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dolores a
10-05-2012, 10:55 AM
Have not posted in a while (always look in though to see how everyone is doing), all is fine except my posture, it seems to me that my hips are pushing forward when I stand, making my belly look pregnant, I'm about 5'51/2" tall and weigh about 132lbs. I look like a skinny (old) preganant woman. Also my neck with I am experiencing pain is also jutting forward. I tried to understand what sagital imbalance is from the posts on this forum and on line.
I have an appointment with a recommended physical therapist on Tuesday coming, this therapist I'm told is all about posture. When I see him I will ask his opinion also. So I guess my question is, could my changing posture have anything to do with sagittal imbalance? thanks, hope everyone is doing well!

SusanG
10-05-2012, 02:43 PM
Hi -- I had surgery last December, and also notice, now, that my head juts forward. It was probably that way before but I am very conscious of it now. I try to consciously push my head back, but it seems very unnatural. When I sleep on my back, I sleep without a pillow, thinking that might help, but really don't know. If you find your therapist helpful with the posture issue, I would appreciate his information, as I am in the NYC area (I assume you are also). Thanks very much.

dolores a
10-05-2012, 03:03 PM
Hi Susan, thanks for your input, I will post after my appt. with therapist what comes of the consult, not sure yet if I should notify my surgeon of what is happening. What levels are you fused?

SusanG
10-05-2012, 03:14 PM
Hi Dolores -- I am fused from T3 down to the sacrum, with pelvic anchors. Had a really severe curve (double major, both over 90 degrees) but never had any pain or problems associated with the curves, just I was getting shorter and the curves were increasing; so I was corrected to approximately 60/50 degrees, so still crooked but much better than before. I next see my surgeon (Dr. Boachie) in November, but when I asked previously about the posture issue, he said just to make an effort to hold my head high, but nothing about seeing a therapist. I will ask him next visit, but in meantime, if I could find a posture therapist, I think that would be of tremendous help. So if you find yours to be helpful, I would appreciate your input about him. Thanks so much! Hope your visit goes well.

jane d
10-05-2012, 09:39 PM
I am fused from T4 to sacrum and had my surgery by Dr. Lenke about 10 weeks ago. I have had a very good recovery so far. I saw him in St. Louis on Sept. 19 and told him that my neck was jutting forward somewhat and that I couldn't tilt my head back at all to put drops in my eyes. (I have to lie down in bed now to do this.) He looked at my before and after surgery x-rays and said that my neck looked the same. It is not. I also can't tilt my head back to drink the last part of water, etc. in a glass. All of this is small stuff since I am now free of lumbar pain and have a straight spine but it does bother me somewhat as he did not seem to have an answer for it or a remedy.
Jane

LindaRacine
10-06-2012, 12:30 AM
Sagittal imbalance simply means that your spine is not balanced in the front/back plane. THIS (http://www.spineuniverse.com/conditions/kyphosis/spinal-curvature-problems-fixed-sagittal-imbalance) article explains it in fairly simple language.

JenniferG
10-06-2012, 12:37 AM
Sagittal imbalance was one of the problems I was most concerned about, that and infection. Dolores, do you know if you had osteotomies? I had some but never found out how many and have a decent curve in my lower back, similar to what I had as a teenager. So far no problems. How does your lower back look - is there plenty of lordosis? I might be on the wrong track but think s.i. has to do with your lordosis? Someone more knowledgeable maybe able to correct me on that.

Hoping the therapist can help you Dolores. Please let us know.

Confusedmom
10-06-2012, 10:04 PM
Jane,

My neck was pretty stiff at first, but it has gotten much better as the months have gone by. I used to be unable to tolerate a pillow, for instance. But now I can use one if I want. I think you will see an improvement in your range of motion over time, as long as you're not fused too high up.

Evelyn

susancook
10-07-2012, 06:25 AM
Thanks Linda for the great resources.

Which way does a positive sagiital imbalance and a negative saggital imbalance lean? Same question for coronal imbalance?

Does zero sagittal and coronal imbalance means "normal or non-scoliotic" [I would assume since the word IMBALANCE is used]?

Thanks
Susan

LindaRacine
10-07-2012, 11:56 AM
Thanks Linda for the great resources.

Which way does a positive sagiital imbalance and a negative saggital imbalance lean? Same question for coronal imbalance?

Does zero sagittal and coronal imbalance means "normal or non-scoliotic" [I would assume since the word IMBALANCE is used]?

Thanks
Susan
Positive sagittal balance is leaning forward. There's no difference in the designation for coronal balance; it can be either right or left. Zero coronal and sagittal balance is the norm.

susancook
10-08-2012, 09:27 AM
Positive sagittal balance is leaning forward. There's no difference in the designation for coronal balance; it can be either right or left. Zero coronal and sagittal balance is the norm.

Thanks, Linda! You are such a wealth of knowledge! I am still learning the scoliosis language. Susan

debbei
10-08-2012, 08:34 PM
I'm sorry you're having problem Dolores. Have you had this issue since your surgery or is it new? Are you having any pain with this problem? ((Hugs))

jackieg412
10-09-2012, 05:43 PM
Hi to all,
I have read the article on sagital imbalance--I feel I may have a problem with it. I have a 16 level spine fusion,done in last year and a half. and 3 level cervical.All summer I have had a harder time walking and have found myself leaning rt and shiffting my hips out and locking my knees. It is tiring to say the least. I fell several times now, and I am back at Pt. The Pt has found right leg shorter and is working on muscles to help that. Thus I am falling right. I do not see the Dr until Dec. I am beginning to think it is a balance issue,and I tried to explain to Pt. I know the people here understand much more about this then even he does. We do deal with things like this all of the time. My question is should I bring this to Dr before Dec, as I will lose my insurance in Feb. Very scary!Please let me know what you think.

jrnyc
10-09-2012, 05:47 PM
hi jackie
i absolutely think you should get in to see your doctor
before December...why wait...???? will your insurance
cover it...? if so, again...why wait...??
what if you need tx...and it cannot be completed by
February...? why not get a jump on it now...

hope you feel better....
jess

JenniferG
10-09-2012, 06:03 PM
I agree with Jess. It may not be what you're thinking, but it may. Ring today for an appt and get the ball rolling. The urgency is mainly because of your insurance situation. Good luck!

titaniumed
10-09-2012, 09:48 PM
So I guess my question is, could my changing posture have anything to do with sagittal imbalance?

I believe so. I have had the “forward lean” in the past, but not due to spinal reconstruction or a spinal problem. It seems to be a soft tissue issue....Changing posture due to soft tissues. Why this happens once in a blue moon, I don’t know. There are many reasons, and hard to pinpoint.

Physical therapy for me was a positive experience. Exercise itself is a positive experience, and it doesn’t have to be too much.

I would say that walking the catwalk just like the models do is a good thing. Head up, spine straight with no leaning. Balance that book up there and don’t let it fall. I also do this when I hike with a sort of mental balance monitor running in the background if you know what I mean...

Dolores, be sure to let us know how it goes.

Jackie,
Falling like you have been is not normal. I agree with Jess and Jen about seeing your scoliosis surgeon. Let him come to a conclusion. Tell him everything.

Did you have a 1 year follow up with him? He should have shot x-rays....if not, then go.

You could extend your medical coverage with a COBRA continuation...

Ed

LindaRacine
10-09-2012, 11:33 PM
Unfortunately, it happens WAY more than once in a blue moon, at least in us "older" patients.

jackieg412
10-10-2012, 06:05 PM
Thanks to eveyone who has been so helpful.I have made an appointment to see Dr next week. It will also be the time Pt is through.They have checked everything they can think of---eyes,ears,weak muscles,and I passed all of it.The one Pt thinks it may be in the S-1 joint as my right leg is shorter after I sit. The legs measure the same,but the rt hip is hiking up. No real pain there or maybe no feeling?I had seen Dr after first 2 falls and he repeated the xrays--said everything looked OK. I think he needs to check the balance as I feel so off at times. Maybe i am just trusting the hard ware and not working on small muscle groups.I will bring all of this to him when I see him next week. I knew that the fellow scoliosis patients would understand,even more than the PT. Where I go they have not had a lot of experience with such long fusions and it is hard to tell someone what it takes if they donot understand the impact of the whole spine being fused. I think mine matches yours Ed, I just don't know if You are fused in the cervical also. My c has 3 levels fused. As far as the insurace I will not be able to get cobra as I opted for an extention on my group insurace that would carry me to Feb. Then I should go on medicare early ,however there could be a problem with that. Very Complicated to explain. Thanks to all. You are my life savers!

JenniferG
10-10-2012, 06:21 PM
How long has it been since your fusion surgery, Jackie?

dolores a
10-10-2012, 06:34 PM
Went to my appointment with pt yesterday for consult and some therapy that was so wonderful! As to the consult, as Linda explained therapy is definately what I will need. When I asked him about sagittal imbalance he explained in simple terms it is exactly what I am experiencing. He just had to look at my posture to see this is what I have, just as Linda explained, but in terms that I understood. My neck is not aligned with shoulders, that it will take therapy and my own conscious effort to try to correct this along with alleviating some of the pain. He asked why my surgeon did not give me a prescription for therapy just due to the nature of this surgery and how I would be overcompensating this area due to the fact that I have no movement below where my fusion is. The therapist gave me an exercise to do at home for the time being, while lying on my back, I need to push my neck and chin into the mattress for about 20 repetitions twice daily. What he did in the office was sort of hands on traction, but prior to that, heat was applied and something like a tens machine, but more soothing. He was amazed at how big and how many knots were throughout my wholly cervicle area. I will follow through with this therapy and my at home exercises to see if I can get rid of this painful tension I experience every day!! I will let everyone who also expiences this also how it goes

Susan g I sent you a private message pm me back and I will give you the thepists number and address

dolores a
10-10-2012, 06:46 PM
Hi Jackie, I have fallen a few times, also others on this forum have mentioned falls also, my theory is, in my case, is when people who are not fused, when they loose balance due to whatever, can correct themselves so the don't go down, when you are fused, especicially with a long fusion, you cannot correct yourself and down you go, timber! Also our gaits are a bit off and probalbly through therapy and being conscious of this will help. Hope all goes well with your appointment.

JenniferG
10-10-2012, 10:13 PM
Thanks for letting us know Dolores. I hope the therapy goes well for you and I will be following your progress with interest. Best of luck!

jackieg412
10-11-2012, 07:37 PM
Hi Jennifer,
My surgeries took place at different times. 12/08 I was fused t10=pelvis, on the 6th day after surgery,while in rehab, I fractured through t-9--I just reached for a tissue. It was real hard after that. However,while I never quit complaining of that area, the fracture was not found for awhile. Then the upper spine went real rapid into a severe kyphosis,curve increased by 20 degrees in 1 year. I tne meantime I had A c5-6-7 fusion,9/10. In Feb of 11 ,I had the fusion extended to t-2. My xrays look alot like Ed's,but at the area around t-10 is where the 2 rods join. The Dr did not take out lower rods--just hooked to them. That area has a wider band of metal around it joining the 2 together.I do get real sore there alot.Also I am 5' and just over 100 lbs. So I can feel these alot.They have no place to hide!The same team of surgeons did all of the surgeries. I just found out that one of them is the current president of the SRS. He is a wonderful man and surgeon.
I agree that we all have to fight for balance and can lose our balance easier. I should agree,as I fell again today in the yard. I was trying to kneel down to cut a shrub at the base and bumped another and down I went. This time I cut my arm and bruised my knee. After this fall,I really feel off balance. it hurts a bit more this time. I will tell pt again and I do see Dr next week

JenniferG
10-12-2012, 12:06 AM
Hi Jennifer,
My surgeries took place at different times. 12/08 I was fused t10=pelvis, on the 6th day after surgery,while in rehab, I fractured through t-9--I just reached for a tissue. It was real hard after that. However,while I never quit complaining of that area, the fracture was not found for awhile. Then the upper spine went real rapid into a severe kyphosis,curve increased by 20 degrees in 1 year. I tne meantime I had A c5-6-7 fusion,9/10. In Feb of 11 ,I had the fusion extended to t-2. My xrays look alot like Ed's,but at the area around t-10 is where the 2 rods join. The Dr did not take out lower rods--just hooked to them. That area has a wider band of metal around it joining the 2 together.I do get real sore there alot.Also I am 5' and just over 100 lbs. So I can feel these alot.They have no place to hide!The same team of surgeons did all of the surgeries. I just found out that one of them is the current president of the SRS. He is a wonderful man and surgeon.
I agree that we all have to fight for balance and can lose our balance easier. I should agree,as I fell again today in the yard. I was trying to kneel down to cut a shrub at the base and bumped another and down I went. This time I cut my arm and bruised my knee. After this fall,I really feel off balance. it hurts a bit more this time. I will tell pt again and I do see Dr next week

Hi Jackie, thanks for refreshing my memory. You've been through the mill over these last few years. I agree, being small, you would feel the area around the hardware much more than someone with more meat on their bones! I'm sorry to hear about this most recent fall. Good luck with your appt next week and I hope you can get the ball rolling on getting your pain dealt with.

titaniumed
10-12-2012, 12:58 AM
Jackie

Your fracture at T9 sounds quite a bit like Michele’s situation in NJ. She is going in soon for a revision. Its also amazing that your PJK progressed 20 degrees in a year..... Did you have any kyphosis or lordosis abnormalities before your initial surgery?

I’m up to T2, and my neck has not been touched. My C5-6 is a little roasted, but I’m hanging in there....

Try to take it easy on the landscaping....it seems that we all end up in the garden at some point pulling weeds with our million dollar spines. (smiley face)

Are you falling because of balance? or weak muscles? Is your right leg just giving out? It probably wouldn’t be a bad idea to get some walking sticks, or ski poles to walk around with.

Ed

Confusedmom
10-12-2012, 11:32 PM
Love it, Ed. If only we could all just have taken the money for our surgeries and used it to employ gardeners, housekeepers, childcare, etc., maybe we wouldn't need these million dollar spines! (Smiley.) Just daydreaming.

jackieg412
10-13-2012, 03:31 PM
yes this fracture sounds like the same thing that happened to Michele. I was explained that the spine was under too much pressure. I know the Dr's felt that I would need only the t10-pelvis,so I think that the upper spine must not have been in a severe kyphosis at that time. The fracture occured on the 6th day out from surgery--so I was not doing too much to have caused it. I knew something snapped. Heard it --really felt it,but I had a very hard time convicing the staff and then later one of the Dr.At a year out it was easy to see something was on the move,but the increase of 20 degrees the following year could not be denied. A Ct scan found the fracture through t9 pedicle. Yes it did hurt.
Now the falling,so far Pt has ruled out major muscle weekness,inner ear and eye problems. Pt thinks the right leg being shorter{or the problem causing rt leg to be shorted} has something to do with it. As well as the s-1 joint. It will be interesting to se Dr and see what he thinks. What ever is with rt leg is causing my rt hip to hike up--maybe why I will not sit for long.
If I ever can find out how to post xrays I will. Like a lot of us I have copies of my million dollar spine also! I wonder if there is a little imbalance as my rods are joined at t9,10. It isn't one compleate long rod,but overlapped and joined there. I need to find the answer because so far I haven't been too hurt by falling,but we all know that can happen.

jackieg412
10-19-2012, 08:05 PM
Hi again,
I did get into the Dr. He took another set of scoliosis xrays. He does think everything is alright with the fusion. And that is very good news. And he and I went over the fact that my right leg is shorter when I sit. It is the same length,but becomes shorter when I sit. The Dr said that is being caused by the scoliosis.And here I thought I was cured!
The final thing we are trying for the balance issue is to reduce the gabapentin. I still need it to control an nerve in my thorasic. If that nerve isn't hurting it is itching! Oh so much fun!I will see him in Dec,if there isn't any improvment then I will see a nuroligist.



Dr Steven Mather and Dr Kamal Ibrahim
t 10 -pelvis 12/3/2008
c5,6,7 9/28/2010
t2-t10 2/23/2011

jackieg412
10-28-2012, 03:52 PM
I did see my doctor and he took more xrays. The Dr thinks everything is as it should be. Nothing appears to have moved and I know that is good news. I still feel so off of balance or I feel like I am trying to adjust myself to stay in balance.We did reduce the gabapentin and I will see him in Dec. Maybe it is the meds!

loves to skate
10-29-2012, 10:58 AM
Delores,
PT should help you, and for myself, I have to continually remind myself to stand up straight. Oh yeah, the belly thing. It seems to be a problem for many of us older ladies. I weigh about the same as you and am 5'5" tall now (used to be 5'9") and in the evening I look about six months pregnant. Ugh! Some women have liposuction, but one big surgery is enough for me. Haha! Good to hear from you BTW.
Sally

susancook
10-29-2012, 02:31 PM
Delores,
PT should help you, and for myself, I have to continually remind myself to stand up straight. Oh yeah, the belly thing. It seems to be a problem for many of us older ladies. I weigh about the same as you and am 5'5" tall now (used to be 5'9") and in the evening I look about six months pregnant. Ugh! Some women have liposuction, but one big surgery is enough for me. Haha! Good to hear from you BTW.
Sally

Sally: This belly thing is getting to me. I have not had surgery, have lost weight [now about 145# on a 5'2 used to be, now 5 feet]. I think that the progressive collapse of my spinal column and the shifting leaves the front no place to go than out! Wonder what a fusion would do to help that? Sounds like not much from what you are saying. I fear that someone will not see my graying hair and ask if I am early pregnant!
Susan

loves to skate
10-29-2012, 06:33 PM
Sally: This belly thing is getting to me. I have not had surgery, have lost weight [now about 145# on a 5'2 used to be, now 5 feet]. I think that the progressive collapse of my spinal column and the shifting leaves the front no place to go than out! Wonder what a fusion would do to help that? Sounds like not much from what you are saying. I fear that someone will not see my graying hair and ask if I am early pregnant!
Susan

Susan, I agree with you about no place to go but out, but I would be willing to bet you could have very tight abdominal muscles and still have a lot of fat in the belly area. I know I do. If you can be corrected to your original weight, your belly probably won't be as bad. My Doc wasn't able to lengthen me to my original height because he was afraid it would put too much pressure on the pedicle screws and they might pull out. I think this belly thing is very prevalent among older ladies. Oh well!
Sally