T10 to Pelvis Fusion. Experience, Comments Appreciated
I would like to hear from others who had a, or something like a, T10 to ilium fusion with multiple interbody support. How long was the surgery? What is a brief description of the surgery? How long was the hospital stay? Were the results what you expected? How long before you were up and walking as much as you were before the procedure? Did the procedure improve the length of time you can walk? Were you offered any other possible procedures? Any other thoughts/comments?
I have been evaluated and found to have severe Degenerative Disk disease, progressive kyphotic deformity in my lumbar spine, and significant sagittal balance deformity due to a complete loss of lumbar lordosis. This results in my inability to maintain normal posture. In 2018 I had an L5-S1 ALIF for lumbar stenosis, sciatic pain, and a left-sided foot drop. This procedure improved my sciatic pain significantly; however, it did not improve my left-sided foot drop. I spent one day in the hospital. I wear an AFO on my left foot and ankle, an LSO brace, and use walking sticks. I do not have radicular or myelopathic symptoms at present.
I often must use my hands and available furniture when ambulating to keep from stumbling and/or to straighten up my posture. I cannot maintain an upright posture without assistance for more than a few moments. My most comfortable position is while pushing a grocery store cart. I am relatively asymptomatic at rest. I can lay flat without pain or difficulty. I have consulted with several spine surgeons who have discussed thoracolumbar corrective surgery that would include multiple interbody support and fusion from my thoracic spine down to my pelvis. However, one surgeon opines that the risks of the surgery would likely outweigh any potential benefit. Another surgeon recommends the surgery, which has a high probability of improving my quality of life.
Imaging and Findings
GENERAL: The patient is a male in no acute distress. He ambulates with the use of bilateral walking sticks.
BP 129/70 | Pulse 64 | Temp 36.4 °C (Temporal) | Ht 6' (1.829 m) | Wt 83.4 kg (183 lb 12.8 oz) | SpO2 100% | BMI 24.93 kg/m²
FINDINGS:
Alignment: Rightward lumbar spine curvature measuring 9 degrees from L2-L4. 4 degree leftward thoracolumbar spine curvature measured from T12-L2.
Coronal balance: C7 is 3.1 cm to the left of S1 (normal less than 3 cm).
Thoracic kyphosis angle: 10 degrees (normal range 20-50 degrees)
Lumbar lordosis angle: 19 degrees (normal range 20-60 degrees)
lumbar kyphosis 2 degrees
Sagittal vertical axis: 2.2 cm (normal range -2 - +2 cm)
Pelvic incidence: 64 degrees
Pelvic incidence - lumbar lordosis: 45 degrees (normal less than 10 degrees)
Pelvic tilt: 39 degrees (normal less than 20 degrees).
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@mydogbb14
My husband is 84 and was very active until the last 5 years. Now he can get around with a walker and can only stand for a short time without one. He is scheduled to have a thoracic 10-pelvis fusion posterior and a lumbar 4-sacral1 anterior interbody fusion the beginning of the year. He is very positive and healthy but I am concerned about his age and the recovery and if the results will really make a difference in his life. Any input from your experioence would be appreciated. Thank you and keep up your good work.
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2 Reactions@happyboppa Welcome to Connect. I’m not 84, but spine surgery is major surgery for anyone and with a fusion for several lumbar levels will be a big surgery and a long recovery. One question to ask is about bone quality. If the bone is not strong enough to hold the screws in place, they can pull out or fail. Screws also must be placed at very precise angles or they can pull out. Has your husband been scanned for osteoporosis?
Smoking is also a hindrance to healing from spinal surgery. His overall recovery health makes a big difference in what a potential outcome may be.
I would recommend get several opinions before making a decision. My cousin in his 80’s had a laminectomy for lumbar stenosis and did very well. His pain after surgery was about 2 weeks and in a month, he felt pretty good. I am a cervical fusion patient and it was about a 3 month recovery and I was in my late 50s.
Has your husband had any surgeries to gage how well he heals afterward?
@happyboppa Hi, I’m sure the past 5 years have been similar for your husband and me. The pain that leads up to this surgery is beyond imagination. It is sciatica on steroids with full muscle spasms included. I had no choice because my previous surgeries collapsed to the point that I developed cauda equina syndrome which was discovered after I collapsed and was admitted for surgery immediately. I’m almost grateful for it now. However the post surgical pain is extremely intense for the first 6-8 weeks. The next steps were all done in the pool at physical therapy which was incredibly helpful. If he is willing to fight for the first few months it will really pay off. My surgery was February 18th and I returned to my part time job at the end of June. My quality of life has increased dramatically compared to the past few years prior. I am here for any questions. Good luck with your journey.
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