Six Week check up

[Pooka1]

Savannah had her six week check up with the surgeon today.

Pre-surgery Cobb Angle was 58*... more on this below. Her post surgery angle is 5*. Given the measurement is +/- 5*, I consider her spine straight. I could not see an angle on the film but it would be hard for anyone, especially someone not experienced in looking at these curves like myself, to see a small angle like that by eye. I can certainly believe he measured a 5* angle though.

She has little/no rotation or shoulder blade protrusion and what little is left of the latter will get even less as her muscles settle completely into their new position. That just blew me away.

I remarked that it is impossible now to know something is amiss with her if you weren't alerted to the fact that she had a a large angle with significant rotation. The surgeon said the instrumentation these days allows for very excellent de-rotation. I said I thought his spine artistry played a factor beyond the instrumentation. He said he didn't mind me calling him an artist. LOL.

The pre-surgery Cobb angle, 58*, surprised me. Here's her dates/curves:

25 Sep 07 - 29*
15 Jan 08 - 48*
24 Mar 08 - 58*

For the first interval, the curve moved 19 degree in 112 days or 0.17 degree/day.

For the second interval, the curve moved 10 degrees in 69 days or 0.15 degree/day.

Those are the same rates given the error bars at every point in this calculation.

I now understand why he said we couldn't wait. If we waited until school ended in mid-June, and if the curve continued to progress at that rate, she would be 71*(!) At that angle, I'm not sure she would have gotten the near-perfect correction that she did.

We had no time to waste as it turned out. I guess he knew it would continue to move at that rate when he said we couldn't wait.

I asked about the future and mentioned the comment from the HSS site that this was a "cure" for the short and middle term but it was unknown about the long term. He seemed to bristle at that and thought it would be good for longer than that as I understand his comments.

He said he will take her off all restrictions at 8 months. As advertised.

[Susie*Bee]

Yay for Savannah! That's great she's doing so super! :D

[Pooka1]

Thanks Susie.

I just hope that kids who are newly diagnosed can come on this site and read all the testimonials that folks are willing to type and have some hope that this is largely fixable in many, if not most, cases.

And I especially hope that somehow Savannah's story can help calm excessive fears some kids might have going into surgery. It's a tough time no doubt but in the case of most kids, it resolves pretty quickly. I wish that were true for the adult patients! I'm not actually clear why it is so different but it certainly seems so. Does it have to do with spine rigidity?

Anyway, thanks again.

sharon

[RugbyLaura]

Wow Sharon, that is fantastic news. How is Savannah doing now? I can't believe 6 weeks have passed already - where does the time go? Although I imagine that for you it's been the longest 6 weeks ever.

One question I have is regarding spinal flexibilty after fusion. I guess there will be some limitation... Have you asked the question (of course you have!) & what was the answer? Does Savannah dance or do anything else that requires flexibilty in the back?

I'm so pleased for you!

Laura x

[Snoopy]

Sharon,

That's awesome! Savannah's back must look so good. I too can't believe it has been six weeks already. Savannah still has a long way to go in her recovery, but she is well on her way.

Mary Lou

[Pooka1]

Wow Sharon, that is fantastic news. How is Savannah doing now? I can't believe 6 weeks have passed already - where does the time go? Although I imagine that for you it's been the longest 6 weeks ever.

Savannah is generally back to normal. But she was having pain daily in her upper back that I thought was near the top of the fusion. I was a bit worried that the junction between the fusion area and the non-fusion areas (T3-T4) was unstable or something. The surgeon palpated the area and said it was her muscles that had to adjust to the very different new position from the previous position.

The area central from her right shoulder blade was taking the brunt of the curve/rotation it seemed and she was having daily pain there for a few weeks before surgery. I think she was hoping that would go away after surgery but she still has it! At least now we know that it will resolve per the surgeon. She doesn't take anything for it but she often mentions it. Sometimes I ask and she will always say it is there.

One question I have is regarding spinal flexibility after fusion. I guess there will be some limitation... Have you asked the question (of course you have!) & what was the answer? Does Savannah dance or do anything else that requires flexibility in the back?

I'm so pleased for you!

Laura x

The fusion went into the lumbar one vertebra so I assume she has some limitation but she doesn't notice anything different yet. She dances only for fun.

And you'll be amused by this... I asked about the long-term limitations after she is off restrictions at 8 months. He said only bungee jumping and such. I idly asked if she could ride in case she became interested in riding again and he said absolutely. I didn't realize they let folks ride after this surgery. Maybe it even makes it easier to find and keep neutral spine! If surgeons were able to show that spinal fusion made riding correctly much easier, I might consider elective fusion. :eek: :D

Thanks for the good wishes.

sharon

[Pooka1]

Sharon,

That's awesome! Savannah's back must look so good. I too can't believe it has been six weeks already. Savannah still has a long way to go in her recovery, but she is well on her way.

Mary Lou

Thanks, Mary Lou. You're right about having a long road ahead. She won't be off restrictions until after Thanksgiving.

I can find asymmetry (in rotation, not curvature) because I know what to look for. But I doubt anyone else who doesn't know a thing about scoliosis would notice anything.

Savannah's concern was getting a good cosmetic result and halting the curve. My main concern is the long-term stability of the fused spine though I'm happy for her that she got a good cosmetic result.

I was also reading an article that was posted to this forum a few months ago about there being no difference in future lower back pain between large corrections to the angle and smaller corrections. So that suggests the surgeon didn't have to correct her back to near zero but any low angle would have been okay in the long term. If I understand that article correctly.

Furthermore, it isn't obvious to me that a fused spine might not be more stable over a longer period if it wasn't corrected to near zero. I see from some of the testimonials that some surgeons leave some curve. There may be a good reason, stability-wise, for doing that. Who knows.

Thanks again.

sharon