View Full Version : some questions before surgery

07-01-2011, 12:42 PM
Bonjour ŗ tous! I have been reading you for some weeks, and today Iím willing to post for the first time. Itís a bit hard for my mother tongue is french and not english. Hope that my post will be clear enough to be understood!
Iím having surgery next fall. My 2 curves (lumbar and thoracic) are around 70 degrees. It took me months thinking about that to make the decision to go to surgery, because I have pain every day, but not a horrible pain. I can manage it with rest, special stretching exercises every morning and the help of an osteopath. Hard to choose going from a well known pain toÖ an unkown condition, with lost flexibility. But I donít have to explain, everybody on this forum has experienced itÖ My decision to undergo surgery rests on the fact that the curves (and pain) are getting worse with time, despite of my efforts to maintain a good physical shape. In 2001, the curves were 60 (lumbar) and 45 (thoracic).
My experience with doctors is similar to Spinetimeís experience : all my life, the doctors Iíve seen didnít seem to take scoliosis for a serious condition. None of them (and I donít talk about generalists only, but about orthopedists as well) told me that I could have a surgery, they all told that the surgery was only for adolescents and that from the end of growing, scoliosis does not increase. Without Internet, I would continue to believe them, even if they are wrong, as I know it now. 2 years ago, I decided to search by myself a solution to the increasing pain in my back. I found an SRS doctor working in Montreal, met him, asked for a second opinion in France, on the recommandation of members of a french scoliosis forum. Both told me that surgery was an indicated treatment in my case.
I have 2 questions :
Does a surgeon who is hypercompetent with children or ados is necessarily as good with adults? Am I right to think that anyway, adults who go to surgery are far less numerous than adolescents, so no surgeon do surgery on adults only? Is adult spinal surgery a specialty of its own? (hmm, that makes more than 2 questions ☺). The surgeon I have chosen has done two fellowships (Pediatric Orthopedic, Spine Surgery and research in San Diego and a fellowship as Clinical Chief Ė Orthopedic Pediatric & Spine surgeryĖ, at the HŰpital St-Vincent de Paul, France), both in pediatric surgery. He is very involved in research about scoliosis. He sees adults too, but Iím curious to have your feelings about that.

My other question is related to long-term outcomes of surgery. As many of you, I undergo surgery with the hope that it gives me a better chance to preserve my health in the future (Iím 53). I have read a lot of posts from persons who are very happy with the surgery at the end of recovery, and also a lot from persons who had surgery when they were adolescents and need a revision surgery in the middle of their life because they have problems as their back get older. What is the stability of the outcomes of the surgery Iím planning? Will its benefit last for a long time? Itís of course an important issue to me. I got an answer to this question from the surgeon, but I would like one from persons who had the surgery when adults and have been living with the fusion for some years.
Thanks in advance for your comments! This forum is great!

07-01-2011, 03:09 PM
As a retired English teacher, I'd say your English is perfect! Welcome to the forum. For quite a few reasons, I haven't had time to chime in on here lately, but I had to respond to your first question especially. I was followed by doctors at Univ. of Iowa hospitals for years. As I got worse and worse in my 50's I asked the question about how many surgeries they did for kids--about 425 per year. For people in my condition--about 10 a year. Those odds didn't sound too great. They really didn't want to mess with me I think. They said I'd probably be all right. Mine progressed more rapidly in the next few years, and I went to Lenke in St. Louis. I think it is a more specialized surgeon that needs to deal with adults especially in the "older" years. I know of 2 people who had the Iowa City surgeries as adults and they needed to go through revisions later--within a couple of years. So, my thinking is there is a big difference dealing with adolescents as opposed to mature, stiffened spines.
Even though I have had some shifting of the top of my fusion on the x-ray, I have a lean to the left (others don't really see it much), and my rib hump has gotten bigger since surgery (although not as bad as before surgery), my overall result has been good. I still have aches and pains but nothing like before surgery. There are flexibility issues but not as bad as I anticipated. I know without the surgery I would really be a mess by now. It was overall a success. Anyway...personally I would urge you to see someone who deals with a lot of adult spines. Best of luck in your decision. Janet

07-01-2011, 03:27 PM
Hello, Bamboo,
Welcome to the forum. I had my surgery with Dr. Lenke (same surgeon as Janet) this past January at age 60. I am extremely happy with the results, although I won't be testing my flexibility (or lack of!) for several more months due to restrictions for now. Dr. Lenke has performed surgeries at a children's hospital, but also has a great deal of experience with older adults with a stiff spine. I was physically fit and extremely active before surgery (like you) which probably kept my pain at a minimum. The decision for surgery was difficult for me, but I knew I had to take the plunge. Because of having the surgery, I hope that I have a much better chance for an active life with less pain for the next several decades than if I had done nothing.

07-01-2011, 07:23 PM
bon soir bamboo
bon chance avec votre chirurgie...

your English seems excellent...my French is not so good


07-01-2011, 07:39 PM
I agree with Janet both regarding your excellent English and the necessity to seek a surgeon who does a lot of adult surgery.

My surgeon does both but does high numbers of both - 2-3 scoli surgeries per week. My outcome has been excellent so far - over two years out.

I believe your choice in surgeon is the prime factor in a good outcome.

Wishing you the very best of luck!

07-02-2011, 06:42 AM
Thank you all for your warm welcome! You give me confidence to continue writing in english! I'm going to ask my surgeon how many adults he operates in a year. What I know is that the hospital where he would operate me is known as one of the best for such complex orthopedic cases. There's no specialist performing that type of surgery in the city I live in, and I know the importance of choosing the surgeon. But for questions of insurance, I have to stay in the limits of the country, I cannot undergo surgery in the States. Only a few canadian surgeons treating adults are on the SRS list. Adults spinal deformities surgery seems to be a very narrow sub-specialty.

07-02-2011, 02:47 PM
Hi Bamboo...

Welcome, and I agree with everyone, that your English is amazing. (Better than many born and raised here!)

I think that almost every scoliosis specialist here in the U.S. performs some pediatric surgery, but not all of the specialists treat adults. There are special considerations for adults, so I think your idea of questioning your surgeon about the number of adult cases s/he does every year is a good thing.