Doctor insights on:
Fetal Surgery For Myelomeningocele
Pregnancy after spinal fusion-i had spinal fusion surgery about a year ago; l4-s1; how does this affect pregnancy and delivery?
It depends: These arethe result after 8 years follow up for patients have the sugery.There were 68% excellent and good, 22% fair and 10% poor results. Back pain was relieved in 91% of the patients. Leg pain was relieved in 76% of the patients. Numbness was relieved in 87% of the patients. Five patients had re-operations. ...Read moreSee 1 more doctor answer
Why surgery?: Chiari is a congenital finding of low position of the cerebellar tonsils. This is usually incidental and not clinically significant. It can be seen on MRI done for headaches, but is not the cause of headaches. Surgery should be avoided unless there is definite indication. Common time for problems is during rapid growth before puberty - not as adult. ...Read more
Spinal Instability: Spine fusion is indicated when spinal stability and/or alignment has been compromised, resulting in risk for further spinal collapse, deformity, or neurological compression/injury. Surgical fusion restores immediate stability and alignment and creates an environment where the vertebra can fuse in a functionally acceptable position. Conditions include fracture, deformity, and spondylolisthesis. ...Read moreSee 1 more doctor answer
Severe hydrocephalus: or Cerebrospinal Fluid build-up in the brain can occur with any Type of Chiari Malformation & can be fatal if untreated. I referred your question to neurosurgeons on HT, but they need to know the Type & the reason decompression surgery has been proposed. Ask your insurance for a 2nd opinion if you're uncomfortable, as this surgery is proposed because of concerns about your function & safety. ...Read more
Delivery after scoli: Depends on the levels of your fusion. Presumably you were treated in adolescence. Most adolescent fusions stop around t12 or l1. Lumbar curves may require fusion to L4 or l5. Neither would narrow the birth canal. The lower fusion may predispose to some back pain during pregnancy due to loss of lumbar flexibility and inability to compensate for that baby out front. ...Read more
Myelomeningocele: Usually the repair of a myelomeningocele is delayed several days after birth to ensure that the child is stable for surgery and to also get a better assessment of potential neurologic deficits. As an adult, some patients develop spinal cord symptoms from tethering of the spinal cord prompting a procedure to release the tension on the spinal cord. ...Read more
Is there a risk of paralysis after spinal fusion? I'm worried about accidental paralysis after spinal fusion. Is this a risk?
Yes, but unlikely: There is a risk of any surgery, and the risk includes paralysis as well as death. However, the risk is very small. Just like there is a risk of dying in a car wreck every time you drive. This just shows how important it is to attempt any alternative to surgery, and only go forward with surgery as the last resort. ...Read more
This really depends: On the health & age of the patient, the extent of the surgery in terms of number of levels, stages and reason for the surgery as well as the skill and expertise of the surgeon. If medically stable for this surgery, not obese, not a smoker, not diabetic, not over 60, not a revision surgery, then rates of complications are low but not zero with a very low mortality rate. ...Read more
Seeking non-surgical treatment options for adolescent bilateral grade 3 spondylolysis (pars defects) with herniated l5-s1 disc?
Options: Congenital variety genetic origin occuring in 6% us population in particularly in certain high level athletes like swimmers, gymnasts, pitchers, football linemen to name a few. Most treated non operatively including associated with herniated disc with bracing, physical therapy & medication and activity modification. Epidural steroid injections can also be considered with 90% treated nonop. ...Read moreSee 1 more doctor answer
Experience/training: Orthopaedic and neurologic surgeons are qualified with basic training to perform spinal fusions. Surgeons from both fields can undergo additional training in spine surgery known as a fellowship. The best recommendation of choosing a surgeon should be based upon experience and training. Understand board certification status, and ask for patient recommendations. ...Read moreSee 1 more doctor answer
It depends: Ecterodactyly is a complex condition that has many forms of severity. Depending on the level of involvement, many procedures may be necessary. In general the goals of surgery are to improve foot function and cosmetic appearance. If foot function is needed it can be performed in early childhood. It is important to be seen by a pediatric foot specialist to discuss the timing of surgery. ...Read more
Many things : Careful positioning to avoid pressure on certain body areas, various monitoring device placement like nerve & oxygen levels, blood loss control techniques, appropriate imaging when indicated, careful counting & assessment of levels operated on, careful handling of all tissues, avoiding too much stress with instrumentation on the bone interfaces & on over lentghening the spinal cord & a correct fix. ...Read moreSee 1 more doctor answer
Not as good : Some orthopedic surgeons and neurosurgeons feel the results in operating on smokers are so poor that they require their patients to quit smoking prior to surgery. Smoking markedly decreases healing rates as well as reducing success rates in general. There are many reasons for people to quit smoking, and in those facing bone surgery, there are even more urgent reasons. ...Read moreSee 1 more doctor answer
What are the risks of disseminated intravascular coagulation after a single fetal demise @ 28 weeks.
This a triplet pregnancy - trichorion/triamnio?
I am truly sorry: for a loss of one of your Fetus. At 28 weeks with the advent of Modern medicine and Technology survival rate of other fituses are 100%. All the best ...Read more
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