Orthopedics
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Join Date: Jan 2007
Location: Spain
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Orthopedics
I am looking for some advise if there's any orthopods out there.
10 months ago I suffered a burst fracture to T12. This was stabilised with pedicle screws into T11 and L1. One of the screws in T11 is mislpaced and impinges on the spinal canal. Last X ray (dec) still shows minimal healing of the multiple fractures to T12. Origional surgeon says just take all the metal out after 12 months. Two other surgeons both say that doing this with no other stabilisation risks collapse of the vertabrae. Both agree misplaced pin needs to be removed but one wants to install more scaffolding to reduce strain on the screws, this will be done via a posteriora approach. The other recomends a spinal fusion graft done anteriorally using a large piece of the illiac crest placed into the front of the 3 vertabrae. Problem is its my decision and I have 3 possible ways to go although take it all out and hope does not seem too bright.
Anybody know anything about this and any thoughts.
10 months ago I suffered a burst fracture to T12. This was stabilised with pedicle screws into T11 and L1. One of the screws in T11 is mislpaced and impinges on the spinal canal. Last X ray (dec) still shows minimal healing of the multiple fractures to T12. Origional surgeon says just take all the metal out after 12 months. Two other surgeons both say that doing this with no other stabilisation risks collapse of the vertabrae. Both agree misplaced pin needs to be removed but one wants to install more scaffolding to reduce strain on the screws, this will be done via a posteriora approach. The other recomends a spinal fusion graft done anteriorally using a large piece of the illiac crest placed into the front of the 3 vertabrae. Problem is its my decision and I have 3 possible ways to go although take it all out and hope does not seem too bright.
Anybody know anything about this and any thoughts.
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Tranquil - without trying to be dismissive, I suggest that PPRuNe probably isn't the best place to be asking for advice on something like this. Without seeing you and your imaging I don't think anyone here should really comment on what would be best.
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I appreciate what you are saying but was hoping there might be someone with some knowledge (poss in USA where this is fairly common) of the general differences in the procedures mentioned. As I say the problem is having a choice of two different techniques to opt for. Also should there be anyone with that sort of expertise I have electronic images avaliable.
It was just a thought.
It was just a thought.
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I understand it is difficult to decide when each specialist you see tells you something different. But I would once again caution against taking advice off pprune for several reasons:
1. there is no way to determine if the person posting information actually knows what they are talking about
2. most spinal surgeons I know are fairly cautious people - I can't see any of them posting anonymous advice on how to manage a person they have never met
3. most spinal surgeons are fairly arrogant people - they all think their opinion is the best
I see from your post that you are in Spain. I imagine that is where you are being treated. Whilst I appreciate the standard of orthopaedic care might vary, my experience in the NHS of tourists returning from Spain (particularly Gran Canaria and Lanzarote) with fractures which have been mismanaged to various degrees would make me hesitant to seek treatment there. If you want a proper opinion, I would recommend making an outpatient clinic appt with a spinal surgeon at Royal National Orthopaedic Hospital Stanmore in London. It might cost you a bit if you aren't a UK resident, but it might save you life long grief if someone ***** your back up or even paralyses you.
1. there is no way to determine if the person posting information actually knows what they are talking about
2. most spinal surgeons I know are fairly cautious people - I can't see any of them posting anonymous advice on how to manage a person they have never met
3. most spinal surgeons are fairly arrogant people - they all think their opinion is the best
I see from your post that you are in Spain. I imagine that is where you are being treated. Whilst I appreciate the standard of orthopaedic care might vary, my experience in the NHS of tourists returning from Spain (particularly Gran Canaria and Lanzarote) with fractures which have been mismanaged to various degrees would make me hesitant to seek treatment there. If you want a proper opinion, I would recommend making an outpatient clinic appt with a spinal surgeon at Royal National Orthopaedic Hospital Stanmore in London. It might cost you a bit if you aren't a UK resident, but it might save you life long grief if someone ***** your back up or even paralyses you.
