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Um, tell me about 360 degree surgeries, fusions, realignments, and so on

happyHBmomhhappyHBmom Posts: 2,070
edited 06/11/2012 - 8:46 AM in Back Surgery and Neck Surgery
I haven't all the details yet. It will involve going in from the back and the side, complete removal of my L2 vertebra, and realignment and fusion. It is something he's done before, and he claims an 80-90% success rate, success being significant decrease in pain levels within 8-9 months after surgery.

First will, of course, bee another MRI, cat scan, and so on.

Anyone have any details on this type of surgery? He would have a general surgeon there too to help him with the side incision.


  • you know its a big complex operation and the term 360 or global means that the surgeon goes in from the back and front and sometime the side .the result you have more wound sites .the operation takes longer but if done well you and me should get a good result my only advice is to find a GOOD surgeon .this kind of operation is hard work and needs to be done by a competent person .so make sure that you do your homework and get the best ..is your body
  • Hi Buddha and Tony..

    Ive had fusions done where they cut through my stomach and also have had fusions where they went in through the side and the back..
    In all honesty the side/back hurt a little more than the front approach as my Dr said that doing it this way he had to cut nerves etc and the operation took 4 hours..When he did the frontal approach it only took it 2 and a half hours and that included putting in a Total DIsc Replacment as well..

    I also recovered quicker from the frontal approach..

    Hope this helps and just ask if I can help any further. :H
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  • He said he would go in from the front and side, and has a general surgeon help him so he does not have to worry about anything except the spine.

    The surgery is big and involves removing what remains of my L2 vertebrae and then realigning my spine from L1-l3. I'm not sure what he'd fuse, I was too flustered to ask many questions, so I decided to wait until after the MRI etc.

    I believe he's an excellent surgeon. Board certified neurosurgeon with a full curriculum vitae, and experienced in complex spinal surgeries (which most are not, I have found). But I've never done this before so what do I know? This is my second opinion, same as the first as far as what the surgery would look like.
  • happyHBmom said:
    complex spinal surgeries (which most are not, I have found).
    Just wondering if you would be so kind as to elaborate on what you have found and from what source/s.

  • Actually, I'm more interested in finding out information about the issues I asked about than in discussing the process by which I found the surgeon I chose. Why on earth would that information interest you?
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  • I'm not asking about the process by which you chose your surgeon, that's your business. I am however, intrigued by your assertion that most spine surgeries are not complex. I am curious as to how you came to that conclusion. There are many members here who have undergone some pretty intricate surgeries as well as those who went in for some fairly common stuff that turned into their worst nightmare. I'm just wondering what the criteria is that determines whether a specific surgery is complex or not.

    Is it the number of levels, the location, length of surgery, type of surgery (MIS or Open), anterior vs posterior vs 360, amount of hardware, type of hardware, etc...

    I've always been under the impression that all spine surgery is complex, just some are more challenging to the surgical team than others.

    Anyway, just curiosity.

  • Not to put words in HB's mouth but I think she is saying that not all surgeons have experience with the more complex surgeries like the 360. If I was having that surgery I would want to know that my surgeon has done it a few times already. This is why many of us have to seek out a specific surgeon who will treat us. For example very few surgeons will do thoracic so you have to search for those doctors.

    Of course we never know what will happen in that operating room, for spine surgery or any surgery. My father went in for what was a simple heart valve fix and someone slipped and cut a major artery. I went in for a pretty straight forward microD and came out with irreparable eye damage.

    Because there can be complications or even additional work to be done we want to find the surgeon who is best prepared to handle our situation. Going into a 360 I think HB is very smart to find a doctor who is experienced in this particular surgery.
  • I think you misread my sentence. I did not say most spine surgeries are not complex, although I would guess if you did a true study you'd find the simpler surgeries much more common. I was saying that most surgeons are less experienced in the more complex surgery that I required, which includes 360, realignment the spine, vertebrectomy, something like a titanium cage, and then the fusion. I was looking for surgeons with specific reconstructive experience and preferred academic authorship.

    But that wasn't the topic of my post. I wanted to know what experience people have had with their surgeries, since I do know that people have had complex (360, corpectomy, etc) and what their recovery was like. I just wonder what I'm walking in to, and was hoping to hear from people who had been there. How painful was the recovery? How long were you unable to drive? How did you cope with life during the recovery?
  • I'll take a stab at this for you. I had a 360 revision surgery done in Jan. of this year. It was a 8.5 hour operation. It is a long time to be out and it takes a lot longer to get your lungs cleared out and working again. I was on oxgyen for 2 days after the operation.

    You are correct that what you have said your going to have done is complex, much more so then a PLIF. Your surgeon needs to be known for doing this type of surgery work, or I personally would still be looking for someone to do it. My surgeon did this type of surgery weekly and that along with he knew what needed to be done and had a team already together sold me on his qualifications. Mine went in from the back first to take out my failed fusion hardware, then had a vascular/general surgeon open me up in the front. There are a lot of things that need to be moved out of the way in order to reach the front of the spine. If the surgeon doesn't do this on a regular basis there is a good chance that a vessel, or organ can be bruised. A bruised organ can make a recovery that much longer. Your sexual hardware can also be effected as it lies in the way, at least it does on men.

    When the disk was removed and a cage and screw was added to the fron of my spine they closed me up rolled me over and went to work putting in new hardware for the fusion.

    I would be asking as much about the infection protocols at the hospital as anything else. This is the last thing you need to have happen is a infection, which by the way hospitals are noted for. Reading your posts I think you already know that.

    Getting set to leave the hospital after your surgery is no different then a regular fusion surgery in that you have to be able to walk, go up and down a few stairs, be able to eat, and also pee/poop.

    I was in the hospital for 6 days and did pretty well on my 1 3/4 hour ride home. I was well past ready to get into my own bed. I came home with a walker which I used for the first week. After that I kind of hugged the walls and used a cane. I was not walking alot but did get up for lunch and dinner in the kitchen. I did not each much at all even though I had a lot of good stuff around. I needed help doing most everything for the first 3 weeks home. I had my wife home all during my recovery. My experience was that if I tried to do something I wasn't ready for that I paid for it for 3 days afterward. If it hurt a bunch then don't do it.

    It was a slow process for me to really start feeling better and that process is still working. You will most likely start feeling better and wake up one day and say this doesn't hurt as much as it did. I took the pain medicine I was prescribed when I left the hospital and went back to the same amount I was taking before I had the surgery and then just started backing down on them. I still take some and I'm 7 months out.

    My surgeon would not let me go back to driving untill I saw him at the 3 month mark. Can't say I was really up to it much before then either.

    I did not endure the surgeon going in through my side. I was told by another surgeon that there are a lot of nerves in the side area and the most common problem was nerve damage. I would make sure that your general/vascular surgeon also does this on a regular basis, like weekly. The more the better in my book. My vascular surgeon did 4 to 7 of these surgery's weekly. He works with 7 spine surgeons at one of the big NYC hospitals. I was put at ease when I had my first meeting with him.

    There is no doubt that what you are having done will be complex and involved but what choice do you have? Are they talking of doing all this in one session on during a couple of them?

    If you have other comments or question feel free to send a PM.

  • Dave, thanks. What was the cause of your surgery, if I might ask?

    I was told 6-9 months total recovery, is this about right?

    I asked if he has done many of these surgeries. He said "Many many of them." I was told I could meet the general surgeon as well. Is this important? I couldn't think of what I'd ask him.

    I will ask about the length of the surgery and whether it will be in one or more settings. He did not say- there is much unanswered as we were working on old MRIs and did not have current information to work with.

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