Scoliosis Support  

Go Back   Scoliosis Support > Scoliosis > General Discussions

Notices

Reply
 
Thread Tools Display Modes
  #1  
Old 28th March 2014, 01:47 AM
Mellie Mellie is offline
Junior Member
 
Join Date: Mar 2014
Posts: 5
Red face Costoplasty / Thoracoplasty

Hi everyone!

I know their are already a few treads about costoplasty on here, but I'm still left with some questions, so I hoped I could ask them here.

My surgery is planned on the 20th of august, but I feel like my surgeon makes it sound quite easy. He did tell me I will be in a lot of pain, but in his opinion, he could reduce my rib hump up to 50-60%, my low long capacity or the fact that I have marfan syndrom didn't seem to be a problem and I would not miss the first day of college (which starts the 22th of september).

So I was just wondering (and I really hope some of you are able to help):
  • Did you feel like the pain was bearable? Was it worse than your fusion? How long did it take for the pain to fully go away?
  • What meds where you on during your recovery?
  • Do you think that after one month of recovery time I should be able to go to college (which means taking the train when traffic is high, biking to the auditorium and sitting on hard benches for more than 3 hours in a row)
  • How about wearing a back pack with some books in it? When will I be able to put some weight on my back?
  • As some people have reported this.. I'm quite curious.. How many of you still feel soreness and are unable to lie down on the side where the rib segments were taken? If you're still hurting now, do you feel like the costoplasty was worth it?
  • My surgeon told me he does this operation once in a month, for 3 years now. Do you feel like he's experienced enough?
  • My surgeon also told me my low long capacity would not be a problem? Do you believe this to be true? Did you notice a difference in long capacity?

Thanks in advance for taking a look at these questions! Sorry if I made them too long or if they aren't understandable (English isn't my native language ;s )



Also, I'd like to give you some background: When I was 3 years old, I was diagnosed with marfan syndrom. At the age of 13, my doctor told me my scoliosis was to severe and that I needed the spine fusion. Few months later I got the fusion and results seemed to be amazing. When I turned 16, I started to get more aware about my rib hump, doctors told me surgery wasn't an option.. my long capacity was too low and they were not willing to do it.
4 years later, I felt like I should give it another change, so I went back to my surgeon, and against all odds he's telling me he's willing to do the costoplasty. In an answer to me asking why he wanted to do it now and not back then, he said to me that getting older made him realize it's me having to bare with the pain, not him, so if I really want it, then he feels like he shouldn't stand in my way. Not sure how to feel about that argument though.
(Just to be clear, many people did tell me he's one of the best surgeons in my country, so he should know what he's doing, right?!)

However, I'd like to thank you for your time and information! I just want to make sure I'm making the right decision. My rib humb is seriously bothering me, but I'm not sure if being in pain for the rest of my days is worth getting it reduced!
Reply With Quote
  #2  
Old 28th March 2014, 11:15 AM
tonibunny's Avatar
tonibunny tonibunny is offline
T Sr: Admin, Big Sister and Da Police!
 
Join Date: Jan 1970
Posts: 15,359
Default Re: Costoplasty / Thoracoplasty

Hi Mellie, welcome to SSO

I've had the costoplasty procedure done twice; once at the same time as a fusion, and once as a standalone procedure.

1. Did you feel like the pain was bearable? Was it worse than your fusion? How long did it take for the pain to fully go away? - costoplasty pain for me was worse than the fusion, BUT it was only very intense for the first few weeks. There was a great improvement in pain levels after a month.

2. What meds where you on during your recovery? - can't remember which meds I took at home, but I was on a PCA morphine pump directly after the surgery.

3. Do you think that after one month of recovery time I should be able to go to college (which means taking the train when traffic is high, biking to the auditorium and sitting on hard benches for more than 3 hours in a row) - Sorry, I think this is likely to be too much for you to cope with after just one month. I was still in far too much pain at this point. Trains and hard benches would probably have been okay at 2 months but I wouldn't cycle following a costoplasty for at least 3 months.

4. How about wearing a back pack with some books in it? When will I be able to put some weight on my back? - take as few books with you as you can. Again, I wouldn't want to have carried much for 2-3 months.

5. As some people have reported this.. I'm quite curious.. How many of you still feel soreness and are unable to lie down on the side where the rib segments were taken? If you're still hurting now, do you feel like the costoplasty was worth it? - All costoplasty-related pain is gone now (though I do still have a small residual rib hump and get discomfort from that). It was actually more comfy to lie on the costoplastied side in bed as my bed is very supportive. I still prefer to lie on this side now.

6. My surgeon told me he does this operation once in a month, for 3 years now. Do you feel like he's experienced enough? - yes, he sounds very experienced, I would be happy with that personally.

7. My surgeon also told me my low long capacity would not be a problem? Do you believe this to be true? Did you notice a difference in long capacity? - following the costoplasty you will experience a drop in lung function but in my experience this returns to Pre-surgical levels as you recover.


I hope this helps! please remember though that it is very rare to get a perfectly straight, flat ribcage from having a costoplasty. The surgery can make a striking difference though

Good luck!
Toni xx
__________________
37 years old, diagnosed with infantile idiopathic scoliosis at 6 months old with curves of 62(T) and 40(L) degrees. Casting and Milwaukee braces until surgery at 10 - ant release/pos fusion T1-T12, halo traction. Post op cast and then TLSO. Further surgery at 18 (ant release/pos fusion extended to L3 to include lumbar curve, costoplasty) and 25 (another costoplasty). Fusion extended to L4 at 33 (XLIF with 4 pedicle screws and two short rods). Pre-op curves: 76(T) and 70(L). Post-op curves: 45(T) and 35(L). Diagnosed with Ehlers-Danlos Syndrome aged 34; scoliosis almost certainly due to this rather than being idiopathic.
Reply With Quote
  #3  
Old 28th March 2014, 03:44 PM
bluestone's Avatar
bluestone bluestone is offline
OrangeL
 
Join Date: Jul 2008
Location: west midlands
Posts: 4,351
Default Re: Costoplasty / Thoracoplasty

Hi and

I had a costoplasty with my fusion three years ago.

I can't say whether the pain from the costoplasty is worse than the fusion because I was in a lot of pain all over-how much of that was the costoplasty I'm not sure.

I was on Sevredol once I was home but I had the fusion pain to control too.

I agree with Toni going to college and using busy public transport one month after would be difficult for you. I would be petrified of being bumped into!

Same as Toni I've always lay on my costoplasty side even though i had eight segments cut into. I can't lie on my sides for more than 20 mins though but that's most likely due to the amount of hardware I have.

I did notice a reduction in my lung capacity especially if I walked briskly but it has improved in the last year.

The result of my costoplasty has been amazing, i do have one slightly protruding rib that's tender but its not noticeable to anybody. I now have a lovely flat back so it was certainly worth it

Wishing you all the best xx
__________________
Thoracic 72 degrees, lumber 30 degrees-fused aged 44, T2-L4, posterior fusion with costoplasty (8 ribs were chopped) on 3/11/10 under the care of Mr Ahmed at North Staffs Hospital. Now nice and straight
Reply With Quote
  #4  
Old 28th March 2014, 05:06 PM
GillyG's Avatar
GillyG GillyG is offline
Admin & Da Police Force!
 
Join Date: Jan 1970
Location: Sheffield, UK
Posts: 16,188
Default Re: Costoplasty / Thoracoplasty

Hi there

I've never had a costoplasty - I was lucky enough to get rid of most of my rib hump from the derotation during surgery, but I just wanted to pop in to welcome you to the site
__________________
Me, a Mod? Nah ... I'll always be a rocker
Reply With Quote
  #5  
Old 28th March 2014, 11:10 PM
ChristinaJ ChristinaJ is offline
Member
 
Join Date: Aug 2012
Location: Hobart, Australia
Posts: 80
Default Re: Costoplasty / Thoracoplasty

Hi Mellie

I had my thoracoplasty a year after my fusion, as my hump was still there but it is gone now

Here are my answers to some of your questions:

The pain was different to fusion…it was more acute I think and only where the ribs were cut. I had five ribs cut. My fusion was going nicely and that pain was really abating, but as I was opened up again in the same incision, only a year later, set my recovery way back. And I think due to my age, is why I am still pretty sore.

I was OxyContin for two? months.

Sitting/standing upright was quite painful. It was surprising how much ribs can hurt!!! I took two months off work, then went back only gradually for a few hours over three days. Probably around six months before I could manage full days.

There was no way I could carry any weight for several months. Even a handbag was a struggle. I haven't tried a back pack since my ops...a little scared.

I am now 20 months post costoplasty, and I am still sore-ish. Can't lie on either side, even after all this time. if I do roll over in my sleep, I wake up in quite a bit of pain. But although still sore, it was one of the best things ever. My hump is virtually gone, and life is much better. I have a high pain tolerance btw

I haven't had any difference in my breathing at all. I think my entire insides work better after both operations

Everyone is so very different with pain and recovery. You are young and will probably bounce back so very quickly!

Christina x
__________________
Lives in Hobart, Australia. Born 1962, developed Idiopathic Scoliosis at around 12 years of age. No bracing, just watch and wait. By 2010 thoracic curve had increased to about 50deg, lumbar to mid 30's. I have had two surgeries: Posterior fusion T4-L1 June 2011 and thoracoplasty (five ribs) July 2012. Still recovering but feeling good! Scoliosis is familial as my younger sister has scoliosis too and had surgery around 1980 with the Harrington technique.
Reply With Quote
  #6  
Old 29th March 2014, 10:14 PM
Mellie Mellie is offline
Junior Member
 
Join Date: Mar 2014
Posts: 5
Default Re: Costoplasty / Thoracoplasty

Hi everyone!

Thank you so much for the quick responses and the warm welcome!

I feel way more informed then I felt after returning from my surgeon, so thank you!
I finally succeeded in finding a good second opinion so I can get more info on the marfan aspect (as I am still a bit afraid about my marfan body not being able to cope with the operation).

I think I will try to find a student room close to my college. In that way I can easily decide if I'm going to attend college that day, or if I rather stay in. I'll make sure it's on a walking distance so I don't have to bike all that much.
As we can always leave during breaks, I might just stay for an hour and then return to my room. Or do you feel like I'm just hoping too much? Because as you can see I'm not fully willing to lose my semester! My exams are in January, that's about 4-5 months after my operation. What do you think? Is it possible or should I just forget about it and take a break and only do the second semester?!

I was also wondering, how are stairs? Cause I remember having a lot of problems taking the stairs after my fusion! And if sitting hurts, do you think a pillow might help, or does it not make much of a difference?

After my fusion, my school arranged a bed for me in class. Which means I could follow classes while recovering, and well, I even had permission to sleep if lessons were too boring, the dream of every student, right?! I even managed to get good results at the end of the semester, so I think I'm just kind of hoping that not losing my semester and recovering are doable at the same time.

However, thank you all again for your quick responses, I'm the kind of person who just wants to know every bit of what will happen during and after the operation to be sure I'm making the right decision. Maybe I will grow out of that habit one day.
Reply With Quote
  #7  
Old 30th March 2014, 12:36 AM
ChristinaJ ChristinaJ is offline
Member
 
Join Date: Aug 2012
Location: Hobart, Australia
Posts: 80
Default Re: Costoplasty / Thoracoplasty

Wow it sounds like you have the BEST ever school arrangements!

If they are ok with you going at your speed, you will be more than ok too. And a bed in class. that is totally wonderful

Stairs are fine as you don't use your upper body. And I expect you will have lots of friends to help you carry things when your upper body gets tired and sore.

Pillows are your best friend after costoplasty and help make sitting comfy and more bearable. Maybe stay on your pain meds for as long as you need to. It might help you get through to your exams without the distraction of pain.

Remember, it is not at all a massive operation, not like spinal fusion. But it will set you back a bit. You are young, so I wouldn't worry too much as you will recover a lot more quickly than I did. The flexibility of your school arrangements will really help you figure out how you get through each day as they come along.

I'd say stick to your plan and don't worry (he he easier said than done!). You can always change things along the way if you need to.

cx
__________________
Lives in Hobart, Australia. Born 1962, developed Idiopathic Scoliosis at around 12 years of age. No bracing, just watch and wait. By 2010 thoracic curve had increased to about 50deg, lumbar to mid 30's. I have had two surgeries: Posterior fusion T4-L1 June 2011 and thoracoplasty (five ribs) July 2012. Still recovering but feeling good! Scoliosis is familial as my younger sister has scoliosis too and had surgery around 1980 with the Harrington technique.
Reply With Quote
  #8  
Old 3rd May 2014, 12:20 AM
Mellie Mellie is offline
Junior Member
 
Join Date: Mar 2014
Posts: 5
Default Re: Costoplasty / Thoracoplasty

Hi everyone!!

So little update: I had my second opinion today, and well it was kind of an eyeopener and I'm really drowning in doubt right now!

Basically he said that the only positive thing about this operation was that it could reduce my rib hump.
He made clear to me that the risk of having chronicle pain for the rest of your life is really something I must take in consideration and he felt like I can still live a good life with the rib hump, so he didn't really got why I would take the risk. However he was willing to do the operation if I really wanted to.

Did your surgeon make you aware of the possibility of chronicle pain? If so, what made you decide to still go true with it (because this surgeon said only 4 people have asked him to do the operation, many others didn't when they heard about the risks) If he didn't, would you have done it knowing this?

Also, I'd like to know if your rib hump can cause more pain throughout your life. I am now sometimes in pain because of it, but not all that much and it's totally bearable. I asked my surgeon about it but he seemed rather in doubt saying it all depends on the person, which probably is true.

Oh, I was also wondering if there are some pictures out there from before and after the operation, I'd love to see some of the results.

(Ps1: The surgeon guesses that about 7-8 segments should be taken away)

(Ps2: ChristinaJ: Those bed arrangements were indeed the best ever! I was thinking about ordering some personalized pillows, might come in handy! )

Thank you for your time!!
Reply With Quote
  #9  
Old 3rd May 2014, 09:00 AM
ChristinaJ ChristinaJ is offline
Member
 
Join Date: Aug 2012
Location: Hobart, Australia
Posts: 80
Default Re: Costoplasty / Thoracoplasty

I have been meaning to get a photo of my back after costoplasty for a long time! I will see if I can get it happening over the weekend so we can see the difference.
__________________
Lives in Hobart, Australia. Born 1962, developed Idiopathic Scoliosis at around 12 years of age. No bracing, just watch and wait. By 2010 thoracic curve had increased to about 50deg, lumbar to mid 30's. I have had two surgeries: Posterior fusion T4-L1 June 2011 and thoracoplasty (five ribs) July 2012. Still recovering but feeling good! Scoliosis is familial as my younger sister has scoliosis too and had surgery around 1980 with the Harrington technique.
Reply With Quote
  #10  
Old 3rd May 2014, 10:58 AM
bluestone's Avatar
bluestone bluestone is offline
OrangeL
 
Join Date: Jul 2008
Location: west midlands
Posts: 4,351
Default Re: Costoplasty / Thoracoplasty

The pain I had in my rib hump before my costoplasty was certainly much worse than it is now, then it was a grinding rubbing, digging sensation especially whenever I did anything involving using my right arm-my hump was on the right. Now its more of a discomfort and it can be a bit tender. I had 8 segments cut into to.

Before my operation my surgeon never went into anything regarding how things would feel after the costoplasty but my guess is that he knew at the age of almost 45 I wanted some body confidence after years of having none and I can't tell you how great I feel now buying tops and not feeling like I want to cry when I look in the changing room mirrors

I did post before and after pics on here so you could check on my history.
__________________
Thoracic 72 degrees, lumber 30 degrees-fused aged 44, T2-L4, posterior fusion with costoplasty (8 ribs were chopped) on 3/11/10 under the care of Mr Ahmed at North Staffs Hospital. Now nice and straight
Reply With Quote
  #11  
Old 3rd May 2014, 12:42 PM
Mellie Mellie is offline
Junior Member
 
Join Date: Mar 2014
Posts: 5
Default Re: Costoplasty / Thoracoplasty

Bleustone: I wouldn't be that much in doubt if I knew that rib hump would one day become very painful, but as it feels today, I'm just not sure if I can risk the operation.

As still being kind of a newby on this forum, I was actually wondering how I can find your histroy, I've been browsing through some of your post, but no luck so far!

ChristinaJ: You don't have to do it just for me of course, but I love to see some results!
Reply With Quote
  #12  
Old 3rd May 2014, 03:06 PM
bluestone's Avatar
bluestone bluestone is offline
OrangeL
 
Join Date: Jul 2008
Location: west midlands
Posts: 4,351
Default Re: Costoplasty / Thoracoplasty

In all honestly my rib hump did become much more painful as I got older. Looking after two young children was very hard, it would ache pretty bad everyday.

If you click on my name Bluestone it will take you to my profile, then click on statistic then threads started by me. The page number is 6 headed my before and after pics. On my ipad they arent showing up though so I hope that's not because after a few years they no longer show. I don't know whether you use Facebook-I have pics on there too.
__________________
Thoracic 72 degrees, lumber 30 degrees-fused aged 44, T2-L4, posterior fusion with costoplasty (8 ribs were chopped) on 3/11/10 under the care of Mr Ahmed at North Staffs Hospital. Now nice and straight
Reply With Quote
  #13  
Old 3rd May 2014, 08:18 PM
sueto123 sueto123 is offline
Junior Member
 
Join Date: Oct 2013
Location: Cheshire
Posts: 6
Default Re: Costoplasty / Thoracoplasty

Hi Mellie,
I don't often post, but wanted to let you know my experience as it may help.

I am 52 now and had a spinal fusion back in 1977 when I was 15 years old with a Harrington Rod (removed 12 months later) and just got on with my life but in later years especially after having children I noticed rib hump getting worse and worse and in 2013 I had a Costoplasty to reduce this.

I had 5 ribs cut and sutured down and was warned that this was likely to be very painful, but I still went ahead because I thought any improvement was worth it after spending a lifetime of hiding my back.

I can honestly say the pain was nowhere near as bad as I expected, it was well managed in hospital (I was in for a week) with a morphine pump and any other painkillers I needed and afterwards I had painkillers at home which I weaned myself off to just over the counter meds within 2 weeks.

I was off work 3 months, probably due to the fact that I am older my recovery took a while and I was quite tired - a younger person would probably bounce back much quicker. The soreness to lie down (now over 12 months post op) is virtually none existant - although I get uncomfortable in the night if I lie on the 'operated side' for too long. There is a little numbness where the nerves were cut, but nothing very notable and there has been no change in my lung capacity that I am aware of. I am quite fit and walk a lot and this has not been at all affected by having the Costoplasty.

As I already had some rotation of the spine anyway, the results are not as good as with someone who had had the newer style of operation with less rotation. That said, the rib hump has been very much reduced and it is wonderful not to have ribs digging into chairs etc., and to feel so much better about myself.

Pre-op I was told that the risks involve reduced lung capacity, potentially having to deflate lung during surgery, putting in a chest drain etc, but I was quite determined to go ahead.

When I went for my post op check up, my consultant told me that many of his colleagues do not like doing Costoplasty operations as they feel the risks outweigh the benefits - ie spine is no straighter - but he argues that this op can make a huge difference to the life of the patient. I am so glad that he did and that I went ahead. I know everyone is different but for me it was something which changed my life for the better and I am really glad I had the Costoplasty done.

Hope this helps.
Reply With Quote
  #14  
Old 4th May 2014, 12:09 AM
Mellie Mellie is offline
Junior Member
 
Join Date: Mar 2014
Posts: 5
Default Re: Costoplasty / Thoracoplasty

Bluestone: I have found your thread but I couldn't open the photos, also, when I tried the facebooklink, they said that no documents were found. :s

Sueto123: Thank you so much for you response, it has been more than helpful! Did you do the operation only for cosmetic reasons, or did you also dealt with pain from the rib humb?
I'm quite sure life without a rib hump will be much better, but it's the risk of chronic pain that I'm doubting about.
Reply With Quote
  #15  
Old 4th May 2014, 08:14 AM
sueto123 sueto123 is offline
Junior Member
 
Join Date: Oct 2013
Location: Cheshire
Posts: 6
Default Re: Costoplasty / Thoracoplasty

Hi Mellie,
I had the Costoplasty done for both cosmetic and pain reasons. I had some rib hump pain but more lower back pain and both are significantly better after the operation.

Having Costoplasty definitely didnot cause me chronic pain. I wonder if the consultant maybe gives you the 'worse case scenario' of what could happen, in order to cover themselves, just in case? Hope this helps.
Reply With Quote
Reply

Thread Tools
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Forum Jump


All times are GMT +1. The time now is 03:00 PM.


Powered by vBulletin® Version 3.7.1
Copyright ©2000 - 2014, Jelsoft Enterprises Ltd.
(c) Scoliosis Support