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from one surgeon at least. 
The hardware is such that in fact 95% of kids do NOT need any physical restrictions. There is NO increased risk of pseudoarthrosis or hardware breakage in the 95% of unrestricted kids over and above restricted kids.
The reason he restricts ALL kids for at least eight months is because he doesn't know ahead of time who the 5% who will have a problem without restrictions are. And he said he considers the need for a revision on a kid a catastrophic situation. I assume he means by that that it's harder to revise than to get it right in the first pace but he may just mean that there is no excuse for it... just restrict the kid. I'm guessing here.
So everyone gets restricted. Absolutely amazing.
He was aware a few other surgeons do not restrict and I didn't get the sense he thought that was out to lunch (
) I guess because of the 95% of kids who do NOT need restrictions. But clearly they are playing the odds, albeit very good odds, in their favor.
He said the issue is a problem with the hardware (screw coming loose or out, rod breakage, etc.). But I still think it comes back to "so what" if a screw comes loose or a rod breaks? The "so what" seems to be that losing hardware integrity increases the chances of a pseudarthrosis. Or maybe hardware floating around is dangerous per se. I didn't pursue it.
Amazing.
I'll make a separate post on Savannah's 7.5 month post-op visit in the Spinecor thread.
Just kidding. I'll put it here in the Surgery section.
The hardware is such that in fact 95% of kids do NOT need any physical restrictions. There is NO increased risk of pseudoarthrosis or hardware breakage in the 95% of unrestricted kids over and above restricted kids.
The reason he restricts ALL kids for at least eight months is because he doesn't know ahead of time who the 5% who will have a problem without restrictions are. And he said he considers the need for a revision on a kid a catastrophic situation. I assume he means by that that it's harder to revise than to get it right in the first pace but he may just mean that there is no excuse for it... just restrict the kid. I'm guessing here.
So everyone gets restricted. Absolutely amazing.
He was aware a few other surgeons do not restrict and I didn't get the sense he thought that was out to lunch (
) I guess because of the 95% of kids who do NOT need restrictions. But clearly they are playing the odds, albeit very good odds, in their favor.He said the issue is a problem with the hardware (screw coming loose or out, rod breakage, etc.). But I still think it comes back to "so what" if a screw comes loose or a rod breaks? The "so what" seems to be that losing hardware integrity increases the chances of a pseudarthrosis. Or maybe hardware floating around is dangerous per se. I didn't pursue it.
Amazing.
I'll make a separate post on Savannah's 7.5 month post-op visit in the Spinecor thread.
Just kidding. I'll put it here in the Surgery section.
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