Dr Bridwell recommended surgery

[JanL]

I saw Dr Bridwell Monday and he did recommend surgery. He compared my standing A/P xray to an A/P xray lying on my back with someone holding my head steady and someone else pulling my feet. This was said to be done to estimated the correction. The numbers went from 60* to 47* thoracic and from 52* to 36* lumbar. That doesn't sem like much of a correction to me.
Has anyone heard of this method of estimating correction?? I have mostly heard of the "bending" xray, not the "stretching" xray.

Also, his nurse mentioned they would use "halo" traction at head and traction in legs to mimic that stretch during surgery. Has anyone else out there had this done??? How are the scars where the traction is placed???

Do you usually get more correction because of the derotation? His nurse told me they could not estimate the amount of rotation very well by xray. Is this why many get a better correction than first estimated???

Also, thought you may want to know that Dr Bridwell says with the advanced techniques in the last 5 yrs, the risk of non fusion is 5-8 %, a big improvement in his prior study showing 17%.

[tonibunny]

Hi Jan,

Back in 1986 I had halo-tibial traction to pull out my spine, following my anterior release and prior to my fusion surgery. I was ten years old and had a very stiff infantile curve which was difficult to straighten. I spent nearly three weeks in the traction, on a rotatable bed with increasing amounts of weight added every day, and it worked well - my 76 degree curve was reduced to 45 degrees with a Harrington Rod (modern instrumentation can give much better results as it allows the spine to be derotated as well as pulled straight).

I have heard of halo traction being employed just during surgery in the way that you describe, and although I would have thought that allowing the spine to stretch gently over time would allow for a better correction, I'm sure that this is a good way to pull it straight whilst the surgeon works.

The scars are nothing - I don't think mine are noticeable to anyone but myself. The ones on my forehead are tiny and I have to look hard to see them, and the ones on my ankles just look like gnat bites. Mind you, they are over 20 years old now!

I would totally expect your surgeon to be able to get you a better correction than he's suggesting, and it is surprising that he didn't do bending x-rays. Have you queried this with him? Maybe he has given a very conservative figure for the degree of correction so that you will think he's amazing when you end up with a far better correction, or maybe he doesn't want to raise your hopes and is giving the absolute worst case!

As I mentioned before, de-rotating the spine can make a massive difference to the amount of correction that can be acheived. I have no doubt that if I had had surgery today my thoracic curve would be a lot straighter as I had (and still have) a huge amount of rotation. I think my back looks amazing though and can't be anything but thankful for the treatment I had, which was the best at the time :-)

I think you need to write down a bunch of questions in a notebook, then go to your surgeon and get him to answer each one. Good luck!