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  • Double Major Curve

    I am a 51-year-old woman with a double major curve since adolescence and wore the Milwaukee brace as a teenager, no treatment since, no surgeries. I have no pain to speak of, but do notice the bottom curve more these days, I have a huge rib hump. Have had consults over the years where surgery on the entire double curve was recommended but I never wanted to have the surgery because of the fusing of practically the entire spine. A thought just popped into my head - it may be a stupid question, but I'll ask anyway - what if I had just the bottom curve operated on - I would get some height, the hump would be reduced - but is this feasible? Any thoughts would be very much appreciated! Thanks!

  • #2
    Hi Susan,

    I guess you could have just one of your curves fused. I had a double major curve as a child (I had infantile idiopathic scoliosis) and had surgery to fuse just the thoracic curve when I was 10. They left fusing the lumbar curve until I was 18, to give me some more time to grow.

    However, if you have a very large curves and have only one straightened, you could end up veering off to one side. Double major curves tend to balance each other out, so scoliosis is usually more noticeable cosmetically in someone with a single curve. I didn't have this problem when I had my thoracic curve fused because they were only able to straighten it to 45 degrees and my lumbar curve was a similar size (my top curve had been 76 degrees and was a very stiff infantile curve, and this was over 20 years ago when techniques weren't as good as today).

    Most people would agree that it is better to have one's thoracic region fused than one's lumbar region. We don't actually bend or twist our thoracic spines much compared to our lumbar spines, so you wouldn't notice much loss of flexibility. In addition, your rib hump would not decrease unless you had your thoracic spine operated upon; the ribs are attached to the thoracic vertebrae, and the rib hump is caused by those vertebrae rotating and curving out of line.

    You should gain a bit of height if you had either curve straigtened. I don't think you should fear having a long fusion though. I'm fused T1 -L4 and can do everything I want to do....including sit-ups! Having a long fusion has never caused me any problems.

    Good luck! I hope whatever you decide to do is the best option for you.

    Toni xx

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    • #3
      I'm fused T3 - L5 at 7 mths post op, now 48 yrs old. If you are seriously considering surgery, best take the advice of a surgeon you are confident with. I am delighted with results cosmetically - 2 ins taller, waist, STRAIGHT back. I think at our age, if you are going to do this, the length of the fusion is not a huge issue and it's best to take the advice of experienced surgeons. I wish you well.
      48 yr old female. 80° thoracolumber curve. Surgery Feb 14 2007. Fused T3 - L5. Correction to 23°. Happy!

      Comment


      • #4
        Dear Susan,

        Hi--I know what a scary thing having a long fusion can be. I also had (have) a double major s curve which was quickly progressing to 80 degrees and more pain and disability with it. I was also very scared about this surgery and read this forum for about 2 years before finally making the decision and finding a surgeon and getting it done.

        You should ask your surgeon the question about just having the bottom curve done. But I believe that when the surgery is done on a double curve, the goal is to equally balance the two curves with the correction which also gives you the best cosmetic improvement as well. My curves were 72 and 77 and they got them both down into the 30's which was a good correction for my age (47). Plus if you just one curve done and the other continued to progress (which they often do at our ages), you might end up having another surgery done anyways.

        Do you know about the scoliosis research website where you can find a good adult scoliosis doctor? It is www.srs.org and is a good place to find qualified surgeons.

        Deb
        age 48
        posterior surgery 7/24/06
        T5-L5

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        • #5
          Thanks to all.

          Just wanted to say thanks to all who responded..I appreciate hearing about your experiences. I have settled in mind the doctor I would plan to see in New York City, just have to make the appointment.

          Comment


          • #6
            Hi Susan-
            I had surgery last December with Dr. Boachie in New York. (I am 46) I had 2 very severe curves as well as kyphosis- I am very happy with the results and am recovering well. (I had a terrible rib hump which is now completely gone!) I think the doctor would be able to determine if partial fusion is possible- (for me it was not.) Good luck Susan!
            Cathie

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            • #7
              My sister, Linda, who just passed away, like myself, had double major curves. She only had to lumbar curve operated on and always wished that she had them both fused. There is a condition referred to as masking. The pain n one area can be so severe that it masks the pain in another area. I am having almost the entire spine fused. However, as you do not have pain, I would put it off as long as possible - until it was either causing severe pain or was interfering with your organ function. Just my 2 cents. Hope it helps.

              Ann
              44 year old female
              Surgery on Nov. 1, 2010
              Dr. Darrell Hanson, Methodist Hospital
              Posterior Only, 9 hours
              Presurgical: T 61 Degrees, L 58 degrees, with 15 degrees of thoracolumbar rotation
              Postsurgical: T 26, L 25

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              • #8
                Delay surgery until disabled

                I
                would put it off as long as possible - until it was either causing severe pain or was interfering with your organ function. Just my 2 cents. Hope it helps.
                houston curves

                Indications for surgery include progression not necessarily pain. I personally would not delay surgery until I was disabled by pain or organ dysfunction because you may not be able to have the organ function restored and the correction would be much less. Going into this marathon surgery requires the best condition possible. Waiting for the curves to be so severe subject the spinal cord to more stress during the straightening process, require larger areas to be fused, prolong the healing process and worsen complications.

                If curves are progressing in adulthood they will not stop on their own until stopped by a surgical intervention. These are the sad facts about scoliosis no matter what we would wish otherwise.

                There also comes a time when it is too late to intervene. Once pulmonary function has dropped below a certain point anesthesia becomes too dangerous. I was warned of this by members on another scoliosis forum for whom it was indeed too late and they needed oxygen 24/7

                However, one must be ready to undertake it.
                Original scoliosis surgery 1956 T-4 to L-2 ~100 degree thoracic (triple)curves at age 14. NO hardware-lost correction.
                Anterior/posterior revision T-4 to Sacrum in 2002, age 60, by Dr. Boachie-Adjei @Hospital for Special Surgery, NY = 50% correction

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                • #9
                  Ann, I have to agree with you on this one. Fusion of the entire spine is HUGE surgery and going into this when one is not experiencing any pain whatsoever in my opinion could be asking for trouble. Surgery is not a cure, and as we can see from many of the posts here, a favorable outcome is not always the end result. Furthermore, I would be wary of a surgeon who right off the bat recommends surgery for an older adult who presents with no history of pain. Perhaps the exception would be in the case of someone who has a severe thoracic curve. Then surgical intervention is probably better sooner rather than later.

                  Chris

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                  • #10
                    I don't disagree

                    I don;t disagree with your comments Karen. There are many personal and subjective facts that have to be taken into consideration when making a decision to have this surgery. For instance, I am in a LOT of pain and have been for a considerable period of time...it isn't getting any better, but worse. I am also progressing. So, I know I have to have the surgery,regardless of the fact that I do not want to. So, now my only "balances" on the scale are rate of progression - pain tolerance - and age. I would definitely opt to have this surgery when I am young enough to recover better and with fewer chances of complications. But I DON'T WANT the surgery, obviously. So, e only reason I have scheduled the surgery is my age, my pain and the fact that I will need it eventually and I know I will heal better at a younger age. So, I don't disagree. However, it is important to stress that there are major complications associated with surgery and you need to be mentally ready for it before you go into this. Make sure it is the right time for you based upon your own balancing of the facts. For me, personally, I am walking a thin rope and could topple to one side or the other before my surgery date. With the loss of my sister, it is just so hard to face now, but, again, this is another personal thing to factor into to a decision... I hope this helps.

                    Ann

                    Ann
                    44 year old female
                    Surgery on Nov. 1, 2010
                    Dr. Darrell Hanson, Methodist Hospital
                    Posterior Only, 9 hours
                    Presurgical: T 61 Degrees, L 58 degrees, with 15 degrees of thoracolumbar rotation
                    Postsurgical: T 26, L 25

                    Comment


                    • #11
                      Glad to see more info!!

                      Hi, I'm 43 years old, was diagnosed with scoliosis at 13, had fusion surgery at 14. I just joined this month, and was glad to find so many conversations from people in similar age groups and conditions. Though I see many of you had your surgeries just in recent years, while I had mine in my teens, and now in my 40s. As I read more, I'm becoming more concerned about my condition. Even though I already had surgery, and Never experienced any pains before or after, I've noticed just in past year or two that I do experience more tireness in my back. Though I don't see anything different when I look at my back in the mirror (with a hump on the right side). I did have x-rays done back in 1995 and 1997 when I joined a health club, and found out mine is a destroscoliosis of the thoracic spine measuring 45 degrees between T3 and T12. I said "found out" because when I had my surgery done I hardly spoke any English back then being that my family and I had just immigrated to this country. I have lots of questions - even having had surgery in my teens, would my curvature continue to increase? I am experiencing more tiring in my shoulders and back, particularly where my rib hump is on my right side. Of course, I don't know whether that's from working in front of a computer all day, or just age. And there are also times when I feel more strange "tiring" sensations in my abdominal/rib area where I sort of suspect it's because of my scoliosis?? Sorry for the long letter, and any feedbacks/comments/information would be much much appreciated!

                      Comment


                      • #12
                        I don't think any of us want to have this surgery, no matter what "degree" of pain or curves we have!!! I wasn't thrilled about it, but I knew that if I wanted to have any kind of future that didn't involve a wheelchair and eventually death, I had to make that decision.

                        I trusted my Doctor and I put my life in his hands. I am fused from T-1 to L-5, a longer fusion, and I'm glad I did at the age of 45. Shorter fusions are much easier to recover from, and I had a rough recovery, but I can't say it wasn't worth it.

                        I know it's a personal choice that is difficult to make, one that you can only make yourself. I am glad I did it sooner than later.

                        I just knew in my heart that I was only progressing for the worse.

                        Whatever path we choose, is the right one for each of us. Of course that's my opinion, but I can't find fault in anyone's decision one way or the other!!!

                        Shari

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