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View Full Version : Scheuermann's Disease: Surgical correction (Dr. Boachie)



ColdBricks
12-01-2010, 11:07 AM
Hi everyone. My name is Dave, and I am 22 years old in upstate NY. I have been diagnosed with Scheuermanns, about 8 years ago. I am now looking into surgery. I trust and like my doctor but want a very good 2nd opinion, so I am seeing Dr. Boachie at the HSS who as you may know is one of the best spine surgeons in the world specializing in spinal deformity. I am 22 so I have put off the surgery for years. I am in nearly constant pain. Sometimes sore sometimes just downright annoying, and I have been through some nasty depressions, a lot related to my back. I am now seeing this as an outsider perspective and thinking I need to consider my options. I wore a brace when I was younger. My curve is 74 degrees. I have heard nothing but praise about the HSS and Boachie. I will be honest, surgery scares me s*itless and while I do not like the way I look and feel, I have waited until it is interfering with my life to really do anything. My spine sticks out about an inch from my back..I guess the easiest way to describe this if if I was a girl, it would be exactly where a bra-strap would go..thoracic spine. Because of this I get bruises, pimples, pinched nerves, etc, etc all along the back of my rib-cage area. It is pretty bad. It looks bad, but the pain is the main concern, but I do not like the way I look either. Being 22 years old I of course want to feel confident about my looks. I am pretty muscular, but my back looks weird. I am guessing if I get the operation done I will be a few " taller. I had a girlfriend for almost 4 years, and hated her to see me without my shirt off. I hate beaches! lol. I am doing physical therapy. Other than this I am 120% healthy. Can anyone lend me any opinions or experiences?

I realize the dr. is the most important part. My uncle had back fusion and he said when you are being wheeled into that hallway/room, you WILL panic, so you will need to use all your resources and knowledge to find someone you trust. It is probably the most important decision of the ordeal.

My other concern is insurance. Has anyone operated on by Boachie...can you tell me about your insurance information? Mine is not accepted by Boachie but it is by the HSS. So I am confused. I know he has been known to do some radical things/write-offs if he feels appropriate.

I have had a fair number of injections, as well as months of physical therapy, which has indeed helped my pain significantly, though I fear that my baseline pain is increasing as I age. In other words PT helps (and being healthy in general), but I am still certainly not what I would consider to be 'pain free'. My doctor up here told me this would happen though. The longer I could put off the surgery the better I would be in the long run, but I am now learning how different opinions can be.

To make matters even more confusing, there are of course different methods of correcting kyphosis, each with it's own pros/cons and some of them are radically different in correction/recovery, etc. Specifically, my doctor here would do a posterior and anterior (front/back) whereas I am quite sure Boachie would do a rear only (from my reading around). BUT I am not the expert in this matter.

Finally, it will be comforting to get a 2nd opinion from such a high respected institution/doctor. It is not cheap, and I have to pay the consultation fee out of pocket. Luckily I am blessed to have parents who are willing to help me, emotionally and financially...because honestly I would be screwed without them.

But the point here is that what if this doctor says surgery is highly recommended, etc, etc. On the other hand he may just say the same thing my current doctor would say which is something like "I cannot actually recommend you for surgery or not, you are the one who lives with your pain, discomfort, etc". I think any educated, experienced, and compassionate surgeon would most definetly not recommend surgery for anything unless the benefits of course greatly outweighed the risks (often by many times)...it is an interesting aspect of all of this, and doctors gain experience as their patients age. I might be fine, but what about in 5, 10, 20, 30 years from now? Technology will improve. In 2050 if I need a revision, who knows what they will do. But this is the now. How do I feel today?

Which will be GOOD news in that I do not NEED surgery. But still, I would of course like a fixed back. I can have surgery any time I want, but I hope this doesn't add to my confusion. I need to gather some data, but after a while I need to make a decision. My uncle was explaining that after a while we subconciously gather data to become avoidant, and I think there is tons of validity to that.

With this said, if Dr. Boachie offers surgery, I am still in pain, and I can afford it, I am going to do it.

If Boachie offers surgery, and I cannot aford him, I will probably go with my current doctor, which is fine with me.

However, if Dr. Boachie says something like 'hold it off, techniques improving, you are not too bad, etc' I may have a different opinion. The man has done this many times before....

I'll be in touch..have a great day!

Thanks

Dave

BadKitty
12-01-2010, 02:47 PM
Hi, Dave!

I think I understand some of what you're feeling...
My doctor left it up to me whether or not to get only my lumbar degeneration repaired, or to also get the entire scoliotic curve fixed at the same time. He also gave me some information to work with: That at my age, my spine would become more osteoporotic over time, that the pain in the curve would possibly become worse (as it already was), that if I got my L4-5 repaired, the damage was likely to move up to the L5-6 and so on because of the stresses of the curve and rotation in my thoracic spine.

He gave me a month of PT to see if the thoracic pain could be improved, and it didn't help. I had to decide on the simple lumbar fusion, or the T11-sacrum fusion.

Looking at these facts, it wasn't hard to see that I needed to take care of the whole thing, since I'd likely find myself back in the OR within a couple of years, and might even risk not being a candidate for scoliosis fusion at that time due to osteoporosis.

You appear to have done a lot of research about your condition and the surgery to correct it. It would be great if a doctor could absolutely tell you what you need to do, but sometimes there is a gray area where you have to make the choice based on your needs. You're young, and can wait as long as you want. You have the option of not waiting, if that's what you want. That's the hard part -- making that decision.

I agree with your uncle that you have to trust your doctor completely, as you will be putting your future in his or her hands. But as for saying you will panic on the way to the O.R. -- I thought that I would, too. In the few days before, I was really worried that I would - those "OMG what am I doing" moments" - but as the time came around, I found myself to be relieved that the day was finally there, and I was totally calm and ready. You can be that way, too, if you are sure it's what you want.

I have read that the anterior surgery is just as effective as the posterior, and less invasive. There are also minimally invasive procedures that might apply in your case - I don't know. (My doc jokingly said the difference is like that of getting hit by 1 1/2 trucks instead of 2 trucks, so I take it it's not that much.) I have also heard that anterior can be more effective with kyphosis, but less effective with rotation. I've heard a lot of things. The main thing is that you have to trust your surgeon and what s/he decides to do.

You mentioned "research" as a means of avoiding getting surgery - I agree with you there, too. In fact, there are a few people here on the forum who will admit to having done that. It only took me 6 weeks of PT (that I already knew wasn't going to work) to make my final decision.

I know this isn't much help, just restating what you already know: that you have to weigh your decision based on your needs in the face of what you'll go through, that it's okay to wait if you want to, and that you have to pick the right doctor for you. Good luck in your decisions!

LisaB
12-01-2010, 03:25 PM
Hi Dave- there are a number of people on this forum who have been operated on by Dr Boachie. He is supposed to be one of the best. I'm not sure about the insurance thing but I think he doesn't deal with it. You may have to submit his bills to your insurance company for reimbursement but I'm sure somebody who goes to him will tell you how it works. Good luck!

ColdBricks
01-04-2011, 07:20 AM
Hi guys. Thanks. I am now back in Albany and I visited Dr. Boachie with my mom+dad. First off, let's just start by saying I love the city, but it is crazy to drive down there! It is really nuts, like a different world. And the HSS is like literally in midtown on the east side so I mean, yeah, you are in the city for sure. The most stressful part of the day: parking. But we found a spot under the office building. His office is not the HSS, but it is about a block or two north.

I got there and everyone treated us very professionally and friendly, and I could tell that everyone wanted us to be comfortable..even though I can't lie, I was pretty damn nervous. Not sure why, just the fact that I was meeting someone with a different opinion can be scary.

They did new Xrays, and I brought a disc with my MRI on it.

First a fellow of Dr. Boachie came in, and he had a resident under him and they talked to me for about 45 minutes, looked at my Xrays, etc and they were very good too. They explained a lot about my condition and basically re-diagnosed me..which I thought was a very professional thing to do, since there was no guesswork as to what was wrong.

Then Dr. Boachie came in and I met him..and the other doctors explained what was going on and Dr. Boachie looked over the X-rays with the other two guys. This whole time, they are all discussing and measuring stuff (and I could tell Boachie was trying to quiz the young one, to which he succeeded). And after this, Dr. Boachie had the floor..

Without any hesitation, within the first 5 minutes of looking at my xrays, he suggested that surgery was recommended. At this point I was pretty floored, since I had been told for 7+ years that surgery is NEVER recommended. What's more is that he said he could do this entirely posterior (as opposed to my other doc who said I would need both front/back). I asked why my current doctor may not recommend the back only, and Dr. Boachie said that the new hardware they use is much much stronger than the previous generation of hardware, and this is why they are able to get such good results from less cutting.

He also said that this is common; they had a kyphosis correction last WEEK. he ever showed me the kids x-rays.

My curve was measured at about 77 degree kyphosis, and he said he could get me down to about 40-50. He said he could do more, but that would be asking for problems, since overcorrecting can result in more damage..'junctional kyphosis' he said.

The most interesting part of the meeting (which was over an hour) was how he mentioned my apex of my kyph was out of place. he said my curve apex (the max) was about T11, and normal backs are about T7 or T8. So he said in surgery he would literally 'move' the apex of my curve up my back. So, my curve would be more 'moved and corrected' instead of just corrected. This was great news, because he said it was the reason my spine was protruding so much (like an inch!) from my back..I blatantly asked him if this would solve the problem and he said without hesitation that it would.

I also asked him about recovery and he said no work for 3 months, but really there arent long term limits to this fusion. Assuming the surgery goes as planned, my back will age normally. He also said I could play my guitar/drums which was good. I was pretty scared this would caused major issues and music is my passion.

So at this point I have to figure out insurance. Which is going to be interesting. I will keep you posted..

but my general review is that, I want Dr. Boachie to do this, and I believe he can do it for me well..

jrnyc
01-04-2011, 07:48 AM
hi Dave
i had a consult with Dr Boachie about 5 years ago, and i know things have changed a little since then...
i liked him a lot, am well aware of how good he is..but he didn't take my insurance, at that time, and i had the kind that didn't do "assignment," i had to go to a doctor who took my insurance or i would have no coverage...so he wasn't a possible choice for me...though he recommended i have surgery fairly soon...

i did find other great SRS scoli surgeons in NYC, (where i was born and raised, and lived most all my life)...
Dr Neuwirth is very good, and Dr Lonner, a wonderful man, has been my surgeon, following me for about 6+ years...i am just not ready to have surgery....yet...as i need fusion T4-pelvis, though we did compromise to T11-pelvis...(i get botox shots in thoracic area which help control upper back muscle spasms), thus the decision to start the fusion lower down...confirmed by consults i had with other surgeons around NY and CA

guess what i am trying to say is there are alternative surgeons who are also excellent...there is also Dr Errico in NYC...another great surgeon...

Dr Lonner does minimally invasive approach now, which is what i will opt for, if/when i go ahead...
i also do not want anterior approach...i would have side and back approaches in my case...side approach for disc disease...

you do have youth on your side, as far as recovery and healing are concerned...
but you have all my sympathy for the pain you live with...i live with pain, too...
i am sorry you are suffering!

best of luck whatever you decide....
jess

Jacque's Mom
01-04-2011, 08:47 AM
Hi Dave,
I had lumbar fusiom by Dr. Boachie four weeks ago today and I am doing well. Dr. Boachie is an amazing person/surgeon and I always had my complete faith in him. You are a young man and should live without this discomfort. I hope this works out for you. As you said you are a young and healthy person and that is a plus. Best of luck and please stay in touch. Happy New Year! Lynn