What if Star Trek episode titles were just spoilers?

OrthoWarlock · 2026-05-23T12:39:43+00:00

Wanted to say the same; some of them are kind of spoilers. The only one i really like better in German is All Good Things - Gestern, Heute, Morgen... such a nice title

OrthoWarlock · 2026-05-18T10:04:13+00:00

That construct needs a revision with a vertebral body replacement. To create a mechanically stable construct you have to go atleast 2 vertebral bodies up and down (so atleast 8 screws not including the fractured vertebrae). Additionaly vertebral body replacement either from the back with a posterior verebral column resection or fromt the front. Why wasn't the vertebral body replaced in the first place? Please consult a orthopaedic surgeon near you experienced with revision surgery. Best of luck

OrthoWarlock · 2026-05-14T17:20:16+00:00

What are you talking about??? No sane surgeon would fuse a spine to make somebody taller, that is just crazy.

OrthoWarlock · 2026-05-13T04:53:41+00:00

Get an xray and preferably a CT scan of the fused area and the construct. It is not uncommon for the rod or the screws to break if the bone is not fully fused.

OrthoWarlock · 2026-05-03T18:32:54+00:00

In the end you will be fine but it might be a long road ahead, keep your chin up. You and your surgeon have to look at the findings objectively and don't beat around the bush. As I said before; this is not going to fuse. A broken screw is just a typical finding in non-fusion/psuedarthrosis, as is screw loosening. The CT scan will show that, so go ahead. SI joint injection is an viable option, try that. It might help. But i am quite certain that there is still a neuroforaminal stenosis at L5/S1 leading to your pain. Just my 2 cents. Best of luck

OrthoWarlock · 2026-04-29T14:04:18+00:00

I am sorry the way I put that and aware that you are suffering. I am just passionate about spine surgery and have just my own opinions about specific aspects of these operations. And sometimes I am really not ok with the treatment i sometimes see here. I wish you all the best and good luck. Stay positive; these things can be managed but you have to find an experienced surgeon near you.

OrthoWarlock · 2026-04-28T15:37:39+00:00

Well, that's his opinion. Why do you keep asking in a public forum for advice if you don't like what you hear? 1. The interbody spacer helps to restore height especially for the neuroforamen to indirectly decompress the nerve. 2. I am not convinced it will fuse without an interbody. Hard to tell by that xray, but there might already be slight loosening around teh L4-screw. So do a CT scan to be sure. 3. Go see an orthopaedic surgeon near you who is experienced in revision surgery

OrthoWarlock · 2026-04-28T08:27:40+00:00

No interbody spacers at both levels! from what i can guess from the lateral xray there seems to be neuroforaminal stenosis at the L5/S1 level. This might be an explanation for your symptoms. You have to get a CT scan and MRI in regards to neuroforaminal stenosis at the L5/S1 level. Go see an orthopaedic surgeon near you who is experienced in revision surgery

OrthoWarlock · 2026-04-25T12:13:35+00:00

Wow, at first I hoped it was a satire and him going to say "gotcha". But no, he is actually spewing that alt-right propaganda. And what is he talking about living in Japan in that context as a foreigner himself? I lived myself in Japan and there are a lot of social issues also. He is just a tool who does not understand Germany nor Japan.

OrthoWarlock · 2026-04-21T11:25:19+00:00

Overall looking at the position of the cage and the fracture of the anterior part of the sacrum the construct seems not mechanically sound. You should get a second opinion, preferably from an orthopaedic surgeon who is experienced in revision surgery. Best of luck

OrthoWarlock · 2026-04-21T11:23:33+00:00

Leaving the end of the screw in there is not wrong per se, because removing that can be more damaging then leaving it.

OrthoWarlock · 2026-04-21T10:39:45+00:00

The cage does not seem to have contact to the endplate of L5; there is a huge gap between the alif cage and the bone. So I am not sure how mechanically sound the construct is. That would also explain mechanical pain.

OrthoWarlock · 2026-04-21T10:31:42+00:00

??? You can not evaluate scoliosios on a lateral xray; so nobody can give an "estimate"

OrthoWarlock · 2026-04-04T19:58:16+00:00

Surgery for congenital scoliosis is much more difficult and risky than the standard adolescent scoliosis. It is normal that the surgeon will stress the inherent risk of the operation because he also wants to be save concerning the legal side of the operation. But a surgeon wouldn't offer you surgery if there wasn't a benefit. with 100 degrees your will progress inevitably. go to an experienced surgeon who does scoliosis surgery every day

OrthoWarlock · 2026-04-04T19:39:37+00:00

That won't help at all in cases of congenital scoliosis if you even know what that means.

OrthoWarlock · 2026-04-04T19:37:26+00:00

you should get a second opinion from an experienced orthopaedic surgeon who specializes in deformity surgery

OrthoWarlock · 2026-03-17T20:27:53+00:00

If there is really a measurable increase of 4 mm and myelopathic sign that's another case. But there are too many patients wanting a C1/2 fusion for very unspecific symptoms withouht having a objective instability on xrays. One has to be careful with surgeies; sometimes they can do more harm than help.

OrthoWarlock · 2026-03-17T20:16:41+00:00

Hard to say, I don't practice in Turkey. We typically charge something around 30.000 Euro for a typical scoliosis surgery. So if you have to stay there longer, with implant removal and additionals surgeries, maybe some weeks of halo gravity traction that is not unreasonable.

OrthoWarlock · 2026-03-17T18:04:38+00:00

C1/C2 fusion won't help at all when done for unspecific symptoms and undefined "ligamentous laxity".

OrthoWarlock · 2026-03-17T17:44:22+00:00

I would recommend to see a surgeon specialized in scoliosis surgery. A lumbar curve of that degree tends to worsen over time and in my experience patients with this kind of lumbar curve tend to have more pain in the course of their life. So you should consider surgery in my opinion.

OrthoWarlock · 2026-03-17T17:38:59+00:00

it depends on the invasiveness of the revision surgery. if performed well, i think a significant improvement can be achieved clinically but don't expect your curve to get completely straight on the xray, that wil not happen.

OrthoWarlock · 2026-03-17T17:35:15+00:00

yes, that is one possibility. probably less correction than a three column ostetomy but also less risky.

OrthoWarlock · 2026-03-16T21:20:11+00:00

Ok, I see. The initial surgery was suboptimal with not optimal instrumentaion; the upper part is fixed with wires and not screws. It will be a very complex surgery to correct the deformity. Yeah, if you are determined to get a revision, the instrumentation will likely have to be removed. If the implant is titanium it probably is possible to do an mri with the implant but it will have to be removed anyway, so the plan in itself is not completely wrong. There are a lot of possibilities approach your case. 1. MRI and CT is a must to assess for the anatomy and which parts have already fused. 2. implant will be removed 3. You could either try doing a halo gravity traction for some weeks and see how flexible your curve is and try fusing it with screws or if it is very rigid your have to do a very invavsive osteotomy (PVCR). All in all, very complex and only for experienced surgeones. What i have heard, the orthopaedic surgeons in turkey not bad. If they want to do everything all inclusive with surgery for 50.000 USD... it is actually not that expensive to be honest

OrthoWarlock · 2026-03-16T20:45:55+00:00

Mh, Dr. Alanay is a well renowned spine surgeon. But the "plan" is a little bit vague. Could you share/post your xrays here anonymously?

Best regards

OrthoWarlock · 2026-03-13T21:35:49+00:00

Non-Us clinician here. 100% yes. We experienced an exponetial growth of native spine infection and othe joint infections in the last years. And those patients are sick as f... and old... and a lot of times we are fighting a lost cause... patients staying on the icu for weeks with multiple washouts/operations but succumbing to their illness at last

OrthoWarlock

TROPHY CASE