"Loss of growth" after spinal fusion?

[phaden]

My daughter has a double major curve -- 41T/36L and progressing fast. If she has to have the surgery, they'll probably have to fuse a lot of vertebrae.

However, at the moment she is only 4'10" tall (she'll be 13 in a couple of weeks and is the shortest in her class). Since her father and I are both tall (I'm 5'10", he's 6'+), we assume she's just a late grower, and would, under ordinary circumstances, end up a lot taller than she is now.

I understand that vertebrae that are fused don't continue to grow normally. So if she gets a lot of fusion, and she has a lot of growth left, what happens? Does she end up with real long arms and legs and a short body, or something?

Has anyone here had their fusion done when they were small and then grown? At the rate she's progressing, I don't see how we can wait until she achieves full growth at 16 or 17.

Thanks - Patricia

[Celia Vogel]

I hate to confirm your worst fears, but yes, your daughter's spine will stop growing once it's fused. I know it may not be a very attractive option for your daughter but, have you considered casting ? I read somewhere that the famous actress Renee Russo wore a cast as a teenager for two years. Look at her now, you wouldn't even know she had scoliosis. Casting will prevent the curve from getting any worse and at her age (depending on her flexibility) you might see some improvement !

There is also a new surgical procedure called the "Plate Rod Spinal System" which does not involve fusion. It involves only ONE operation. It's quite remarkable. You may want to read about it under the "Surgical Procedures" heading. You will need acrobat reader on your computer to access the full text at the bottom of the page.

Anyway, that's my 2 cents.




Celia

[Carmell]

Patricia,

No one can tell you how much your daughter will or will not grow, unless we know the growth pattern she's had up to now, what her bone maturity is, etc. There are generalities that exist, but may or may not apply in her situation.

Fusing the spine stops the vertical growth of the disks between the bone, but the bone will continue to grow in thickness. As a teenager, there isn't much "thickness" growth left in the bone, but there is a chance that the restriction of growth won't be as severe as it sounds. (I hope this makes sense).

I would make sure you get several opinions before jumping into a surgery. Watch the progression of her curves. Make sure the measurements are done accurately. Her numbers are at that borderline where there is not an exact right way to go. Ask the ortho about waiting until her body grows more, even if the curves progress more than they'd like to see. See how things go, don't jump to conclusions. Good luck and let us know how things go.

[Celia Vogel]

Carmell,

Normal growth of the spine varies according to age. In a healthy child, the longitudinal growth of the T1 to S1 spinal segment is 1.4 cm/year from birth to the age of 5. It is estimated to be 0.9 cm per year between the ages of five and ten years, but it increases to 1.2 cm/year from the age of 10 to 16 years. The average height of the T1 to S1 segment at maturity is 26.5 cm in women and 28 cm in men. It is my understanding that once a spine is fused it will not grow. Am I wrong ?

[Carmell]

Celia - your numbers are probably correct for a healthy spine. I was trying to explain that when a patient has fusion surgery, depending on the age, there may be some growth that is not accounted for. I only know this by watching my son who was fused (no instrumentation) at 11 months old. His fusion is T5-L1 - a pretty significant amount of the thoracic spine. The fusion involved disabling the growth plates and placing bone material as the fusion material to stop the progression of the curve. Over the years, his spine has not gotten straighter, but the bone mass has grown in thickness. His trunk is shorter than it would have been if he had a normal healthy spine, but the significant amount of restriction in the bone growth is less than we feared, thankfully. He still has quite a bit of growing to do. He will turn 9 this month. My point was that the growth plates are not the only part of the structure that grows. The actual bone itself can grow if the circumstances allow it. It grows in 3-dimensional thickness... I don't know how to explain what I'm trying to say... sorry.

[Celia Vogel]

Carmell,

I understand what you're saying. I wonder if fusion without instrumentation would be different than fusion with it ? Would the instrumentation further restrict growth of the spine ?

Considering Braydon's fusion surgery at such a young age, albeit without instrumentation, it is quite remarkable that he looks so well proportional. He really IS one remarkable kid !






Celia

[Carmell]

Thanks for your nice comments, Celia. I feel very blessed that Braydon's physical appearance is so good. Even his ortho says that his xrays and his physical appearance look like completely different people. He is very well-balanced and is pretty well proportioned.

I think what you said about instrumentation -vs- no instrumentation is correct. The instrumentation would further restrict any bone growth, but I have still been told there is some growth when very small children are fused at an early age. We'll see...

I hope all is well with you!

[MaryK]

I had my surgery at age 13 and my doc said it was possible that I would grow to 6 ft tall. Thankfully that didn't happen. From what my doc explained the portion not fused can continue to grow. It's not always true, but quite possible. I didn't grow at all after surgery.

[ellen]

i had my surgery last october at age 15 and im still growing i was like 5'5 before surgery and now im like a little over 5'7 and still growing....i think it just depens on what part of the spine is fused and how much. but autimatically after surgery you are taller because your spine isnt curved anymore, its straight so that adds height as well....any questions? just email me at LilCutiPie_07@yahoo.com buh-bye ~*ellen*

[Peggy]

My daughter grew 2 inches post surgery, 5'10, and the surgeon told her she still has about a year of growth yet. Her spine was fused from top to bottom.

[racin2win]

Hi Phaden,
Like most are saying on here, it depends on what's getting fused and where. I am 17, petite, and supposedly still have some growth plates left. I had my fusion a little over 6 months ago. Many, many children do grow post-surgery. I grew around an inch, inch and a half. When one's spine is so curved, you have got to envision how tall they would be if they were "straight." Taking that curve out with surgery--improves so much...posture, balance, etc. and I wouldn't be surprised if your daughter straightened out to be an inch taller or more after surgery, if you have the surgery done.
Take care :)

[Joe's Mom]

One thing I was told about growing, and this was before the kyphoscoliosis was even diagnosed in Joe, was that kids will continue to grow for two years after they have reached maximum foot growth. So once your child's feet have STOPPED growing, they will continue to gain in height for about 2 more years.

I was amazed to learn this! Had no idea about it! My son is a late bloomer/grower. His growth plate changes didn't begin until he was 13 1/2 - 14 and he is now 15 and his feet and height are still growing. A lot in the last 6 months and that is the period in which his spine condition is worsening. *sigh*

So one measurement you can look at is foot growth and when that stops you can guesstimate that about 2 more years of growth can be expected.