lordoscoliosis x-rays

[scoliboymom]

Today is the one year anniversary for my son's surgery and he's doing great. Hurray!!!
I know there are a few others out there who have been told they have lordoscoliosis so I wanted to share my son's x-rays as there is so little mentioned here on this forum or in the literature that I have seen. Could be that it is more common then I realize and maybe not that note worthy. But could be of interest to some. Unfortunately I didn't have any "good" presurgery x-rays but my thinking is that there was not a significant decrease in the lordosis after surgery.
I can't seem to find any other sideview x-rays post-surgery on this forum. If anyone can refer me to some I'd really appreciate it.

Just as an aside his surgeon said that because of the lordosis he would never have been a good candidate for bracing because the brace would have pushed the spine into an even bigger lordosis position. That is to say it would have pushed his spine more into his chest cavity.

Zoomed Lordosis Picture (http://s283.photobucket.com/albums/kk307/scoliboymom/?action=view&current=Sideviewrods.jpg)
Unzoomed Lordosis Picture (http://s283.photobucket.com/albums/kk307/scoliboymom/?action=view&current=sideviewrods2.jpg)

[terri watkins]

Thank you so much for your input on lordosis. My son was braced for seven years and never any mention of lordosis until we went for our appt with Dr Hey and he pointed it out. It evidently had progressed in his last few years of bracing. His pulmonary function has also decreased over the last few years of bracing. He has a large thoracic C curve at 68*with lordosis and not sure of the numbers for the lumbar at this time. I have some hope that correcting his scoliosis and lordosis with his upcoming fusion will enhance his pulmonary function, although most literature on the subject says most scoliosis correction does little to increase pulmonary function. I have read a few articles stating that correcting the lordosis allows for more room in the chest cavity and more room for lung expansion.
(see this article below)
Excessive thoracic lordosis and loss of pulmonary function in patients with idiopathic scoliosis
RB Winter, WW Lovell and JH Moe

Idiopathic thoracic lordoscoliosis is more common and more productive of respiratory compromise than is kyphoscoliosis. In some patietns with idiopathic scoliosis, thoracic lordosis is the predominant component of the disease. Five such patients, all of whom had idiopathic scoliosis with excessive thoracic lordosis, progressive deformity despite Milwaukee brace treatment, and significant compromise of pulmonary function, are presented. Harrington instrumentation (distraction rod only) and spine fusion improved the deformity and respiratory function. The recommended treatment for this type of idiopathic scoliosis is early recognition and prompt surgical correction. The Milwaukee brace should be avoided. Postoperative management must include early ambulation combined with vigorous breathing exercises.

I also saw this at Dr Hey's blog: I saw an 11 yo boy who had 40 degree scoliosis, who had severe hyphokyphosis of his thoracic spine to the point where his thoracic spine was actually sunken in, or lordotic. These severe hypo-kyphotic scoliosis spines result in severe changes in lung volume, since the anterior-posterior (AP) diameter of the chest cavity is severely diminished.
Again thanks for your input and I am happy you son is doing so great!

[laurieg6]

Congratulations on reaching a year post-op so successfully! Patrick looks really great and I am so happy for him and your whole family.

[malka22]

My daughter & I have some experience with lordosis. Laura wore a brace for a year & when we went for a 2nd opinion, we were told that since she had a thoracic lordosis, brace wearing was contraindicated, & she should not have worn a brace, just as scoliboymom & terri wrote. Her breathing was compromised, as her thoracic spine was curving into her chest cavity. Since side view xrays were never taken specifically to measure her lordosis PRE-brace, the xrays taken when she stopped wearing her brace cannot be compared to anything. Therefore, we really don't know if wearing the brace 24/7 for one year made her lordosis worse or not.

Laura had spinal fusion 4 weeks ago. Prior to her surgery, when I asked her surgeon if the lordosis would be corrected, he said that by de-rotating her spine during the fusion, it would improve. I do not yet know if her degree of lordosis has improved or not. I will ask at her 6 week post op appointment on May 30th, after the xrays are taken.
As far as my daughter's fusion improving her lung function, I can already see a difference in her breathing ability. By correcting her 66 degree thoracic curve, it allowed more space between each rib on the right side, where the curve was, thus allowing more room for lung expansion.

Scoliboymom, when we get side view post-op surgery xrays, I will be sure to post them. Terri, thanks for the lordosis article & Dr. Hey's blog post. And good luck to both of you!