slicing vs. cutting the sacrotuberous ligament
Posted: Wed Sep 19, 2018 10:52 pm
Hi Everyone,
I have decided to go ahead with decompression surgery, but I’m not sure if I should do it with Dr. Hibner or Dr. Conway. They both do the transgluteal surgery, but Conway slices the sacrotuberous ligament and Hibner cuts it. Slicing does less damage to the ligament (Conway said it is like separating the strings on a violin), but (according to Hibner) it gives the surgeon less visibility than cutting it. In fact, Hibner said his cutting approach gives the surgeon “significantly more visualization” than the slicing approach. I didn’t get a description of the cutting approach (so if someone has that info, I’d be interested). I thought cutting meant cutting it in half (the short way) and pulling the ligament back on each side, but I just did a search and found an entry where the “windowing” approach (which may be the same as cutting) is described as cutting out a rectangular shaped area, which sounds awful. But, Hibner said that when he’s done a second surgery on patients that had that their ligaments cut, the severed ligament looks just like the other one. He also said that his physical therapist has said the severed ligaments feel to her just like unsevered ligaments once they have healed. So, that is encouraging. My top priority with the surgery is to have a successful decompression, so I’m leaning toward Hibner, given that it seems like it would increase the odds of successfully decompressing the nerve. On the other hand, Hibner said my MRI suggests the compression is in a place that is easy to get to (in between the ST and SS ligaments), so maybe that extra visibility isn’t needed. So, I’m wondering if anyone has any thoughts on this. Have you had one or the other surgeries? And if so, how is your ST ligament? Did the surgery reduce your pn pain?
Many thanks,
April
I have decided to go ahead with decompression surgery, but I’m not sure if I should do it with Dr. Hibner or Dr. Conway. They both do the transgluteal surgery, but Conway slices the sacrotuberous ligament and Hibner cuts it. Slicing does less damage to the ligament (Conway said it is like separating the strings on a violin), but (according to Hibner) it gives the surgeon less visibility than cutting it. In fact, Hibner said his cutting approach gives the surgeon “significantly more visualization” than the slicing approach. I didn’t get a description of the cutting approach (so if someone has that info, I’d be interested). I thought cutting meant cutting it in half (the short way) and pulling the ligament back on each side, but I just did a search and found an entry where the “windowing” approach (which may be the same as cutting) is described as cutting out a rectangular shaped area, which sounds awful. But, Hibner said that when he’s done a second surgery on patients that had that their ligaments cut, the severed ligament looks just like the other one. He also said that his physical therapist has said the severed ligaments feel to her just like unsevered ligaments once they have healed. So, that is encouraging. My top priority with the surgery is to have a successful decompression, so I’m leaning toward Hibner, given that it seems like it would increase the odds of successfully decompressing the nerve. On the other hand, Hibner said my MRI suggests the compression is in a place that is easy to get to (in between the ST and SS ligaments), so maybe that extra visibility isn’t needed. So, I’m wondering if anyone has any thoughts on this. Have you had one or the other surgeries? And if so, how is your ST ligament? Did the surgery reduce your pn pain?
Many thanks,
April