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  • Spine Rotation Question

    I'm starting to think my rotation is opposite of what it "should" be...

    I have a 20-25 left lumbar curve (by left I mean if I bend over and you look at my back you would see a "c" or that the convex side is my left side and concave is my right).

    Anyways, from what I have read it looks as though the rotation is normally on the convex side... which would mean I would have the rib hump on my right side and the left ribs would bulge in the front. I've also read that the convex side is the compressed side meaning the ribs would be more constricted.

    But, in my case, my left side is where I have the rib hump, my right ribs stick out furter (in the front) than my left. And my right ribs are more compressed. By compressed I mean I have about 3 fingers space between my last rib and hip on the left side and about 4 or 5 fingers space between my last rib and hip on the right side.

    This makes me think if I follow the "normal" exercises and stretches I'll be doing the opposite of what I really need.

    Can anyone give me advice on this or explain why this might be? I've been told by my specialist that my rotation is much worse than my curve. The part that worries me the most about my scoliosis is that I don't have much space between my ribs and hips. At times stretching or exercises the left rib gets caught on my left hip. I feel like my stomach is compressed to a smaller area because of it...

    Sorry for such a long post I'm just thoroughly confused and because my curve is so minor most doctors won't bother to explain things more since its not "severe" enough.

    Any advice/info/similar experiences would be greatly appreciated.

    Thank you,

  • #2
    K - here's more confusion. (When I think too hard, I confuse myself, so if I'm wrong, someone let me know.)

    http://www.iscoliosis.com/symptoms.html

    This is a photo of a boy doing the forward bend test. His main thoracic curve is convex (larger side) on the right, and concave (caved-in, smaller) on the left. You described your back as different, unless you are talking about viewing your body from the front... its very confusing anyway.

    This is the most common idiopathic scoliosis position. If you have a curve that is opposite this (convex to the left and concave to the right, like my Braydon) that is more unique, and sometimes can have underlying medical issues in addition to scoliosis. Many times, its just the way the spine curve - right or left.

    A rib hump on the back is typically on the convex side of the curve, because those ribs are being rotated in an unnatural position. That side of the ribs pokes out, while the other side often sinks in. The spine is attached to the ribs, and when the spine rotates, the ribs have to go somewhere. Rotation is sometimes more reason to have corrective surgery than "just" a curved spine, because of the invasiveness to the chest and organs. If you look at this patient's xray below his photo, his curves don't look too impressive/bad. But his rotation is significant by the fact that his body is asymmetric.

    You mentioned that you have a lumbar curve. My daughter has a lumbar curve of about 35 degrees (she's 21yrs old). She has not had surgical intervention for her scoliosis. Her waist is very asymmetric. Her ortho says her xrays don't look like they are from the same patient. She has a more visible deformity (don't like that word) than most who have this same degree of lumbar curve. He also told her that a lumbar curve of less than 40 degrees at skeletal maturity means she is no more likely to progress than the average non-scoliosis patient on the street. I hope he's right. I don't know where his stats came from.

    You need to discuss these specifics with your doc. Only your ortho can address the specifics of your case. If you curve is less than 30 degrees, you must be very short waisted to have your ribs touching your hips in a standing position (maybe you mean when you bend to exercise?). My daughter is fairly long wasted and has never complained that her ribs touch her hips... Good luck.
    Carmell
    mom to Kara, idiopathic scoliosis, Blake 19, GERD and Braydon 14, VACTERL, GERD, DGE, VEPTR #137, thoracic insufficiency, rib anomalies, congenital scoliosis, missing coccyx, fatty filum/TC, anal stenosis, horseshoe kidney, dbl ureter in left kidney, ureterocele, kidney reflux, neurogenic bladder, bilateral hip dysplasia, right leg/foot dyplasia, tibial torsion, clubfoot with 8 toes, pes cavus, single umblilical artery, etc. http://carmellb-ivil.tripod.com/myfamily/

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    • #3
      Is it typical/usual to be that short waisted though or could that be a side-effect of the scoliosis?

      I find it strage my ribs have rotated so much since my curve is only lumbar. My physical appearance/showing of the curve is much worse than the x-ray measures out to be.

      I'm slowly becoming more and more irritated with doctors. It seems as though they don't want to hear my case or answer my questions or get into specifics. I get an attitude from them like scoliosis shouldn't cause pain, your spine is in worse shape than other people your age, but its not as bad as it could be so be happy and forget about it.

      I still believe mine was caused by a bad accident I had around age 12. I'm leaning towards alternative treatments but am first trying to get the bank account to back them. My next step is rolfing and a structured yoga/pilates practice instead of doing it once in awhile.

      Thank you for the response,

      Comment


      • #4
        This is strictly my opinion from observation, and not scientific evidence...

        The stereotype teenage scoliosis patient is usually tall and thin with loose ligaments, leading to larger gaps in the disc space between the vertebrae. When the growth plates do not grow evenly (for whatever reason) scoliosis occurs. My daughter is 5'7" (not too tall) and has a long body. My own body is opposite - I have a short, yet sturdy, torso. There are many variables that play into having scoliosis. This is just one of the many things.

        Have you had a full spine MRI? Are you seeing a scoliosis specialist? Have you gotten more than one opinion about your scoliosis and potential issues related to scoliosis? If your curve is a lumbar curve in the 20s, on paper, you should not have pain that affects your daily life. There may be something else going on. Has anyone told you if you have any abnormalities in the makeup of your spine? Do you have any other medical conditions that may complicate the spine issues? So many questions...

        It's not too strange that your ribs have rotated with a lumbar curve. Remember that the ribs are attached, and when the spine rotates and/or curves, they have to go somewhere. Honestly, I don't believe an accident "caused" your scoliosis, but I would certainly be looking at any disc damage or something that may be causing chronic pain possibly from an accident. If you've had an MRI, has a neurologist or neurosurgeon looked at the images? Was there obvious damage to your back during the accident? If so, where along your spine was the damage? There are probably many more questions you should be asking.

        Are you in S. Ca? I saw that you mentioned a few scoliosis specialists in that area. Have you contacted the San Diego chapter of the Scoliosis Association's support groups? Their website is: http://sdscoliosis.com They may be able to give you local information.

        My daughter has been told (and has learned from experience) that staying physically fit is the best form of "therapy" for her back pain and scoliosis. Strengthening the obliques and abdominal muscles support your back/spine. Unless there is a medical reason not to exercise regularly (including dancing, sports, etc.) this may help your daily pain be reduced some. Good luck.
        Last edited by Carmell; 12-20-2007, 04:52 PM.
        Carmell
        mom to Kara, idiopathic scoliosis, Blake 19, GERD and Braydon 14, VACTERL, GERD, DGE, VEPTR #137, thoracic insufficiency, rib anomalies, congenital scoliosis, missing coccyx, fatty filum/TC, anal stenosis, horseshoe kidney, dbl ureter in left kidney, ureterocele, kidney reflux, neurogenic bladder, bilateral hip dysplasia, right leg/foot dyplasia, tibial torsion, clubfoot with 8 toes, pes cavus, single umblilical artery, etc. http://carmellb-ivil.tripod.com/myfamily/

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        • #5
          I have seen quite a few specialists- all have the same response- stay healthy don't smoke and we'll watch it.

          I had my 2nd MRI done last year. The results: L? or S? is degenerative, the 2nd and 3rd cervical discs naturally fuzed together and thats about it. The curve measured based on the MRI was worse than the one measured by the xray.

          I do live in SoCal and saw Dr. Bhatia. He came highly recommended and is closer to me than San Diego.

          I don't think the accident directly caused the scoliosis but I think the reaction my muscles had to the trauma caused an imbalance and as my spine was still growing it pulled it out of place. If only I really wanted to be a Dr. I could spend time and money researching it on my own instead of basing my opinion on other research (as all of it seems to contradict each other).

          Thats an interesting observation you stated about scoli patients. I too am tall and skinny (about 5'8/5'9).

          I want to see more doctors and get more opinions but I have to wait until college is over and I get benefits from whatever company I go to work for. I tried applying for coverage as an individual and got denied because of my history with scoliosis even though every doctor would tell them they would never even consider surgery on my spine- but thats a whole other rant I don't want to get started on.

          Thank you again for the information and advice. Hopefully I can schedule an appointment down in SD this summer and get more of my questions answered or get a 2nd opinion.

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          • #6
            Originally posted by Carmell
            This is strictly my opinion from observation, and not scientific evidence...

            The stereotype teenage scoliosis patient is usually tall and thin with loose ligaments, leading to larger gaps in the disc space between the vertebrae. When the growth plates do not grow evenly (for whatever reason) scoliosis occurs. My daughter is 5'7" (not too tall) and has a long body. My own body is opposite - I have a short, yet sturdy, torso. There are many variables that play into having scoliosis. This is just one of the many things. .
            I know what you're saying Carmell, but I got a big, much needed chuckle ;-).

            I'm thinly athletic, 5'2" (pre-surgery... and I don't think I've grown since 5th grade - LOL). Although I don't appear short-waisted (a current pic), I actually wear a 31-32" inseam (very odd for my height).

            I'm also linking to this pic to demonstrate how well a 53° curve can hide on some people. Who knows why.

            My daughter, who has a ~slight~ AIS lumbar curve, is barely 4'11" - and built like a linebacker.

            (and no one ever accused me - or Larra - of being typical *anything*, so it all fits, I suppose ;-)

            Best regards,
            Pam
            Fusion is NOT the end of the world.
            AIDS Walk Houston 2008 5K @ 33 days post op!


            41, dx'd JIS & Boston braced @ 10
            Pre-op ±53°, Post-op < 20°
            Fused 2/5/08, T4-L1 ... Darrell S. Hanson, Houston


            VIEW MY X-RAYS
            EMAIL ME

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            • #7
              to the txmarinemom-

              are you having surgery now due to pain? i''m wondering about my daughter's prognosis. she is almost 14 and has 47' and 48' curves. she is 5'10" and thin- i have her wearing the cheneau brace and have NO plans for surgery but know that she may decide as an adult to have it.. is this what you've done?
              thanks for the opinion.

              Comment


              • #8
                Originally posted by scoliomom
                to the txmarinemom-

                are you having surgery now due to pain? i''m wondering about my daughter's prognosis. she is almost 14 and has 47' and 48' curves. she is 5'10" and thin- i have her wearing the cheneau brace and have NO plans for surgery but know that she may decide as an adult to have it.. is this what you've done?
                thanks for the opinion.
                The only reason I'm having surgery is because of pain that can't be lessened (and is increasing) by either traditional/non-traditional treatment.

                I think I've tried almost everything: Exercise, meds, medial branch rhizotomies (4, I think), Botox injections into knotted muscles, facet joint injections, myofascial release, acupuncture, rolfing ... you name it, chances are, I have the t-shirt. That's not to say one or ALL of the above aren't efficient means of pain relief for many ... just not effective for me.

                My curve has not progressed since about age 17.

                I wore a Boston brace as an adolescent. My surgeon agrees with my suspicion I am techically JIS vs. AIS; my curve was diagnosed at ±35° about age 10-1/2 ... and was most likely there for some time prior to age 10. I haven't *grown* much since 10 years of age, so there was never really a growth spurt to make it obvious - and even now (from outward appearances) it's barely visible.

                My son (20) arrived home on leave from the Marines Saturday. He saw my x-rays and was FLOORED. My daughter (18) had the exact same response. My mother, my brother, my best friends - and even my ex - were even more shocked.

                *I* see it clearly, but I FEEL it 1000x more.

                Regards,
                Pam
                Fusion is NOT the end of the world.
                AIDS Walk Houston 2008 5K @ 33 days post op!


                41, dx'd JIS & Boston braced @ 10
                Pre-op ±53°, Post-op < 20°
                Fused 2/5/08, T4-L1 ... Darrell S. Hanson, Houston


                VIEW MY X-RAYS
                EMAIL ME

                Comment


                • #9
                  thanks for the response!! good luck !

                  Comment


                  • #10
                    New and having surgery for possible revision due to 1965,Harrington rods and fusion

                    Hi! I am so glad to be able to talk to yall(I was born and raised in Texas City, Texas) now I live in the middle of Alaska and love the cold(-14*). Lets get started: I had my first surgery in 1965 it was done by Dr. Paul Harrington(yes the same)in Houston,Tx. I had Harrington rods and fusion(I do not remimber the right word to explain)Pre-op top 43* and Lumbar 28*,Post -op top 12* Lumbar0*. It was soch a tramatic Surgery for me to go through I never did follow-up after the first year post-op. In 2002 I had lamminectomy L3-4+L4-5. I could not walk due to permanent muscle spasms.Post-op I was up and off and going the day of the surgery ,and was releised the next day(My friend went out to eat straight from the hospital)not good to do. Now at 57yrs. my main is PAIN from my neck down to my tush,I can really say I have a pain in my tush(saying it nicely).I have had to go to Seattle,Wa. to find good doctors we do not have many specialist in Alaska. I have seen Dr.Hillard a neurologist and she said the surgery would be more than she woul want to tackel alone so she want me to see a bone specialist also . On Jan.9,08 I will see Dr.Lee who is part of a med-group which has another doctor in it who specializes in adult scoliosis so I may ask if I can switch to him. I have learned so much from reading what yall have been saying, Thanks for letting me listen in. I am not sure if I am in the right place so if I am not sorry. I have seen my flims and it is amazing how my spine has twisted and curved in odd directions even though it is still connected to the Harrington rods and everything not connected to the rods is so degenerated so bad it is ucky looking. Sorry this is so long I don't know where to start. If anyone has information to help me make the right choices I will gladly except them. Thank You Again.
                    Last edited by Alma in Alaska; 12-26-2007, 06:34 PM. Reason: I am not sure if I am in the right so if I am not,sorry

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                    • #11
                      Galv. Cty. Memorial Hospital ...

                      Alma - this is bizarre ... we grew up less than 20 minutes away - and both my son and I were born in the SAME (*only* one in Texas City) hospital ...

                      Same doctor delivered both me *and* my son ... only the name of the hospital had changed ...

                      Pam
                      Fusion is NOT the end of the world.
                      AIDS Walk Houston 2008 5K @ 33 days post op!


                      41, dx'd JIS & Boston braced @ 10
                      Pre-op ±53°, Post-op < 20°
                      Fused 2/5/08, T4-L1 ... Darrell S. Hanson, Houston


                      VIEW MY X-RAYS
                      EMAIL ME

                      Comment


                      • #12
                        rotation more visible than curve

                        I was glad to see this thread. My daughter was diagnosed with scoliosis at 12 yrs old she is now almost 18. She has an almost 30 degree curve which has not caused her pain or very many problems at all. But over the past 2 years the rotation in her spine has been considerable. And at her check ups her doctor only talks about the degree curve which is a lower lumbar curve which was caused from a stress fracture from gymnastics. But her curve has not changed in 4 years. But her hump and gotten terrible. It is very visible even under clothes. So the doctor does not recommend surgery and I do not want her to have surgery but what can be done about the rotation anything!!
                        Or are there any exercises which can help the rotation??
                        Denise

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