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Lower Lumbar Spinal Fusion, Then THR, Anyone Had This Done?

Discussion in 'Hip Replacement Pre-Op Area' started by VSlowLife, Aug 7, 2019.

  1. VSlowLife

    VSlowLife junior member
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    Hi all,
    I know only a few people can answer this. What was your experience?
    I am a bit taken aback this morning. According to an article from Feb. 2019, Hospital for Special Surgery research, my spinal fusion is considered a risk factor, for THR, right along with neuromuscular problems.
    “.....Dr. Sculco. "We may find that precautions don't make sense for any of our patients, but we need to look at in a stepwise fashion." Risk factors include neuromuscular issues, such as stroke, Parkinson's disease and lumbar spine fusions.”
    I was under the impression that as long as they could compensate for the change in angle and movement of the pelvis, as a result of the fusion, my THR post-op treatment and result should be as good as anyone else’s post -op treatment and result.
     
  2. Elf1

    Elf1 graduate

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    @VSlowLife I've read most of your posts but my brain isn't always engaged totally. I have to ask, do you actually have an Orthopedic Surgeon that you are seeing? And, if so, what does he/she say about your lumbar fusion? And if you don't, I highly recommend you get one and talk to them and quit playing with Mr. Google and finding all these articles. Not trying to be mean/rude/unfriendly but sometimes the more research one does online, though well meant, the more scary it gets. I did this myself before finding this sight. Had myself scared witless. I'm case you don't remember some of our conversations I have had a lumbar spinal fusion at L5/S1 to stop my disc from sliding back and forth due to Spondylolithesis.

    My OS was aware of my fusion, also aware that previous drags showed that I had a tilted pelvis. He did additional drags himself in various positions so that he could see how much bend I still had, etc. He did say that yes, there was a bit of a higher possibility of dislocation due to the fusion BUT, if he did his job right and took everything into account, there should be no problem. Today I'm a month out from surgery and feel pretty darn good. OA pain is gone, referred knee pain is gone and other than dealing with some muscle and tendon aches I'm awesome!

    I know when I first came to this site I had asked the question about spine surgery and dislocation as like I said was scared witless. Had numerous hippies come on and tell me they have had both spinal fusion and hip replacement and some of them multiple of both and doing fine. Don't know if this helps you any of not, hopefully it at least helps put your mind at ease.
     
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  3. Mojo333

    Mojo333 FORUM ADVISOR Forum Advisor

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    I agree.

    Great to get the scoop from those who have been there, done that.
     
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  4. VSlowLife

    VSlowLife junior member
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    Hi Elf, @Mojo333
    First, I am glad your recovery is going well. I have been following your progress! May you continue to improve. You had told me your OS took some extra types of x-rays to plan your surgery, based on the fact that you have a lumbar fusion, not just the standard hip x-rays. I was glad to hear that. I am very interested in your recovery.
    I think I had also read from you, that you thought you may be getting a duo-mobility cup.
    So few people on this site have spoken about lumbar fusions in relationship to their surgeries, but you have.I am grateful you shared that. I know It is not common to have both issues. I expected that.
    I have a medical background and was trained to read professional journal research. Now it helps me understand what the doctors have been telling me. It’s little consolation.
    I have an appt at an excellent OS research hospital, because that is where the spinal surgeon and OSs who have published the latest research on this issue are located. My spine issues are more complex. Since Elf1 mentioned spondylolithesis, I have that in the adjacent vertebrae above my 12 year old, un-instrumented fusion, just as one example. So far I have just been told to keep my core strong and it’s working.
    Meanwhile I am focused on losing some pre-surgical weight, and doing some of the things I have read here, that are important pre-surgical check list items, since I have a snail’s life.
    As previously stated, I started seeing my local OS back in 2010, when I was first diagnosed. In 2012 I requested a THR. I was judged to be too much of a risk because of my spine, to my great disappointment. They did not know then, what they know now. Then I went to an OS, the same year, at The Hospital for Special Surgery, since they do complex cases and I was told to wait until I was 65. I have called the doctor at HSS annually, and have been told the same recording, “Wait.” I have seen other OSs, too, because pain is frustrating, when you have been told to wait. They all must play golf together, lol.
    In 2014 I was already a couple of years bone on bone on the right side with a cam impingement and a labral tear. My left hip was nearly bone on bone with two labral tears.
    My left hip is speaking up, too loudly at times, this year. The left is my “good” hip. I do not think I can wait until I am 65, which is why I am here. I feel more confident I will get a “Yes” from the next OS I see. I think both hips are bone on bone, now, which is why I read Mojo333’s recovery from bilateral surgery. Mojo333 and I have spoken about this.
    Hope that answers your questions.
     
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  5. Elf1

    Elf1 graduate

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    @VSlowLife the OS and I had discussed the dual mobility cup but to my knowledge it was never used. You may want to look at my pre-op thread The Waiting Game towards the beginning and see who all had mentioned they had fusions. I know there were a few that had multiple fusions.

    Question, it says you're from Mass but you seem to keep referencing NYC hospitals, why when Boston area has some of the best hospitals around? Just curious. Hubby is originally from New England and quite a bit of the family still live there and quite a lot of the family are in the medical field. That's what I'm basing my assumption on so you know where I'm coming from.
     
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  6. VSlowLife

    VSlowLife junior member
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    Hi Elf1,
    Thank you for your suggestion to look at the beginning of your pre op thread. I hope your recovery is continuing well and you are getting stronger everyday.
    I had put in location as Northeast, perhaps that made the program choose Massachusetts?
    I do live far from NYC, but I am willing to go where I feel best with the surgeon. I use trains because they are easier on my hip than driving. The handicapped section lets me put my bad leg at any angle I need, to feel better. For my surgery in May I stayed at a hotel near the hospital until I was well enough to get back on a train. They release you so quickly after surgery theses days.
    Yes, Boston has great hospitals, and easy above ground trains, too.
     
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