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Letter fom my surgeon

AnonymousUserAAnonymousUser Posts: 49,623
edited 06/11/2012 - 7:21 AM in Back Surgery and Neck Surgery
my surgery is next tues. Today I got in the mail a paper from the surgeon saying he is doing a "2 lifs at L4-5 and L5-S1." and "we will also do facet fusions at L4-5 and L5-S1 with no transverse process fusion". I have researched the TLF but I do not know what facet fusions are or what "no transverse process fusion" means. Can anyone help me understand this? Thanks!
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Comments

  • Shay sorry I can't help you with the meanings. I do believe that you should call your surgeon's office and have them explain in more detail your surgery to you. Your surgeon should want you to completely understand all that he or she is doing in the surgery. Is this letter something different that they explained during your surgery consultation. I hope you get all the answers you need before the surgery and good luck on Tuesday.
  • I've never heard of anyone getting a letter in the mail - very interesting. Anyways, its good to have that written down so you can make sure that you understand exactly what your surgeon is planning on doing. You should understand everything about what is going to be happening to you so there are no surprises.

    I had a TLIF done, but it also included what's called "gutteral" fusions where they lay down additional bone material out near the tranverse processes so maybe this is what your doctor is referring to. The LIF's you refer to mean "...lateral interbody fusion" and are usually proceeded by either an "A", "P" or "T" for Anterior (front), Posterior(back), Transforaminal (posterior incision but angled to the side of the vertebrae), respectively. This is in reference to the actual entrance point for the interbody fusion.

    Also, facets are the joints that attach each vertral body to the one above and below and allow the motion of the spine, much like any joint does anywhere in the body (bending, twisting, etc).

    Anyways, I was just throwing some info out here for you, but please ask your doctor for specific clarification. It's a known fact, too, that surgery patients fare better when they know exactly what to expect during and after surgery.
  • I agree that you need to contact your Drs surgery. It is really important for both you and him to have a clear understanding of what is going to happen.
    Even if you talk to his assistant, they will be able to explain the procedure to you.
    Nothing worse then going in to surgery not knowing what is going to be done (unless it is exploriatory surgery).

    Blessings to you and all the best for Tuesday.
    Sara
  • may mean that he is going to use the facet joints (which I would prefer myself) for the fusion rather than using harvested or cadaver bone. Please keep us updated when you get clarification. Good luck.
  • That's exactly what I was thinking. I dont know what "lifs" would be though.

    Good luck with your surgery shay.

    Best Wishes,
    Christina :)
  • lifs refer to lateral interbody fusion, which is the commom fusion area between two vertebrae (the circular part of the vertebral body). See my response a few posts back.

    Most fusion surgeries involve fusing this specific part of the spine but the surgeon may also fuse other components, such as the regions to the outside - much like creating a vertical bridge between two vertebrae. These types of fusions are called "gutteral" (think gutter). Doing both concurrently has also been referred to as a "belt and suspenders".
  • How cool is it that you got a letter with the surgery procedure listed.

    My NS was chuckling when I asked him exactly he was going to do - he said to just leave it to him.

    I laughed along with him and then said, "So, will you be doing a PLIF, ALIF or TLIF. Will you be harvesting bone from the iliac crest or using cadaver bone along with my bone. And will you be using bone growth hormone?"

    He then took me seriously, told me that although the incision is centered, he moves around and enters the spine from the side. He has not harvested from the iliac crest for about 5 years as the hip harvest site just created a lot more problems for people. And that yes, he uses BMP.

    Since that was what I had decided I preferred (PLIF or TLIF, cadaver and BMP) - it made me feel good to know the details.
  • I went to my preop appt yesterday and the asst. told me what that was. They are using bone from my hip to do the fusion but they are also fusing the facets together (with screws). Although...I am little worried since the assistant did not know that he was also doing the facet fusion and he did not have the paper work drawn up for me to sign for it. I guess the surgeon did not tell him about it-so I do not know if the surgeon is not going to add the facet fusion now or if the surgeon just forgot to put it in the paperwork-so I guess I will find out when I go in at 5:30 AM on tues-and I will just have to sign for it then. Thanks for all the responses!
  • I went to my preop appt yesterday and the asst. told me what that was. They are using bone from my hip to do the fusion but they are also fusing the facets together (with screws). Although...I am little worried since the assistant did not know that he was also doing the facet fusion and he did not have the paper work drawn up for me to sign for it. I guess the surgeon did not tell him about it-so I do not know if the surgeon is not going to add the facet fusion now or if the surgeon just forgot to put it in the paperwork-so I guess I will find out when I go in at 5:30 AM on tues-and I will just have to sign for it then. Thanks for all the responses!
  • didn't mean to post 2 times.
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