Sacrum vs. illium

[Singer]

Here's a question: what's the difference between fusing to the sacrum and fusing to the illium? Am I right in assuming the illium is further down the pelvis?

Thanks...

[LindaRacine]

Hi Chris...

Actually, the ilium is several inches off to the outside of the sacrum:

http://www.hughston.com/hha/b.frntsac.jpg

Regards,
Linda

[structural75]

Hi Chris,

Actually, the sacrum articulates with the ilium (SI Joints, sacroiliac joints). It is literally attached to the sacrum via dense fibrous tissue in one half of the joint, and a gliding surface in approx. the other half. It's not several inches away, but mere fractions of a millimeter away. If the sacrum is fused you will probably still have slight mobility in the SI joints (albeit the mobility is minor to begin with... 1 - 4 degrees axial rotation, 1 - 3 millimeters translational). If they fuse the ilium it will effectively make the sacrum and ilium essentially one single component, thus no articulation at the SI joints. Articulation of the lower spine and pelvis would then take place entirely via the hip joints (femur in the acetabulum).

The sacrum is the next spinal segment below your 5th lumbar vertabrae. The ilium meets the sacrum on the left and right and extends upward alongside L5 and L4. There are ligaments attaching all of these boney structures to one another.

Structural75

[LindaRacine]

I should have stated that screws into the ilium are several inches away from screws in the sacrum. I was thinking of implant attachement and not anatomy. I need not worry, however, since Structural is always there with his textbook to correct me.

--Linda

[structural75]

Linda,

Please don't take offense now. I simply answered his question.

And by the way, my responses are always impromptu, no textbook required. It's prerequisite knowledge in my profession. I've done my homework too. A good anatomy atlas is always useful nonetheless.


Kindly,
Structural

[Shari]

Hi Structural,

No offense, but if you had really "done your homework" and had a such a "good anatomy atlas", I would think that you would know that he (Chris), is a she.

I read some of your other posts and clicked on to your website. It only made me wonder why my spine looked almost exactly like my Aunt's did when she was 40 and I was 12. Mine progressed and her's didn't, and I was physically active up until my surgery, and she never was.

I remember back in the early 70's, when I was diagnosed, and the research back then claimed that one of the reasons, among many others, for my condition could have been "weak back muscles". For me that was a joke!

I realize that you are an educated person, but do you have scoliosis??? Or are your responses connected to your profession???

I hope that your research and practice can help some people, but I also hope that you know that it can not help all of us. Does anyone really know why some of us progress and other's don't.

I personally am not convinced that there is one perfect solution to our condition. But I applaud your efforts to try and find one!!!

And by the way, my response was impromptu, no textbook required either.
It's comes from the knowledge of having scloiosis.

Shari

[Singer]

Thanks all. I suppose I can conclude in layman's terms that being fused to the ilium would be a much tougher recovery than being fused to the sacrum! At this point it looks as though I will either be fused to L5 or to the sacrum, but I wasn't sure if the sacrum and the ilium were the same thing.

Thanks for the gender correction Shari, but unless I call myself "Christine" I can't expect people to know right off the bat that I'm a she.....

[structural75]

Sheri,

Sorry for the honest mistake in Chris's gender. I'm thankful she's more forgiving than you. Besides, how in the world would an atlas help me determine Chris's gender??? That was the second uneccessary biting remark towards me on this thread (and more was to follow)!

Would someone please tell what was so effensive about my reply to Chris's question. I believe it was quite direct, and possibly more technical than expected, but what is the harm in learning something about our bodies. Sheri, what seems to be the problem? It was Linda who in fact added the biting remark towards me on this thread.

And Sheri, I don't recall speaking to Chris about my profession or its applicability in her situation.???

Yes, I had ideopathic scoliosis - 27 degrees, now about 2 or 3 degrees for the past 15 years (stabilized). And of course my responses are informed by; 1. my previous scoliosis 2. my profession 3. my clinical experience working with people both with and without scoliosis. But I don't believe I was suggesting 'my work' was the answer to everything, I can tell you quite comfortably it's not.

I also have never said anything about "weak muscles" being the cause of scoliosis. If there are weak muscles present in a situation, as determined by electromyographic testing, it is the result of a dysfunction of the autonomic nervous system which regulates muscular tonus. Central nervous system dysfunction is considered, by Doctors/Scientist, to be one potential causative factor in ideopathic scoliosis. Those qualified experts will continue on with their research and hopefully it will shed some light on the matter.

As for your Aunt and yourself, that kind of discrepency in progressions is common... I don't have the answers as to why that is... And I don't recall attempting to give one. I think it goes to show just how unique each of us are. We might all be human, but how each of our bodies responds to any given situation will be different. It's similar to why two people incurring a minor whiplash can have drastically different reactions/consequences. One may have little or no pain, the other may end up with serious restrictions/problems. There are an infinite number of variables involved in life, the human body and it's physiologic processes. I'm sorry, I can't tell you why, but I can say that we are not the 'soft machines' that we're often treated as.

Best to you,

structural

[LindaRacine]

Hi Chris...

Although iliac bolts are often painful at the head of the bolts, from what I can tell, I don't think there's all that much difference between sacral screws and iliac bolts. It's really just a different fixation point. From what I've heard, there are pluses and minuses for both.

You can see an xray where both sacral and iliac screws were used in Figure 2 here:

http://www.medscape.com/viewarticle/545049_4

Regards,
Linda

[Shari]

Hi Structural,

I have to apologize for my rudeness!!! I can only speak for myself, in regard to why I got defensive, and it is not an excuse because there is no excuse.

Over the last couple of years, this forum has saved me in many ways. It's been a comfort zone with knowledge, support and understanding.

Every once in awhile there has been someone join here that tries to convince us that surgery is not the only answer. And I unfairly assumed that you may be another one.

If there would have been any other solution for me other than surgery, I would rather that have been the case, but it wasn't. I am all for finding a reason, a cure or other solution to this condition for other people in the future. And I commend all the medical professionals that perform this difficult surgery and all that are dedicating their time for a different answer!!!

I'm here on this First-time-surgery section, because of the support I have gotten and the support I can give to anyone one that is about to have this surgery and those that have had it.

Sorry I got defensive,
Shari

[structural75]

Hi Shari,

Apology accepted... no worries! Thanks for the sincerity and honesty behind your words.

I suspect that you're not alone in having those feelings towards 'strangers' who present themselves on this forum with less commonly heard of approaches (Given your situations, it's understandable to me why you might react that way). You're certainly not the only person who's come after my suggestions, comments, or ideas without fully understanding my intent. I hope that some previous 'dialogue' I've had with others has helped to clarify all of that.

And just for the record, I would like to repeat once again that I'm in no way against surgical corrections, bracing devices, etc.. Nor do I believe there is, or ever will be, "one perfect solution to our condition".

In my efforts, and those of other medical professionals, we seek to gain a greater understanding of the 'potential' causes in an effort to enhance the effectiveness of all forms of corrective treatments. I think that both surgical and non-surgical approaches alike would prove more effective, longer-lasting and involve less complications if we are able to address some of the underlaying etiologies of each individual case. For instance, using a brace can be quite effective at minimizing or even reducing the rate of progression. If we could add to that some adjunct therapies/treatments that aim to remove some of the obstacles that lay in the path of growth, then we'll surely get even better results.

I'll keep working on my end of things, as others keep working on their end. Hopefully we can continue to meet somewhere in the middle and exchange our findings/ideas/experiences to keep this boat moving forward.

I too have great admiration for the talented surgeons who are performing these procedures and making a difference in people's lives. Just as I admire those of you who have been through it and care enough to share your experiences and encouragement with everyone.

All the Best,
Structural75

[Shari]

Hi Sructural,

Now that I have become aware of some of your other posts in the Non-surgerical section of this forum, I feel the need to retract my apology!!! I usually trust my first impression, but I thought I had made a mistake in your case. Now I'm not so sure!!!

You have criticized several people for expressing their opinions, and taken offense when they have done the same to you. You have also mentioned, the editing of posts, which you have also done here.

I have and still find it interesting, that you find the need to be so technical about certain things, in a way that you appear to be condesending yourself. Yet the terms that we are all well aware of, you explain to us, for example MRI. We've all had one and know what it is.

And if your profession is guided by the desire to truly help us, you can't possibly be so incompassionate to those of us that are experiencing the difficulties of having scoliosis and all the problems that come with this condition, that you can't see that we may be a little defensive, especially when you join a forum where those of us that have been here for a while, and feel that our main purpose is to comfort and support each other.

I honestly feel that if you think you have a "breakthrough" possible solution to our condition, many of us would be more than elated for the future generations that may benefit from it. But just for my curiosity, would you be willing to explain it in much more laymen terms???

I'm still not quite sure what your profession is, and would love to know!!! Where do you work from and what exactly can you do for anyone that has not already had the surgery??? Just curious!!!

Shari

[Joan50]

How did your curve go from 27 to 2 or 3 degrees?

Structural,

Exactly how did your curve go from 27 (you refer to it as your "previous scoliosis" to 2 or 3 degrees "stablized." Just tell us how it was corrected if it was not surgery.

Joan

[structural75]

Shari,

I'm sorry you feel that way about me. I don't know if you read all of the posts you were refering to or not. They all seem to start with me making a simple benign statement as the one on this thread (my very first post), and then folks come at me with insulting, sarcastic or denigrating remarks. I haven't criticized anyone for expressing their opinions unless their opinions contained personal remarks about me. Wouldn't you be offended by that as well?

And I don't recall ever explaining what an MRI is.??? Could you please show me where I did that. As you said, why would I do such a thing on a forum where everyone knows what it is? I apologize for using technical language.. it's force of habit, a subconscious part of my vocabulary that I have a difficult time putting aside. I thought my first post on this thread was helpful, was it not? How would you like me to speak? I mean Linda attached a picture of the pelvis, how come you didn't see that as "technical"? ...I thought it was very helpful.

I'm a certified and licensed Structural Integration and Visceral Manipulation Practitioner. For the sake of keeping this post from getting too long, you can find info on it through the following links.

www.theiasi.org
www.rolfdoc.com
www.rolfguild.org
www.rolf.org

Yes, it has helped people with scoliosis... but no, it is not a 'miracle cure' or a "breakthrough". It has been around for about 50 years now and the Dr. who created this approach to working with the human structure developed it, in part, to help her son who had scoliosis. It has reduced, eliminated, stopped progression and proven unsucessful in varying cases. For those exploring non-surgical options prior to surgery or progression and in combination with M.D. supervision, bracing, etc, it is often worth the time and effort... and will not drag people along for months or years before knowing otherwise. Treatment is not indefinite... it is usually done in relatively short and intensive periods of time. Everyone's case is different... it will not 'fix' a structural scoliosis. If you would sincerely like an explanation of it, I'd be happy to post again.

I maintain a private practice... .

Hope all of that helps to clarfiy things.

structural

[structural75]

Joan,

Am I on trial here? Who is "us"?

My curve was corrected using Structural Integration. I had no way of knowing beforehand if my body would respond that dramatically, but it did. That was 15 years ago, the curve has never returned or worsened since. ("stabilized")

structural