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thinking about my 2 surgical choices

JulieAJJulieA Posts: 1,420
edited 06/11/2012 - 8:56 AM in Chronic Pain
Today I saw my NS and we discussed the second opinion as well what they would do.

First I should go in for a ESI while I am waiting. So I will try to get on the books for that the week after next (even next Friday).

My trusted NS would recomend a Transthoracic approach t7/8 discectomy with fusion (harware)- lung deflated etc.

The second opinion wanted to do the t7/7 XLIF (no hardware minimally invasive).

My NS doesn't recommend the XLIF- he doesn't do them at all. He said he fix's too many and he sees too many go wrong. But if that is what I decide Good-Luck.

The XLIF is about 2 month recovery. 1-3 days in Hospital. The bigger fusion is 3-5 days in Hospital with 2-4 months recovery.

I still have to get one of my insurances to approve it. The attorney will help with that I am sure.




  • I've not had either procedure you are asking about, however after doing a search of the forums it appears many have asked the same question and they have for the majority remained unanswered.

    I'm a person who believes in intuition. What does the intuitive part of you say? If it is your trusted NS recommending the bigger surgery ... there's gotta be a good reason that you trust him.

    I like writing things down so that I can see them in black and white. I can list the pros and cons of each concern, or in your case each surgery. Seeing it written out like that can be quite an eye opener.

    Well best of luck and I hope someone with XLIF experience chimes in.

  • Julie,

    If you take the lessor of the two surgeries and say it wouldn't work out would they then go back and do the big one, or would that not be a option.

    Like C, intuition and what you feel is best for you, is a good place to start. Making the list also helps. Don't forget the FAQ section with the 38 questions to ask a surgeon, possibly that could help you in weighing your decision or guide you in some exact questions. Unfortunately you are not new to this and have done the whole rodeo in making surgery choices, it still is a bit overwhelming to decide. I say take the weekend to think about it and get the injection, and hopefully with a little less pain, you can have a clearer head. When were in so much pain, sometimes where willing to say do whatever to make it stop. Well I have been there before, and then as the pain lets up, I can think more clearly about what I am doing or going to do. Hopefully the injection will give you some relief. Whatever your choice you make I am sure it will be the right one for you, and will all be here to support your decision. Good luck and keep me posted.
  • i DONT like the sound of either of your options and would advise you to get another opinion .and fusions take longer than 2 months to recover from ..try two years ..{from my consultants mouth} and he does ADR/FUSION ALL THE TIME ., i would definitely find some one else to give you another opinion .i can see lots of problems with your options ..i don't like lt one bit ..just a feeling hun ...good luck don't be in a rush its your spine ...
    tony x
    1997 laminectomy
    2007 repeat laminectomy and discectomy L4/L5
    2011 ALIF {L4/L5/S1}
    2012 ? bowel problems .still under investigation
    2014 bladder operation may 19th 2014
  • Tell me why, again, they are recommmending a fusion rather than just a discectomy initially? I think often times the least invasive is best initially. I had T8-9 and T9-10 operated on, a two-level thoracic discectomy, and it was done completely posteriorly. Now T7-8 might need to be operated on as well, but still my NS, who specializes in the thoracic spine btw, is only going to perform a discectomy. He said he'd still try to do it posteriorly by enlarging my existing incision. He did say, however, that if I were to re-herniate, he'd have to do a fusion because the t-spine is not like the lumbar spine where you can go in and do a repeat discectomy.

    I'm going to have to agree with the above poster...I would seek out a third opinion, preferrably one who specializes in the t-spine, even if that means traveling a little to find one.
  • Thanks Guys,

    Kim the reason why they need to fuse it is because of the edema I have on T7 & T8 vertabrae. It is very painful. The reason they don't just do the disectomy is because the height of the disc has to be restored I am bone on bone pretty much and the edema is from some movement. Both surgeries take out the entire disc and place a bone filled graft (in the old fashion fusion) and a bone filled cage (xlif). The difference is the hardware and of course the entry. One deflates the lung,one uses a 2-3 in incision. I do not want to go through this more than once. In fact I don't want to do either, but I am literally all but on bedrest now. Unfortunately- I am not wealthy. I need my income.

    Tony- Thanks for the encouragement :) I am considering another opininon but these are the only two NS (2 neuro surgeon offices in Anchorage). I would have to see an Ortho Surgeon who specializes in Thoracic and we don't have one in the state of Alaska. I may be sending out my file after I get the attorney on it, the insurance is a cluster right now, I owe everyone money. This car accident has been a nightmare. It is going to take 2 months at least to get it scheduled and aproved. Plus I can't spend a lot longer in the pain I am in. It isn't fare to myself or my family. This had been going on since 4/27/2010 and that is a long time to be in accute pain. Last November my NS said it might get better and I wasn't ready to go through with it.

    We are going to think about it until Oct 20th when I have my next appt, do some more research and see how the ESI goes again. Really listen to how well the nerve block part works. Last time it was only good for a few hours- then I felt worse. That was almost a year ago.

    Thanks friends,


  • I think that the idea of a list of pros and cons is a good idea. It will help to focus your mind and looking over the list helps to balance one against the other.

    I think we are safe to say that you will need some sort of surgery???

    You have had both lumbar and cervical fusions so you know that these are not easy recoveries. From things I have read, thoracic fusion is even more difficult. However, if you need surgery to get you back to your life, then even a year of pain and restrictions would be worth it to move forward with your life. Do you agree?

    If you are sure that you only want one surgery (all of us feel like that!), then would you prefer to have a more invasive surgery? Would that make the chance of a 'one surgery to fix all' more likely? Or would you want to do the least invasive and spinal altering surgery to see if that will be enough to improve things enough to get your life back on track? So many questions! Hopefully they may help you make a list of questions to ask your surgeon and to decide what you want to do.

    I haven't seen anyone about my thoracic problems (yet) so can't really offer much more than that, but please know that I am thinking of you and really hope that you will find a way to get relief. I am following your progress closely.

    Take good care
    >:D< >:D< >:D<

  • Thanks :)

    Great idea- I will be making a spread sheet with the pros & cons and surgery details etc.

    The recovery time that I am talking about is (time off work) btw I know fusion takes much longer. I realize most people who have had multiple fusions probably go permently disabled (I can't afford to). I hope to get some kind of settlement from the MVA, but I am a realist and I not counting on anything.

    Did I tell you all I am officially fused in my cervical spine? Finally good news. This one took longer do to the car accident,but it is done.



  • Getting the news that you are fused is wonderful. It is what us fusion spineys long to hear.

    To have the other parts of your spine solid before moving on with thoracic surgery will be a good position to be in.

    Are all your thoracic problems due to the MVA?
    I wonder why I have so many problems in my thoracic spine as I haven't been in an accident. I did fall out of a tree as a child of about 7 and knocked myself unconscious, but that is a very long time ago!!

    Take care,
    >:D< >:D< >:D<
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