were the consequences of that?

It really struck home to me yesterday when I asked for a disabled

access room at a conference I am attending. (All the other rooms have

step over baths.)

Aussie Margaret

LTHR 1990 revised 2004

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