Natural fusion from calcification/arthritis

[livingtwisted]

In a visit to a chiro earlier this year (please no rants about chiros, but if it helps I am no longer going to him) he was reviewing my x-ray and pointed out that a couple of my lumbar vertebra had calcified and fused together. You could see a little C shaped hook connecting the two vertebra. He described it as a form of arthritis where the bones were rubbing together causing the calcification as a defense against further wear (at least that's the way I understood it).

I'm wondering if anyone else has this. Is it a good thing because it's protecting itself? Obviously it would be better if it didn't need to. And it means it's fused in the "wrong" position, and I've lost flexibility there. So I'm wondering if there is anything specific I can be doing to prevent this from happening in other places. Would love any thoughts on the subject as I haven't been able to find anything online.

[Pooka1]

Well I have a natural two-level fusion somewhere in my lumbar which I believe is a sports injury (sitting the trot incorrectly). I had a herniated disc which dissolved finally and I was told the vertebra would fuse together. My memory of the radiograph is that there was much less distance between those two vertebrae.

This was stable for almost 20 years but is now bothering me more and more. I think it was a matter of time with even a two-level fusion anywhere in the lumbar.

I expect I'll have to get a radiograph soon to see what new damage is there. I'll post it when I get it.

[LindaRacine]

Hi...

Natural fusion is relatively common, especially in older folks with degenerative issues as well as people with scoliosis.

--Linda

[jrnyc]

ACK!! (as Snoopy would say)...all the things no one ever told you!!!

jess

[livingtwisted]

Natural fusion is relatively common, especially in older folks with degenerative issues as well as people with scoliosis.

Good to know. Is there anything that can be done to prevent/slow it? Is it ever removed for any reason?

(I'll now open up chiros for further attacks.) The reason I ask is because this particular chiro believed he could get some correction, except for where the spine had already fused. He suggested that if in time we saw improvement in the thoracic, he would recommend that I have a small surgery to sever the fused area so that he could continue with his treatment. I was of course skeptical but willing to try his treatment, even if for just pain relief, since at the time my insurance was covering it well. But my insurance changed and so I didn't go long enough to prove or disprove his theories.

But now I'm left wondering about this fused area. Does his suggestion of removing the fused portion make any sense? It sounds painful to me if it is there to protect the vertebra from rubbing. But does the presence of natural fusions change things for those out there still hoping for a Martha Hawes type treatment?

[hdugger]

I have zero medical training, but I would suspect that the vertebrae fused because there was some problem in the disc between them. I can't see how unfusing them would reverse that problem.

[Pooka1]

But now I'm left wondering about this fused area. Does his suggestion of removing the fused portion make any sense? It sounds painful to me if it is there to protect the vertebra from rubbing. But does the presence of natural fusions change things for those out there still hoping for a Martha Hawes type treatment?

I am wondering if you could even find a surgeon to break up a natural fusion for any reason.

I suggest the lumbar is irrelevant to trying the Hawes approach. Hawes has a thoracic curve and in her efforts to expand her chest cavity, it seems she was blindsided by the decrease in the thoracic curve which may have been inevitable when you change the geometry of the chest cavity in the way she did.

Because Hawes is dealing with a thoracic curve and the chest cavity, it would seem completely irrelevant to anything in the lumbar or thoracolumbar area. Also, it makes no sense to think changing the chest cavity will have any effect on a lumbar or perhaps even a thoracolumbar curve.

[livingtwisted]

I am wondering if you could even find a surgeon to break up a natural fusion for any reason.

Agreed. If anyone knows the answer to this... I'm curious to know if he made it up. Or if he didn't, in what scenario does it make sense?

Because Hawes is dealing with a thoracic curve and the chest cavity, it would seem completely irrelevant to anything in the lumbar or thoracolumbar area. Also, it makes no sense to think changing the chest cavity will have any effect on a lumbar or perhaps even a thoracolumbar curve.

I should have been more clear. I was referring to Hawes just as an example of improvement in an adult case, not her specific situation since everyone's curves are different.

There are a few people on this forum still looking for the alternative solution and I would be curious to hear what they say about natural fusion. We know that there are only a handful of examples of improvement, which for some equals a lack of substantial evidence, but for others it means hope. And we know that there are a variety of forces working against us (depending on the cause), but once you have been living with scoliosis for years and develop fusions naturally, that is where I lose hope.

Not to be Debbie Downer, but I'm interested to hear what those still hopeful would say about this. Maybe in the rare cases where it improved they were able to avoid any natural fusion? Or maybe the improvement was in other areas not fused since I don't think anyone hopes for 100% improvement.

[LindaRacine]

Sure, you could remove the fused area. It would be called an osteotomy. Unfortunately, it would probably just fuse again. To do what Hawes did, I suspect you need relatively healthy discs.

[Karen Ocker]

Just a comment on Hawes

I hear so many persons referring to Hawes as a great example to be emulated.

She's just one person.

Why do we not see hundreds of Hawes?

[hdugger]

I think it has to do with how many exercise-based treatments are formally tracking their patients.

The SEAS group in Italy, for example, seems to be turning out a small Hawes-like army - in their reports, no patients' curve increase, all at least stay the same, and several decrease. The torso rotation folk show a similar result - I think only one of their patients progressed.

I think that presents a pretty clear picture that regular, targeted exercise can hold a curve, but there simply aren't formal long-term studies for reasons that have more to do with the logistics of doing research then they have to do with exercise specifically.

[mamamax]

I suggest the lumbar is irrelevant to trying the Hawes approach. Hawes has a thoracic curve and in her efforts to expand her chest cavity, it seems she was blindsided by the decrease in the thoracic curve which may have been inevitable when you change the geometry of the chest cavity in the way she did.

Because Hawes is dealing with a thoracic curve and the chest cavity, it would seem completely irrelevant to anything in the lumbar or thoracolumbar area. Also, it makes no sense to think changing the chest cavity will have any effect on a lumbar or perhaps even a thoracolumbar curve.

Hawes has 3 curves: thoracic, lumbar, and cervical. 2 of the 3 have reduced by near 50% as of her last publication. She publishes every 4 years.

[Pooka1]

Hawes has 3 curves: thoracic, lumbar, and cervical. 2 of the 3 have reduced by near 50% as of her last publication. She publishes every 4 years.

Hawes has a structural thoracic curve with compensatory other curves.

My point was that it is not rational to expect what she did to expand her chest cavity to have the same effect on a structural lumbar or structural thoracolumbar curve as it would on a structural thoracic curve.

I am not talking about lumbar compensatory curves improving somewhat along with improving a structural thoracic curve.

And she did not improve her curve 50%. From the 2009 article, the authors (including Hawes) wrote:

Decrease in coronal plane Cobb magnitude From 1990 (Figure 4A) through 2005 (Figure 4B) the magnitude of Cobb angle for the primary thoracic curve declined by >10 degrees (Table 2). Grade I-II rotation of each apical vertebra was present [64].

There was a decrease from 45 to either 33 or 34. Note the authors themselves do not stand behind the measurement of 24 for some reason. I think it is because they are clearly not using the most tilted vertebrae to measure in-between. Note they don't say "The curve decreased by 21*. Instead they simply say >10*. There is a reason.

The decrease those authors are standing behind is more correctly stated as >22%, NOT 50%.

[hdugger]

Just carrying this over from the other thread - the SEAS group has shown reductions in lumbar curves as well as in double major curves. So, there do seem to be exercises which target and hold (or may even reduce) a variety of curves.

[Pooka1]

Just carrying this over from the other thread - the SEAS group has shown reductions in lumbar curves as well as in double major curves. So, there do seem to be exercises which target and hold (or may even reduce) a variety of curves.

Yes that's fine. What I am saying is that the exercises Hawes did to improve her breathing unexpectedly improved/expanded her chest geometry which then blindsided her with reduction in her STRUCTURAL THORACIC curve.

It makes NO SENSE to suggest that those PARTICULAR exercises that expanded her chest cavity would have any effect whatsoever on a structural L or TL curve, yes?

Hello folks? Are we on camera? Is this really so complex?