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Old 11-11-2008, 10:20 AM   #1
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Fusion Surgery- Questions to Ask

Hi All-

I will be having spinal fusion surgery done for my spondylolisthesis. I have not met with the surgeon yet, I am waiting for my appointment. I plan to get several opinions. What types of things should I be asking to make sure I pick the best surgeon to do this? I know there are different techniques when doing the surgery. Which have you found to be the best.
I am terrified by the way!

Thank You

 
Old 11-11-2008, 10:36 AM   #2
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Re: Fusion Surgery- Questions to Ask

Being terrified is normal.....I would lean more towards the doctor that is "Fellowship trained" and is a specialist in his field....ask around the hospital and do internet searches....you will be amazed at what you will find...people love to talk...brag or even the bad! Find out how often he/she does the proceedure they are recommending for you....after you get the big picture ask more questions on here...Im amazed at how much these ole broken back people know...lol Good luck and keep us up to date.

Devon

 
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Old 11-11-2008, 06:18 PM   #3
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Re: Fusion Surgery- Questions to Ask

Thank you!

I am only 27 and this will be my first real surgery. (I had a vaginal Hematoma repair in the OR after having my baby). Needless to say I am very un-experienced. Should I ask about anything post op? Will there be different recovery times with different methods of surgery? I am pretty much expecting to take 3 months off of work, and hire someone to help me with my 14 month old daughter when my husband is at work and family cannot be there.
Any other insight would be appreciated! I need all the help I can get!

 
Old 11-11-2008, 08:16 PM   #4
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Re: Fusion Surgery- Questions to Ask

[QUOTE=megss;3790056]Hi All-

I will be having spinal fusion surgery done for my spondylolisthesis. I have not met with the surgeon yet, I am waiting for my appointment. I plan to get several opinions. What types of things should I be asking to make sure I pick the best surgeon to do this? I know there are different techniques when doing the surgery. Which have you found to be the best.
I am terrified by the way!

Thank You[/QUOTE]

I was told to plan on taking a year to fully recuperate after my fusion surgery. The first three months were difficult pain wise and getting around, but I had complications that lasted far longer, so I didn't make much progress in that first year. It can take up to a year before the fusion is declared a success or failure. If you have nerve damage , it can take up to two years for that to resolve if it is going to improve.
Questions that you should be asking are- what kind of surgery will you be doing? How long do you expect me to be on pain meds post op? What/when will I start PT? What things do I need to have at home in regard to medical equipment, dressing supplies, etc, raised toilet seat?
Since the surgeon determines which surgery type is best for your physical problem, he can tell you about expected recovery times....
Ask him how many of that particular procedure he does yearly and what he determines as a successful outcome. It might not be the same as yours, as in he might determine success or failure of a surgery as solid fusion of the bone graft, and you might be considering "success" as a relief of pain that you currently suffer from. Ask him if you might still be in pain once the surgery has had time to heal and your body has had time to recover.
Ask him what a reasonable time line is for you to be able to care for your daughter by yourself? I was told no bending, lifting or twisting for any reason for the first 3 months, extended to 6 months.
Ask about a brace? Will you have to wear one? How long? Custom made or one of the adjustable ones?
Bone growth stimulator? How long would you have to wear one?
What if something goes wrong? How will that be taken care of?
About pain medication if needed outside the first 3 months? Will you be referred out to pain management or will the surgeon continue your pain meds indefinately?
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Old 11-13-2008, 03:33 PM   #5
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Re: Fusion Surgery- Questions to Ask

Those are all great questions already posted. I got three opinions on whether surgery was necessary. The third surgeon was awesome - he actually asked me about my family and if they would be supportive, both physically and mentally. He actually said he wouldn't do the surgery on me until he met with my husband and felt comfortable that he (husband) understood how hard this was going to be on everyone. If you don't like your surgeon or don't feel totally comfortable with him/her, I would definitely seek another one. They are each VERY different. Good luck.

 
Old 11-13-2008, 07:57 PM   #6
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Re: Fusion Surgery- Questions to Ask

Thank you everyone! I have 2 appointments set up so far. One is on Dec 2nd with an orthopedic surgeon, and the other is on Dec. 8th with a neuro surgeon. Is one better than the other? (orthopedic vs. neuro surgeon?) The orthopedic surgeon is in the same practice as the Orthopedic Dr. I have been working with, and I really liked him. He is compassionate, which I think is a really great quality for a Dr. to have. At this last appointment when it was decided that I need surgery, I showed him a pros/ cons list I had made for having the procedure. He liked it so much he kept it for my chart! I thought that was cute.
If anyone else has anything else to add, please feel free!

 
Old 11-13-2008, 08:31 PM   #7
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Re: Fusion Surgery- Questions to Ask

I had my lumbar fusion when I was about your age. At that age you tend to heal more quickly so 3 months may be realistic. In actuality your body continues to heal throughout the first year after any fusion - but you'll be doing relatively well at 3 months post-op if you take care of yourself.

Ask your doctor if they reccomend any post-op bracing, what they'll provide for at home pain control, and as you said what technique they will use. There are some who use what is called a metal cage, some use plates/screws and some use your own bone harvested from your hip. In my case I had plates and screws with some bone shavings (not a lot - so taken from the incised area).

Personally I've had more positive experiences in both my back and neck fusions with an orthopedic spine surgeon. I just feel they do solely spine work so they have an edge. Some neurosurgeons do specialize in spine surgery but make sure to ask (as neurosurgeons can also work on the brain, etc). In either case, a NS or an OSS, be sure they are board certified and that they do this type of surgery all the time.
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Fusions: L5-S1 (87), L4-S1 (93), C5-C7 ('06), L3-S1 ('10)
C5-C7 foraminotomy 08

 
Old 11-13-2008, 09:44 PM   #8
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Re: Fusion Surgery- Questions to Ask

Megss,
I wish you luck at your appointments. My daughter was sixteen when she had her two level fusion for spondylolisthesis and stenosis. I feel because of her age she recovered quickly. She had a really rough first two weeks but each day improved after that. She was off narcotics at ten days. She took it very slow. She had the no bending, lifting and twisting rule for six months. The only exercise her dr had her do post op is walk. She started walking one house and increased her distance each day. By the end of 2 1/2 months she was walking about three miles.

She did not have to wear a brace post op. I did put a bed in the family room so that she could be a part of the family. She slept there for four to six weeks. I did not have any special equipment for her except a shower chair.

I guess I haven't answered your questions about questions. Sorry. Along with the previous questions, I would ask: What is he using for bone graft - donor bone, bmp? Ask how long until you'll be allowed to drive a car, or even ride in one as a passenger. My daughter's doc didn't even want her to be a passenger until she was checked at her two week post op appt. Your hospital stay - Will you be in a regular room or ICU and average length of stay. My daughter spent her first night in pediatric icu and then was switched to a regular room.

I certainly hope you recover quickly because you are young too. Best wishes.
cas

 
Old 11-14-2008, 06:30 PM   #9
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Re: Fusion Surgery- Questions to Ask

I had my posterior fusion 9 months ago....Finally feeling like my old self again ...The First 2 months are the toughest..As most people here have said...First and foremost......Try not to be petrified.......With the wonders of medicine/surgery today believe us you will feel better...That nagging/burning sciatica pain will go away...Don't expect to be 100% but you will appreciate that you do feel much better, you'll be able to do the simple things you probably can't right now...Standing became SO painful prior to my surgery and now I can stand for hrs....It's important to surround yourself with loved ones and friends that will HELP you..

Be prepared before surgery, setting your home up with things at waist level so you won't have to bend..GET THE GRABBER.........and satin bottom sheet for your bed...helps to slide and not strain your incision...

Once you have found the right surgeon...A trained spine specialist that only does spines......A fellowship trained surgeon...Find out how many fusions he/she has performed.....success rate etc...

Can't remember are you near NYC??....Hospital of Special Surgery is the BEST.Just do your research and get 3 opinions.

I'm SO glad I did the surgery and for me it wasn't as bad as many people told me it would be...You must be patient with the recovery as it is SLOW...If you are not prepared or able to do this....I wouldn't proceed..

I found once I found the right Dr...I was in such pain that I was encouraged and hopeful he would make me feel better....When I read my prior to surgery journal it's hard to remember now just what awful pain I had been in...I FEEL SO MUCH BETTER NOW..

Once you secure a surgery date...ask the hospital for a relaxation therapist and get some relaxation tapes...Once I was close to the date I became resigned to the fact that my Dr. would help me.

Ask your surgeons office for names of patients that live near you that had had the exact same level surgery and speak with them.........THIS HELPED ME TREMENDOUSLY..I actually had lunch with a woman who helped me thru the process and we are now spiney friends..

Please know once you've made your decision this is the best decision for you..

One thing you will find with recovery....the first 3-4 weeks it's difficult to sit down...You can't sit on a soft sofa and hard upright chairs are painful and you can only sit for 10-15 minutes and must walk again.....

WALK>>>>>>WALK>>>>>>>>>>WALK after surgery and ice several times a day.

AFter surgery.listen to the nurses and take your laxatives...you don't want to get constipated from the pain meds...Miralax...or Milk of Magnesia...SAVED ME>>>>

All the best....We will pray for you...but believe in yourself and your Dr.And we're all here for you..

LAF...(Laurinda)

 
Old 11-14-2008, 06:38 PM   #10
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Thumbs up Re: Fusion Surgery- Questions to Ask

PS....You are young.......and you will do fine...You are probably in better shape than most of us were prior to surgery..I am 54....I did do stomach (core) strenghtening prior to surgery and also arm strenghtening...You'll be surprised how much more you'll need to use your arms to pull you up etc..

ALSO....look into a raised toliet seat ... You'd be surprised how far 5 inches is when you have to squat to reach your normal seat.......Hope this doesn't sound weird......just a friendly tip.

Again...you'll do fine....but be patient..

Last edited by Mod08; 11-15-2008 at 09:10 AM. Reason: edit ed last line..spelling change

 
Old 11-14-2008, 08:35 PM   #11
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Re: Fusion Surgery- Questions to Ask

Thank you everyone so much. I am looking forward to the day where I feel better. All of these tips have been so helpful and I have a list of questions written down now to take to my appointments. I am also bringing my mom to my appointments so she can ask questions as well. I tend to forget things I planned on discussing with the doctor when I am anxious. I always had to bring a list to my prenatal appointments as well.
Laf- I live in Minneapolis, so no where near NYC. I used to live in Fairfield CT though! Right by you!
Crazyman- I like the idea of having a bed in the living room. The only problem with that is my house only has 1 bathroom and it is upstairs! (My house was built in 1905 and back then they only did 1 bathroom). So unfortunately I will have to stay in my room.
Spine- Thanks for the advice regarding the ortho vs neuro surgeon. I know a lot of people that have had major operations through the orthopedic practice I have been going to, and everyone has said nothing but good things about the,.

Is it possible I will not be able to return to work at 3 months post-op? My company only allows 12 weeks max per year. If I loose my job, or at least loose my salary and benefits while on leave (if it extends beyond 12 weeks), are there government programs to help with finances? We could always go on my husbands benefits, although they are wayy more expensive, but we cannot afford to go without my salary. I have already told them that, once I get past that initial hump, I can work from home as much as possible. Maybe that will be enough.

 
Old 11-15-2008, 08:30 AM   #12
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Re: Fusion Surgery- Questions to Ask

I'm sure Minneapolis has great Dr's and hospitals...

Yes it's good to bring someone along to your appt...I brought my Mom and sister too...When you're receiving all that information from the Dr..you do get overwhelmed...Do bring your list and don't let him/her rush you...YOU are paying for your time with the Dr. and a good Dr. will answer your questions.

Again since you're young you may be able to head back to work sooner..Depending on the actual procedure your Dr. will tell you..Do you drive to and from work...Sometimes the travel time in the car sitting so much gets uncomfortable.

Good luck w/ everything and stay POSITIVE....Believe in your choice and yourself and keep moving forward.

LAF.....

 
Old 11-15-2008, 04:27 PM   #13
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Re: Fusion Surgery- Questions to Ask

Hey Laf-

I actually DRIVE for my job, mostly anyway. I am a Rep for Silestone, and I spend at least half of my work day driving around visiting accounts. Right now, driving really agrivates my pain. I have a special cushion to sit on, but it doesn't help much. I have a really bad feeling that I will loose my job over this....

 
Old 11-15-2008, 08:31 PM   #14
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Re: Fusion Surgery- Questions to Ask

Oh Megss....After you recover and return to work when you drive can you take frequent breaks??...To get out of the vehicle and walk a bit...stretch your legs etc?? It's very important...I have to sit alot at work and at 1st had to get up every 15 minutes and walk around...sitting alot isn't good..The more I stand and walk the better I feel...

Hope you find a good solution..Maybe there's some way you can stop and do it without telling anyone....

Again hope these tips are helpful...good luck w/ everything.

 
Old 11-18-2008, 01:35 PM   #15
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Re: Fusion Surgery- Questions to Ask

Laf-
Yes I could take frequent breaks. I pretty much set my own schedule, and just as long as I get my work done, I can do whatever I want.
Good news, my surgeon had a cancelating for tomorrow morning and they offered the appointment to me. I am scared and nervous and excited, but now I have a lot of great questions to ask!

 
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