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  • Spontaneous improvement?! Not likely...

    I had a new X ray done last week (13 months after the last one). The radiologist measured the first one at 44 degrees and my specialist measured it at 45. The same radiologist measured the new X ray at 37 degrees, an “improvement” which I find hard to believe in the absence of any treatment apart from pilates twice a week (sometimes less). I suspect measurement error and have emailed both x rays to my specialist to confirm the measurement (still waiting).

    The other factor which may or not be relevant is that the X ray in January 2012 was done at about 4 pm, whereas the 2013 one was done at 10 am. Do scoliotic curves tend to collapse toward the end of the day with gravity/muscle fatigue etc?

    To my uneducated eye the second one may be very slightly worse, going by the size of the gap between the vertebrae and the sternum (which I know is not the right way to judge it!)

    Cheers

    Silvercat
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  • #2
    Originally posted by Silvercat View Post
    The other factor which may or not be relevant is that the X ray in January 2012 was done at about 4 pm, whereas the 2013 one was done at 10 am. Do scoliotic curves tend to collapse toward the end of the day with gravity/muscle fatigue etc?
    I certainly have read that this can be the case. I have not seen a study trying to quantify it though. But I suspect you are absolutely correct.

    Otherwise, if this were my daughter, I would credit it to the power of no prayer whatsoever. :-) YMMV.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

    Comment


    • #3
      Hi...

      There's no question that the xray labeled as the most recent has a small curve than the prior one. And, you appear to be slightly more balanced in the newer film. (If you drop a plumb line through the middle of your high thoracic vertebrae, it's much closer to the center of the lumbar vertebrae than in the earlier film. Are you doing any regular exercise? And, how old are you?

      --Linda
      Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
      ---------------------------------------------------------------------------------------------------------------------------------------------------
      Surgery 2/10/93 A/P fusion T4-L3
      Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

      Comment


      • #4
        Hi Linda

        I'm 44. I do Pilates twice a week (sometimes less) and that's about it. I ride a horse for a couple of hours most weekends if I'm lucky but most of my waking hours are spent sitting at a desk or in a car.

        I can't believe that would make so much difference in one year - its got to be due to the different times of day the X rays were taken and the way I was standing at the time. In the second one the technicians kept nudging my torso over to the right (to be closer to the board) and not mentioning anything about my feet. After I while I asked if I could move my feet slightly in the same direction they pushed my torso so I could feel more balanced. I can't remember what happened during the first X ray a year ago.

        Pooka - I saw a suggestion in Wendy Murdoch's book about quick fixes for rider position about putting a folded washcloth or narrow piece of dense foam under one seat bone to become more functionally straight so have been doing that lately. Not sure if it has made much difference though. My horse goes much straighter if I twist around to look at her tail while moving forward but it is quite disorienting to not be able to see where we're going.

        Cheers

        Silvercat

        Comment


        • #5
          Don't think you'll ever know for certain. 8 degrees is a lot of difference in terms of explaining it away by time of day. The next time you have xrays taken, be sure it's late afternoon.
          Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
          ---------------------------------------------------------------------------------------------------------------------------------------------------
          Surgery 2/10/93 A/P fusion T4-L3
          Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

          Comment


          • #6
            Originally posted by Silvercat View Post
            Pooka - I saw a suggestion in Wendy Murdoch's book about quick fixes for rider position about putting a folded washcloth or narrow piece of dense foam under one seat bone to become more functionally straight so have been doing that lately. Not sure if it has made much difference though. My horse goes much straighter if I twist around to look at her tail while moving forward but it is quite disorienting to not be able to see where we're going.
            Oh hey I bet that does work. You are trying to create a functionally neutrally spine in lieu of an actual neutral spine. I know of a very high level dressage rider with a moderate scoliosis so she is obviously achieving a functionally neutral spine. There is also a woman with a lumbar scoliosis at my barn. She has to pay attention to the imbalance and compensate but she does well if she does that. And then there is Sally Swift. :-)

            People without scoliosis are sometimes told to turn around to look at the tail. I have been told that at times. It works great to bring attention or an unconscious imbalance. People with normal spines probably can get as out of balance as people with scoliosis. Learning to ride is no cakewalk. It takes two lifetimes to learn as the saying goes. :-)
            Sharon, mother of identical twin girls with scoliosis

            No island of sanity.

            Question: What do you call alternative medicine that works?
            Answer: Medicine


            "We are all African."

            Comment


            • #7
              I once had X-rays taken a month apart that were 10 degrees different. The doctor explained it as difference in equipment, posture, time of day and just the margin of error in measurement. He said the first was probably 5 degrees better than reality and the second was 5 degrees worse than reality. That's why I use ballpark figures in my signature.

              Also, I did find that when my curve progression slowed down, my rotation sped up. So even though it looked like things were stabilizing on the X-rays, they actually weren't.
              age 48
              80* thoracolumbar; 40* thoracic
              Reduced to ~16* thoracolumbar; ~0* thoracic
              Surgery 3/14/12 with Dr. Lenke in St. Louis, T4 to S1 with pelvic fixation
              Broken rods 12/1/19; scheduled for revision fusion L1-L3-4 with Dr. Lenke 2/4/2020
              Not "confused" anymore, but don't know how to change my username.

              Comment


              • #8
                Oh, this is interesting. Just look at my signature to see why.

                I had x-rays done in 2005, 2010, and 2013. I was told at each one that they were 38*, 46*, and 42* respectively for the upper and worse curve. When I was told that it had progressed to 46*, I got a second opinion via mail/e-mail from another specialist who noted the very same progression. Now I just went to my surgeon last month with the most recent x-rays. He told me that they ALL measured at 42*. Yes, that's right, all three x-rays. Now if you look at anatomical "markers" like where my clavicles are in relation to the spine (collar bones) you can see a difference. You can also see progression in the lower curve. This curve was measured at 28*, 38*, and 35* respectively. However, the ROTATION of my spine has changed. My belly button is off center now an I can FEEL the rotation happening in the lumbar even though it looks great on film. My surgeon said, "Curves don't improve." I have been exercising over the last 8 months, so hope this is why the 5* improvement in the lower curve. But it could also be positioning and time of day. The technician this time around kept trying to "straighten" me out. I finally told her to leave me alone and quit trying to move my hips, as that hurt. I also noticed that when my surgeon measured the curves, he measured from facet joint to facet joint. The time before, he measured the endplates of the vertebral body. I noticed that the facet joints aren't completely parallel with the endplates. If you want to see what I'm talking about, go to the "non-surgical" section under the thread "I Have Some Imaging CD's".

                Yes, it's a mystery. I'm also 44 years old. Out of curiosity, let me know what you think.

                Thanks.
                Be happy!
                We don't know what tomorrow brings,
                but we are alive today!

                Comment


                • #9
                  I looked at your films and this is my untrained impression.

                  It looks as if in your newest film your curve has progressed in the sense of moving upward on your thoracic spine to include at least one more vertebra. Your shoulders are also uneven in your newest film. Finally, in your newest film, look at the distance between your spine and your heart. The gap there is larger. I don't know if any of this is relevant, but those are some subtle differences that I noticed.
                  Be happy!
                  We don't know what tomorrow brings,
                  but we are alive today!

                  Comment


                  • #10
                    Rohrer,

                    Just looking at your curve numbers, I wouldn't say you've had any definite progression since 1985. However, that doesn't account for your rotation or lower curve development. It seems like your case is one that should be considered for treatment because of pain, not progression. (Especially since the curves aren't necessarily in surgical territory.) Is the exercising helping the pain at all? Is it possible anything else is causing the pain? I have also heard of bracing to reduce pain. Have you ever asked about that? Have no idea if it works. You're in a difficult position. Have you gotten multiple opinions? I thought Linda said that surgeons were starting to look at correcting smaller curves based on pain. You have the polar opposite of what I did: small curves + pain vs. big curves + little pain. They both stink!

                    Evelyn
                    age 48
                    80* thoracolumbar; 40* thoracic
                    Reduced to ~16* thoracolumbar; ~0* thoracic
                    Surgery 3/14/12 with Dr. Lenke in St. Louis, T4 to S1 with pelvic fixation
                    Broken rods 12/1/19; scheduled for revision fusion L1-L3-4 with Dr. Lenke 2/4/2020
                    Not "confused" anymore, but don't know how to change my username.

                    Comment

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