Kickas.org Forums Treatments, Drugs and Alternatives Surgery Has anyone had Pedicle subtraction Osteotomy ?

Ok fine we will agree to disagree Ive said what I think and I will stick by that.Any one can say they would do it again after the event.
Kevin

Agreed

Hello Alan, yes and that's why I wanted to ask that question since I felt Kevin might benefit from your answer.

It is hard to imagine for me... I am not sure I could have made the same decision as you... not due to reading your posts so much, but from having been at my Mom's bedside and watching what she had to endure after her surgeries. Horrendous to watch someone in such pain (she's not allowed morphine due to ailing kidneys), but, she has enjoyed some wonderful years afterwards with such an improvement in her quality of life, and she may not have lived otherwise to be with us still.. though hers was not a choice, I am thankful everyday for her good outcome. I am also very grateful for your success too, as I wonder if we would have ever met, if you didn't have the surgery, but then that is just plain selfish of me! lol

*Oh I should add since not obvious, my Mom's surgery was not the same at all, she had her left leg amputated just below the knee, after a failed surgery trying to restore bad circulation problem.

Kevin, I can't imagine the difficulty and appreciate how the experiences of others must weigh more heavily on you, but I know that whatever YOU decide will be right for you.

Wow! I hadn't popped in here in a while and was stunned when I saw how many posts were now included in this thread! I'm trying to get caught up today, but it might take a while.

I just got done reading your post, Kevin, about the surgeon who said they would have to break every joint in the spine as they worked their way up. My response to that is the same as Alan's--huh? Or less politely, WTF? That is definitely not how the pedicle spinal osteotomy works, and in fact, I don't think doing it that way is even possible with an AS patient!! With the surgery that Alan and I had, along with John, Cheerful, and others, the doctors made a break in the spine at just ONE place, cut out a wedge-shaped piece of bone, then pull you backwards from your shoulders so that your spine slowly pulls back and down and "closes" the wedge up. Without being able to do a drawing, it's pretty hard to explain it any better than that. Just picture holding onto a curved metal rod. You want the rod to be straight, but it's too strong to bend as is. But, if you cut a small wedge out of hte metal right at the point where the curve is at its most extreme, you should weaken the rod and now you can bend it. OK, now picture holding the rod in your hands. The curve angles upward in the exact middle of the bar, meaning that you hold one end of the bar in each hand, and those ends are both a couple inches lower than the curved center is--it's not even close to being a U shape, with the ends pointed down, but instead picture maybe the wooden part of a bow (as in bow and arrow), ends pointing down, curve of the bow pointed upward, you holding onto those downturned ends.

OK, I realize I am totally overexplaining this, but on we go. As you hold that metal rod, which now has the wedge cut out, just picture bending each end upward. Whereas it was too strong to bend when you tried it before the wedge was cut out, now that it's been weakened, it bends easily. As you bend it, if you watch the wedge you will see it start to close as the rod become straighter--the rod starts to pinch together to fill in the gap that is now there. Eventually, the rod will be totally straight, and when it is, the wedge will be almost filled in because the two ends closed it off.

Now, that is exactly what they do with your spine--as I started to right before I got sidetracked trying to explain things better--and that wedge closes up too. With your spine, however, the wedge cannot close all the way by straightening out the patient--you can get close, but not closed al the way. Because of this, as another part of the surgery, they cut a small piece of living bone out of a donor site in your body--usually the pelvic bone--and insert those small bone chips into the small opening that still exists in the wedge. Because that bone is living, if things go right, it will graft to your spinal bone and, in a fairly short time, completely seal over whatever openine was still left in the wedge. This is important, because until it does totall graft and seal, your spine is at greater risk of breaking or being damaged and is not as strong as it will eventually be. That fact--that the spine is at great risk until the break that was created is totally sealed by new bone growth--is just one of the hundreds of reasons I can think of that I can't EVER see a doctor doing an osteotomy where he breaks EVERY joint in the spine. Make sense? I would be very leery of that doctor, and at the very least, I'd ask him what in the h*** he means when he says he'd have to break every joint in the spine? Tell him this is now how any osteotomy you've ever read about works (nor is it similar to any that your friends at an AS have been through), so how does this particular surgery even work? Better yet, why doesn't he do the standard
wedge osteotomy that only involves breaking the spine once, not multiple times?

On a completely different note, Alan, thank you so much for telling your entire story! I am through part 3 as I right this and can't wait to read the rest of it. I had no idea you were ever a police officer! You have led one totally fascinating life my friend--makes me even more bummed that I didn't make it to Toronto!!!

Brad

I knew there was a down side..............lololol


In the end the decision was made for me really. Kevinmentioned in a post somewhile ago, that he thought that fis stoop compared to mine at surgery, was worse, However (Oh cripes, starting with a preposition again, ahh well) the photos of me were 2 years pre surgery, I was a head lower at the surgery time. I have now lived 15 years more sins and have bent another foot despite the rods. What would I have beebn like now if no surgery No I had no choice in the end I would have been dead else.

hi Brad, yes so sorry not to meet and it was YOUR round too...Mig wouldnt pay !!

Sorry to have bored you all with this tale of surgery

Read it with bated breath Alan. Dunno how you endured that pain. (When I had my shoulder replacement, apparently I was delirious with pain and screaming in the recovery room - but have NO memory of it! TG...) Lots of memory afterwards mind you, ALL 9 months of it. Hell. So, again, dunno 'how' you survived those pain levels. Dear Lord.

Next installment please.

You write well. No glossing over, just simple facts. Good. Very readable. One empathisers. More power to you -

Molly C (France)
Keeping on Keeping on - but nowt like our Alan

Oh Brad, maybe you just haven't read it all yet, but Alan's was a bit different than the norm - his was a double osteotomy - two wedges! Check his xrays and the drawing on them, there is a link on an earlier post.

Yes, is too bad you couldn't make it to TO, but maybe next time eh?

Thanks Molly, you are kind. Yes it sound ridiculous to say "Scream in agony" nobody does that do they..........well actually you did, and I did, a grim experience. Thank you for pitching your experiences into this. Makes me realise that I am not writing from distorted memory.

So Molly, Mig's question to you then


would you do it again?

Hi Brad
Thankyou for that I understand what your saying.The difference in my case as I was told is that my spine is mostly curved at the top and they would have to do the operation like yours at the bottom of my spine and work up and do the same at the top and break my neck to reset the position of my head. Because the operation at the top of my spine and breaking my neck is very dangerous they will not do it at the moment. They have not ruled it out completely obviously if I get worse then there might not be a choice and I am getting worse.
Kevin