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Spinal Fusion Surgery Chronicles

Published March 16, 2021
 

Thoracolumbar spinal fusion surgery isn't common. It's also not common to see a centralized rupture of the spinal disc at the junction of the thoracic and lumbar spine areas. SpineNation staff member Kelly "Nerdzilla" Mendenhall recently shared her journey through a thoracolumbar spinal fusion with honesty and transparency in a 3-part blog series

What is Spinal Fusion Surgery?

Doctors sometimes recommend spinal fusion for pain relief, correction of a deformity, or to improve a patient's spinal stability. Patients with scoliosis, severe arthritis in the spine, degenerative disc disease, or a herniated disc may all be candidates for this surgical procedure. Fusion is accomplished by grafting together different levels of the spine.

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There are a few different types of spinal fusion surgeries, depending on how the surgeon approaches the spine: 

  • Anterior lumbar interbody fusion (ALIF) means performing surgery on the front of the spine, approaching the side of the patient's abdomen.
  • In a posterior lumbar interbody fusion (PLIF), the surgeon makes an incision in the patient's back.
  • Transforaminal Lumbar Interbody Fusion (TLIF) also requires an approach through the back of the patient's body.

Each procedure has advantages and disadvantages and carries a different set of risks. Which approach works best depends on the patient's condition and the surgeon's skill.

A rare insight into the entire surgical process

In our most recent blog series, Spinal Fusion Surgery Chronicles, Kelly "Nerdzilla" Mendenhall gives her first-hand account of life pre-op, in the hospital, and post-op. Mendenhall's surgery was a thoracolumbar fusion, ranging from T-10 to L-2 vertebrae. The surgery corrected a large rupture of the disk at T-12-L-1, which was overlooked and neglected for at least 2.5 years.

The initial rupture had become a mass of calcification and bone cells that crushed and deformed Mendenhall's spinal cord. Beyond the spinal fusion, Mendenhall received laminectomies from T-10 - L4 vertebrae, in addition to a discectomy as well as artificial disc placement. It was a very major and serious surgery, and the recovery grueling at times.

Pre-operative treatment & testing

In the first of the series, Spinal Fusion Surgery Chronicles: Part I, the reader follows Mendenhall through the business of preparing for surgery. A photographer is present with Mendenhall to navigate the various blood labs, scans, and classes required for the surgery. This behind-the-scenes look is made possible through a partnership between Mendenhall, her photographer, and Vanderbilt University Medical Center (VUMC.)

Mendenhall opens up regarding the way she views herself as a spine and chronic pain patient. She also explores how she used to see others while reflecting on the misery of waiting room seating and tireless efforts to be as comfortable as possible against all odds. 

Preparing for the operating room

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In Part II of Spinal Fusion Surgery Chroniclesthe reader joins Mendenhall and her guests as they navigate parking, the waiting room, and the hospital's landscape as she prepares for surgery. From the angry charge nurse on the pre-operative floor to the surgical team that accommodated Mendenhall's incredible anxiety as she was wheeled into the operating room.

Regarding the charge nurse, Mendenhall wrote:

"She was visibly and audibly angry that I had more than one person accompanying me and that one of those people was a photographer. I tried showing her the emails proving this was planned. I had permission from the News and Communications department at VUMC. She was very uninterested in reading the emails I offered for proof."

Mendenhall describes a surgical staff full of compassion and care for her genuine fear for the operating room experience. The thoracolumbar fusion would be a significant undertaking with plenty of risk factors at play. Beyond that, this would be Mendenhall's fourth neurosurgery in 10 months.

One anesthesiologist made the call that to allow Mendenhall to breathe in the general anesthesia gas through a tube rather than having a mask placed over her face. They didn't want to make her feel more vulnerable than she already did.
 
 Mendenhall stated:

"Lucky for me, every single one of those O.R. staff members was a sweet baby angel. They saw me crying, and I told them I was having a panic attack. They started coaching me into good thoughts territory."

The healing begins

In Spinal Fusion Surgery Chronicles: Part IIIMendenhall awakes in the post-operative recovery suite in the series's final installment. There she learns that her surgery was much more involved than had been anticipated initially by the surgery. The operation lasted about twice as long as they'd thought it would.

Mendenhall walks the reader through waking up out of anesthesia, interacting with nursing staff, and her time on the neurosurgery ward at VUMC. She shares photos of learning to walk with the walker and physical therapy in her home after being released from the hospital. She discusses the fear that accompanied the return to home; how would she manage her pain and care without an army of nurses and other staff?
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Spoiler alert: Mendenhall survived. And she now has four working limbs and much more controllable pain. Her quality of life has increased exponentially. She cautions others to explore alternative procedures when possible, such as Artificial Disc Replacement. Mendenhall further cautions readers to strictly follow post-operative care instructions and remain active participants in their recovery.

Mendenhall closes the series with these thoughts:

"Remember that no surgery is a magical cure-all. It is imperative, in my opinion, that we follow doctor's orders and keep up with our physical rehabilitation long-term. For me, that includes exercise and an anti-inflammatory diet, and a lot of mindset work as well. Keep your head up. It isn't easy, but it's worth it.“

To read the series, visit the SpineNation blog at blog.spinenation.com. 

Updated: March 16, 2021
Disclaimer

Information provided within this article is for educational purposes and is not a substitute for medical advice. Those seeking specific medical advice should consult his or her doctor or surgeon. If you need to consult with a specialist, you may be able find a health care provider in our Specialist Finder. SpineNation does not endorse treatments, procedures, products or physicians.


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