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pilar
04-23-2011, 06:50 PM
Can your rib hump come back after surgery? Is that suppouse to mean that you are not fused? or can you be fusing but still get a bit of the rib hump back?
Can your rib hump get better months after surgery?

JenniferG
04-23-2011, 07:18 PM
This is something I've also wondered about, whether, during the time of fusion taking place, the spine can perhaps rotate a little more, particularly if fusion is taking a longer than usual time. At one point I thought my rib hump (which disappeared completely after surgery) was coming back, but I think it was my "paranoid delusions" because there's no sign of it now. It was my rib hump I disliked most of all.

golfnut
04-23-2011, 08:14 PM
Pilar,
Those are good questions. I don't know the answers.
Jennifer,
I constantly feel my back to make sure the rib hump is not reappearing. I think I'm a little paranoid, as well. I hated it more than the curve. By the way, I've appreciated your support during my pre-op and post-op days.

Doodles
04-23-2011, 10:10 PM
Hi--
I think I'm sort of unusual since mine reappeared but not near as bad as before. Maybe it was just that the surgery pulled it up straight so it was better & not curved off way to the right. Plus, my left bottom side was totally caved in. It seemed to me at about 3-4 months?? after surgery I started to notice it and was really worried. (Maybe it was just hidden by the swelling until then. I had never had rotation measured for some reason. At 1 year rib hump was measured at 12 degrees. Just went for my 2 year this week and it was 14. He seemed to think since I am now totally fused that it should not change any more. I'm sort of worried about doing twisting stuff like yoga though, even though he said it was fine, since I don't want to make it worse. Lean to left had increased too--he said it had settled. I discussed this on my 2-year appt. thread. Don't know if this helps. Most on here seem to have their rib hump gone so maybe you shouldn't go by me!
Janet

JenniferG
04-23-2011, 10:45 PM
Pilar,
Those are good questions. I don't know the answers.
Jennifer,
I constantly feel my back to make sure the rib hump is not reappearing. I think I'm a little paranoid, as well. I hated it more than the curve. By the way, I've appreciated your support during my pre-op and post-op days.

Thanks for the kind words Karen. I was also always feeling for my rib hump. Gradually, I've stopped doing that.

LindaRacine
04-24-2011, 01:33 PM
Hi...

I suspect it's as Janet guessed... that there was swelling in the area that made the ribs appear flatter than they actually were. Over the years, I've heard on boards from people who felt that their rib humps were reappearing, but I've never actually witnessed anything like it, and have never heard a surgeon talk about anything like this.

Regards,
Linda

Doodles
04-24-2011, 08:38 PM
Linda--
So is this really unusual for a rib hump to get worse from year one to 2-years post op? Since I'm fused should it really stay put or will it keep going? He seemed to think it wouldn't but I'm still a bit fearful of doing the twisting type exercises, etc. that might increase the rib hump. Thanks. Janet

Heidiv2
04-24-2011, 10:44 PM
I too have seemed to notice that my rib humps, although tiny compared to before, seem to be more prevalent lately and I thought that I was going crazy/paranoid. But I also think that the swelling that was there after surgery is pretty much completely gone and had wondered if that is why they are noticed now and possibly were always there. I catch myself just staring and comparing them day to day. I go for my 6 mos checkup Wed. and almost feel faint to think that something is wrong after all of this recovery under our belts. I had checked this board quite a few times and had too noticed all of the people posting that their humps were completely GONE and I was scared. Still am of course, but feel better knowing that I am not alone in this. Once again, thanks to all who post here to keep me from going crazy. :)

titaniumed
04-25-2011, 12:33 AM
Janet

I cant say I blame you, I feel the same way about twisting. Its something I would be hesitant to do often....
------------------------------------------------------------------------------------

If the fusion is solid, and hardware is solid, it seems unlikely that a hump would grow....why would the rib change shape after being fused? (fused through the thoracic)

I donít think that this is something to worry about....The main thing is trying to come through pain free.
Ed

LindaRacine
04-25-2011, 12:57 PM
Linda--
So is this really unusual for a rib hump to get worse from year one to 2-years post op? Since I'm fused should it really stay put or will it keep going? He seemed to think it wouldn't but I'm still a bit fearful of doing the twisting type exercises, etc. that might increase the rib hump. Thanks. Janet

I don't think it's common at all, but I have seen others mention it. I would love to hear your surgeon's explanation.

You shouldn't be concerned about twisting at 2 years postop. If your fusion is solid, no amount of twisting during exercise is going to allow your rib cage to change.

--Linda

Doodles
04-25-2011, 02:05 PM
Thanks for your reply, Linda. At one year, he basically said that since I had so much rotation & twisting, it had to go somewhere. Something like that. That it couldn't be totally taken care of.

LindaRacine
04-25-2011, 11:42 PM
Thanks for your reply, Linda. At one year, he basically said that since I had so much rotation & twisting, it had to go somewhere. Something like that. That it couldn't be totally taken care of.
That answer doesn't seem to apply to the question of why you feel your rib hump has increased since surgery. The next time you see Dr. Lenke, have him explain it to you in terms that makes sense to the question.

Regards,
Linda

Doodles
04-26-2011, 01:40 PM
I don't see him again for 3 years. Maybe it's a question I can ask through Kelly at the office.

pilar
04-26-2011, 03:02 PM
Thanks for your replies!
It's probably me being paranoid, or the swelling on my left side subsided and makes my right side, the rib hump side, to protude. However, I can see and feel my rib hump now... It is not like before post op. Maybe the fusion is settleling? who knows... I am still happy with the results though. I only wish that the hump would have been all gone...
P.

littlebird
04-26-2011, 04:05 PM
Linda--
So is this really unusual for a rib hump to get worse from year one to 2-years post op? Since I'm fused should it really stay put or will it keep going? He seemed to think it wouldn't but I'm still a bit fearful of doing the twisting type exercises, etc. that might increase the rib hump. Thanks. Janet

Janet,
We met in Dr. Lenke's waiting room. My husband and I were seated next to you and yours. In fact, you told me about this forum. Thank you. My surgery is June 6th and 7 th. halo traction on 5/27.
Now, for the rib hump. I had my first surgeries in 1978 and 1979. I had a sharp hump and my last surgery was a resection of it. It was not gone but it was much, much better. Over the years I have lost my correction and my "new Hump" is different, as is my curve. It is much higher and is causing my neck to move dangerously forward.
My cervical spine is a real mess. I am sure is was just moving forward to balance the changes that were happening in my spine. I urge all of you to check your vitamin D and calcium levels; keep your bones strong. My spine is still fused but it bends;it feels like I am caving in. I am a post polio person and our bones are a bit different. Be careful about bending and twisting; just do the good spine care that we are told to do.
Your hump will not just reappear, but if you start to lose correction, you may get a change, as I did. I am sure that Dr.Lenke is correct in saying that the first couple of years, your back is just settling. I am sure that you must have had a Dexa scan.
Remember, if you have a fusion, you don't use the spine for the Dexa, you use the hip and wrist. If they do the spine, you get a false reading. This happened to me.

I hope I didn't increase anxiety but our bodies are all different. Best wishes.

littlebird
04-26-2011, 04:24 PM
Linda--
So is this really unusual for a rib hump to get worse from year one to 2-years post op? Since I'm fused should it really stay put or will it keep going? He seemed to think it wouldn't but I'm still a bit fearful of doing the twisting type exercises, etc. that might increase the rib hump. Thanks. Janet

My rib hump changed after 20+ years! We are older and our bones can become weaker. I plan to ask Dr. Lenke for a brace to wear some of the time for the next couple of years. I am working with a osteoporosis specialist to help strengthen my bones. Remember, people shrink some with age. Our ribs can shift depending on the forces pulling on them. When we are rotated, it can change the pull on our ribs, which is what cause the original hump. If your curve is staying put, so will your rib cage. The rib cage is not fused, nor would you want it to be, because it is helping with your breathing. They cut pieces out of mine, trying to make it less sharp. It helped but it also made my rib cage more ridged. Oh, to be rid forever of that dreaded rib hump!!! Best to all

Doodles
04-26-2011, 07:18 PM
Littlebird--
So good to hear from you and to meet you and your husband the other day. I almost missed your post about that! So glad I backed up to page 1. You provided some very good info for me to know. I certainly hope and pray for a great result with your surgery in June. Keep us updated. Is Dexa the bone scan? I don't remember that term. Janet

golfnut
04-26-2011, 08:14 PM
Dr. Lenke has told me that I can play golf after 1 year, but after reading these posts, I think I will be afraid that the twisting in a golf swing might ruin my correction and cause the return, if only partially, of my rib hump. I hate to think I might have to wait 2 years to play golf again, which I used to do daily in spring,summer, & fall, but I sure don't want to do anything to ruin the correction that I am so happy with. My husband wants to go to Florida and play golf for a month next Feb., but . . . I'm worried.

littlebird
04-26-2011, 09:30 PM
Littlebird--
So good to hear from you and to meet you and your husband the other day. I almost missed your post about that! So glad I backed up to page 1. You provided some very good info for me to know. I certainly hope and pray for a great result with your surgery in June. Keep us updated. Is Dexa the bone scan? I don't remember that term. Janet

Yes, Dexa scan is the type of bone scan you need. If you have osteopenia, or osteoporosis, your back will start bending. I neglected this because I thought I was fine. The test that I had checked my hip and spine, which is wrong for us. The fusion showed a lot more bone mass than my wrist, where no bone has been added. Once it was done corrected, I was told that I have osteoporosis. I take Forteo, a injection, and 50,000 iu of Vit. D a week. If I recall, you are 57, so you are of a age where this could be a factor. We all search for things we can do to help keep our backs as straight as we can. I hope this is of some help to you. You and your husband are a very delightful couple. He seems very proud of you. Take care, Ann

LindaRacine
04-26-2011, 10:28 PM
Yes, Dexa scan is the type of bone scan you need. If you have osteopenia, or osteoporosis, your back will start bending.

While osteopenia and osteoporosis can cause kyphosis and/or scoliosis, they don't always.

--Linda

jrnyc
04-27-2011, 02:01 AM
i had scoli waaaaay before i had osteopenia...
looking back, i realized i had scoli as a kid/teen!
not sure at what point my being "particularly hypokyphotic" (per surgeon) kicked in

jess

LindaRacine
04-27-2011, 12:54 PM
Dr. Lenke has told me that I can play golf after 1 year, but after reading these posts, I think I will be afraid that the twisting in a golf swing might ruin my correction and cause the return, if only partially, of my rib hump. I hate to think I might have to wait 2 years to play golf again, which I used to do daily in spring,summer, & fall, but I sure don't want to do anything to ruin the correction that I am so happy with. My husband wants to go to Florida and play golf for a month next Feb., but . . . I'm worried.
Hi Karen...

Unless you have some underlying disorder, your fusion probably won't be any more solid at 2 years than it will be at 1 year. And, no average amount of twisting is going to do anything to make your rib hump more prominent. The ribs are attached to the spine, and the spine is what caused the ribs to become misshapen. I definitely encourage you to discuss this with Dr. Lenke.

Regards,
Linda

Doodles
04-27-2011, 01:53 PM
Ann--
We really enjoyed meeting both of you! It's always good to exchange info with those who have been there! I have had bone scans too pre-surgery and they came out pretty good but with some osteopenia, if I recall correctly. Janet

flowerpower
04-27-2011, 01:56 PM
"The ribs are attached to the spine, and the spine is what caused the ribs to become misshapen."


Good explanation, Linda. When my oldest son had surgery (2005) he had a significant rib hump, we were told that the hump would be corrected approx. 50% of pre-surgery measurement. Post surgery, there appeared to be no rib hump, but over the course of the year while the body "settled" the rib hump slowly reappeared, and the dr.s explanation was that the rotation/curvature had caused the ribs to not form properly.

Confusedmom
04-27-2011, 08:52 PM
So, is this to be pretty much expected then, that correction to rib humps (without thoracoplasty) will be temporary? Or at least it may appear that it is corrected and then reappear over the course of time? Is there anyone out there who had surgery a long time ago who still has a good rib hump correction? Just want to know what to expect.

Thanks!
Evelyn

Doodles
04-27-2011, 09:09 PM
Thanks, Flowerpower, that helps me understand it better. Janet

flowerpower
04-27-2011, 09:43 PM
So, is this to be pretty much expected then, that correction to rib humps (without thoracoplasty) will be temporary? Or at least it may appear that it is corrected and then reappear over the course of time? Is there anyone out there who had surgery a long time ago who still has a good rib hump correction? Just want to know what to expect.

Thanks!
Evelyn

I think for the most part, the majority get satisfactory correction of the rib hump. My son had a very significant rib hump, it progressed quite rapidly prior to surgery. I do believe that the ribs may have malformed over time.
My youngest son (13) just had surgery March 7th. His rotation also progressed quite rapidly prior to surgery but the dr. felt he got way better correction of the rotation because he did a anterior release (removed some discs) in addition to the spinal fusion. He looks fairly straight and even right now, but still bends a little to the right; he may still be favoring that side due to the side incisions, but I'm not quite sure. Time will tell. We see the dr. tomorrow, hopefully a restriction or two will be released.
Also wanted to add that even with a thoracoplasty, a rib hump "might" return if the ribs were malformed to begin with. I don't think that is a common scenario either, but well worth asking a dr. about

LindaRacine
04-28-2011, 12:05 AM
"The ribs are attached to the spine, and the spine is what caused the ribs to become misshapen."


Good explanation, Linda. When my oldest son had surgery (2005) he had a significant rib hump, we were told that the hump would be corrected approx. 50% of pre-surgery measurement. Post surgery, there appeared to be no rib hump, but over the course of the year while the body "settled" the rib hump slowly reappeared, and the dr.s explanation was that the rotation/curvature had caused the ribs to not form properly.

That explanation makes absolutely no sense to me. Do you think the surgeon was saying that now that the rotation and curvature had been corrected, the ribs were now able to form properly?

Pooka1
04-28-2011, 05:29 AM
So, is this to be pretty much expected then, that correction to rib humps (without thoracoplasty) will be temporary? Or at least it may appear that it is corrected and then reappear over the course of time? Is there anyone out there who had surgery a long time ago who still has a good rib hump correction? Just want to know what to expect.

Thanks!
Evelyn

My one daughter was extremely rotated and therefore had a very large, very noticeable rib hump. At least 90% of that rotation was removed in March 2008 and has never returned. The only remnant of the rotation is that her right shoulder blade sticks out a bit more and the amount of that has been stable in the entire post op period (just over three years now) to my eye. It is not enough for an untrained person to notice in my opinion.

I do not believe a fusion allows the rib hump to return in a visible fashion although there is one issue... there was a paper published on how changes in the transverse plane (looking straight down from the top) can go on long term - several years. I interpret that to mean the rotation can increase slightly over many years but the numbers are small and I don't believe that would be noticeable to anyone except maybe the person if they are specifically trying to measure it somehow.

Doodles
04-28-2011, 02:02 PM
Just wondering...do most people have this measured ? My rib hump or amount of rotation, I guess, was measured at 12 a year after surgery and is now at 14 degrees. Is this typical? Until a year ago I didn't know such a measurement existed. It was almost like a weird level that was put on my back as I bent over. Janet

Pooka1
04-28-2011, 02:23 PM
Just wondering...do most people have this measured ? My rib hump or amount of rotation, I guess, was measured at 12 a year after surgery and is now at 14 degrees. Is this typical? Until a year ago I didn't know such a measurement existed. It was almost like a weird level that was put on my back as I bent over. Janet

I have never seen anyone measure rotation on either of my kids. I have never seen a scoliometer in person. Clearly, though, the surgeon makes mental notes as to how much he will have to correct and be able to correct.

pilar
04-28-2011, 04:13 PM
Janet,
Yes, my rib hump was measured and pre-op was 75 degrees, post-op is 37. I understand the logic of fusing and swelling, but I still se a bit more rib hump in my back now at almost 5 month post-op than 2 month post op. I am most def going to ask about this to Dr. Pashman at my 6 month visit. I'm might just be gaining weght or being paranoid. Here is the link to Dr. Pashman's measurements on my back.

http://www.facebook.com/#!/photo.php?fbid=180482341972311&set=a.153029314717614.26970.153023814718164&type=1&theater

Pilar

Pooka1
04-28-2011, 04:25 PM
Janet,
Yes, my rib hump was measured and pre-op was 75 degrees, post-op is 37. I understand the logic of fusing and swelling, but I still se a bit more rib hump in my back now at almost 5 month post-op than 2 month post op. I am most def going to ask about this to Dr. Pashman at my 6 month visit. I'm might just be gaining weght or being paranoid. Here is the link to Dr. Pashman's measurements on my back.

http://www.facebook.com/#!/photo.php?fbid=180482341972311&set=a.153029314717614.26970.153023814718164&type=1&theater

Pilar

That 75* is for your kyphosis which is a SPINE hump in the middle of the back.

What folks are talking about in this thread as far as I can tell is an ASYMMETRICAL rib hump, usually on the right side due to rotation.

That said, with a 98* main curve, you must have had some significant rotation, much of which was removed but some remains based on the sagittal post op radiograph.

Doodles
04-28-2011, 07:35 PM
Yes, Pooka, that's what I was referring to. Yes, I had a lot of rotation. Thanks for the info. Janet

Doodles
04-28-2011, 07:38 PM
I now realize you were referring to Pilar who started with the 98. I wasn't far behind her at 96 so mine may not be so bad. As long as it doesn't progress more!

Pooka1
04-28-2011, 07:47 PM
Yes I was commenting on Pilar's post. I guess kyphosis produces a hump also but it is not a rib hump... it is a spine hump.

Rib hump is pretty specific for the one-sided hump from the ribs protruding due to the rotation accompanying high-angle scoliosis (except in the hysterical cases).

flowerpower
04-29-2011, 12:57 PM
That explanation makes absolutely no sense to me. Do you think the surgeon was saying that now that the rotation and curvature had been corrected, the ribs were now able to form properly?

No, that's not what I was saying at all. Sorry if you misunderstood or I didn't explain correctly, sometimes my thoughts don't transpose into type the way I mean to, especially if I'm in a rush.

During growth, the progressive curvature, rotation and asymetrical muscle force may cause the ribs to malform/become misshapen.
Once ribs are formed, they're formed. With surgical correction of curvature and rotation, it seems that most patients get satisfactory correction of the rib hump, even if there may be some slight malformation of the ribs. Not often, the ribs may malform to such a degree that even with good curvature/rotation correction a rib hump may still be quite measureable. My older son's curve correction is still holding 5 yrs. later at approx. 17T/10L, yet his rib hump still measures at approx. 18. Reasons: spine not as flexible as hoped and ribs were malformed. At younger son's appt. yesterday, curve is not even really measureable, less than 10T, and rib hump (measured with scoliometer) was 5. It remains to be seen if the rib hump measurement will change over the course of the year. There is still a little unevenness in the hips, but dr. feels that may still straighten itself out as the skeletal frame adjusts to its new position.

I hope I'm not coming across as negative or hysterical. Patients/decision makers should consider all angles of post surgery outcomes and maybe this will help someone in asking questions during their consultations - there is so much to consider it can make your head spin.

Linda, if you feel this is still unclear or incorrect info, feel free to delete it. I don't want to misinform or mislead anyone.

LindaRacine
04-29-2011, 06:50 PM
No, that's not what I was saying at all. Sorry if you misunderstood or I didn't explain correctly, sometimes my thoughts don't transpose into type the way I mean to, especially if I'm in a rush.

During growth, the progressive curvature, rotation and asymetrical muscle force may cause the ribs to malform/become misshapen.
Once ribs are formed, they're formed. With surgical correction of curvature and rotation, it seems that most patients get satisfactory correction of the rib hump, even if there may be some slight malformation of the ribs. Not often, the ribs may malform to such a degree that even with good curvature/rotation correction a rib hump may still be quite measureable. My older son's curve correction is still holding 5 yrs. later at approx. 17T/10L, yet his rib hump still measures at approx. 18. Reasons: spine not as flexible as hoped and ribs were malformed. At younger son's appt. yesterday, curve is not even really measureable, less than 10T, and rib hump (measured with scoliometer) was 5. It remains to be seen if the rib hump measurement will change over the course of the year. There is still a little unevenness in the hips, but dr. feels that may still straighten itself out as the skeletal frame adjusts to its new position.

I hope I'm not coming across as negative or hysterical. Patients/decision makers should consider all angles of post surgery outcomes and maybe this will help someone in asking questions during their consultations - there is so much to consider it can make your head spin.

Linda, if you feel this is still unclear or incorrect info, feel free to delete it. I don't want to misinform or mislead anyone.
Sorry, I am still confused. The issue is increase in rib hump after spinal fusion, but it sounds like you're describing the malformation prior to surgery.

flowerpower
04-30-2011, 10:03 AM
Sorry, I am still confused. The issue is increase in rib hump after spinal fusion, but it sounds like you're describing the malformation prior to surgery.

I was, as a reason that a rib hump might "reappear" post surgery once swelling has gone down, body settles, etc.

Are you talking about an increase in rib hump beyond pre-surgery measurement after fusion has taken place???

littlebird
04-30-2011, 02:41 PM
While osteopenia and osteoporosis can cause kyphosis and/or scoliosis, they don't always.

--Linda

True, but for those of us that have kyphosis and, or, rib humps, bones that are soft are prone to bend with our curves. We can do something about this by being aggressive in our treatment of our osteopenia and osteoporosis. I have started working with a specialist.