Moderate scoliosis, big rib hump

[PyCy]

Hi, I was recently diagnosed with a relatively moderate 30 degree curve. However my rib hump is pretty huge.
Isnt it typical to get a large rib hump only after significant scoliosis? i'm sorry i am new to scoliosis, and dont have alot of info yet.

[LindaRacine]

PyCy...

The size of our rib humps is based on how much rotation there is in the thoracic vertebrae. Your rib hump could be larger than one would expect for a 30 degree curve, but I have to tell you that when it's your own hump, it always feels huge. :-)

Regards,
Linda

[lrmb]

Hi PyCy...

My upper curve is around 49, but the low one is about the same as you; recently I've noticed the rib area around both becoming more pronounced. I can tell because my clothes fit differently. At my most recent surgeon's appointment they measured the rotation - first time ever! I think he said it was 20. 20%? This was one thing I forgot to write down... Is this big, does anybody know?

Also, can somebody tell me, when they do fusion surgery do they also correct the rotation of the vertebrae?

Few last questions. Are the net results of rotation and kyphosis the same? Is kyphosis front-to-back scoliosis? My low spine seems to me to curve forward quite a bit, and I was wondering recently why no surgeon had ever commented on it. Does scoliosis exaggerate the normal front-to-back curves throughout the spine??

Any info most welcome. I tried to figure this out online but it still eludes me...

Thanks!!
Laura

[LindaRacine]

Hi Laura...

I think that rib rotation is measured in degrees (by scoliometer) or by the pedicle method which grades how far from the midline each pedicle sits. (The range for the pedicle method is + to ++++.) There may be other methods of well, but I think those are the only two I've ever heard of.

Regards,
Linda

[Mary Lou]

Hi Laura,

I am not an expert, but let me try and explain some of this to you. My daughter has Kyphoscoliosis, which means she has both Kyphosis and Scoliosis. Kyphosis is more of a front to back curve which we all have to some degree--Jamie's Kyphosis before surgery was severe or maybe a better word is exaggerated. She also has Scoliosis which is the side to side curve. She did have some rotation before surgery. Her surgeon ordered a CAT or CT scan plus an MRI and they used them partly to look at her pedicles and like Linda said, I think that is how they determined the amount of rotation. Some people have just Scoliosis and some have just Kyphosis and some like Jamie, have both. I hope this helps explain things a little bit for you.

Mary Lou

[Jonny]

I also had a large rib hump for a 30 degree thoracic curve:http://img.photobucket.com/albums/v12/jonajsil/20-01-04_01-23-02.jpg

My larger curve was lumbar and at 53 degrees, so both curves were fused, and the surgeon decided that there was still enough rotation to perform a thoracoplasty on the rib hump, even though the 30 degree curve was brought down to very little (under 15 degrees).

[lrmb]

Thanks Linda and MaryLou!!

Talking about pedicles, I seem to remember some diagrams in Dave W's book, so I will go review that as well.

Thanks again!
Laura

[cowprintrabbit]

Also, can somebody tell me, when they do fusion surgery do they also correct the rotation of the vertebrae?

Laura

What she said ;)

Also, will being fused T3-L3 correct my kyphosis? It's not affecting my health, but every time I catch a glimpse of myself in a store mirror or a plate glass window; I look like my 63-year-old mother.

[LindaRacine]

Also, can somebody tell me, when they do fusion surgery do they also correct the rotation of the vertebrae?

Laura, it's difficult to explain, but I'll give it a try. In posterior scoliosis surgery, before being placed rods are bent to the approximate desired amount of kyphosis or lordosis. The rods are attached to the spine (usually with hooks or screws). Then, the rods are rotated 90 degrees. So as the spine straightens, it also derotates.

You can find an animation of the procedure here:

http://www.understandspinesurgery.com/


Click on Understand the Procedures, enter your ZIP code (use 94108 if yours doesn't work), click on a surgeon's name, click on Patient Education, enter your email address and click on I Agree. When the animation starts, click on Spine, then Scoliosis, then Derotation with Instrumentation



Few last questions. Are the net results of rotation and kyphosis the same? Is kyphosis front-to-back scoliosis?


Kyphosis is the normal front to back curve at the top of the spine. If the curve is larger than about 50 degrees, it's considered abnormal kyphosis. It sometimes goes along with scoliosis (in which case it's called kyphoscoliosis), but most people with scoliosis have normal kyphosis.



My low spine seems to me to curve forward quite a bit, and I was wondering recently why no surgeon had ever commented on it. Does scoliosis exaggerate the normal front-to-back curves throughout the spine??


The curve in the lower back is lordosis. Normal lordosis is about 30-70 degrees. If you have more than 70 degrees of lordosis, I believe you would have abnormal lordosis. If you have less than 30 degrees of lordosis, you would have flatback.

Regards,
Linda

[lrmb]

Hi Linda,

Thanks for the info... I understand the procedure on the whole a lot better now. That web visualization stuff is amazing. Made me feel a bit queasy, but completely amazing to think they can actually do all of it :)

Thanks again!
Laura

[lrmb]

By the way, does anybody know if the people at UCSF are involved in total disk replacement trials? Any experience of those??

Laura

[LindaRacine]

Hi Laura...

They were part of the Charite trial (which is completed) and are now participating in the ProDisc trial. They're also participating in the ProDisc-C trial for the cervical spine.

Regards,
Linda