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Aussiemum
12-21-2008, 09:37 PM
Hi folks,

Well for all you who followed Elysia's progress prior to Surgery in Feb this year - you will be aware of how concerned I was at the time that she was being fused with a Risser 0. She had a compensatory curve in her lumbar of 23 degrees and we hoped by having this surgery on her Thoracic that the lumbar would sort itself out.

Surgery was successful and she was fused T5-L1 with 5 ribs removed. June 08, 5 months after surgery and her x-ray looked beautiful.

In the last few months - problems started. I noticed Elysia's hips out of line again and her chest development prominent on one side.

Our x-rays last week and subsequent Dr appointment confirmed my fears. Her lumbar is now curving and her spine is crankshafting!

At this stage we're back playing the scoli waiting game again and will see our surgeon in June 09 to see what is happening, but things don't look too promising. Elysia has only started menses and will have by all accounts another 2 years of growth.

Our surgeon is suggesting that he may have to try removing her hooks (she did not have pedicle screws, all hooks as her pedicles were just too tiny for the screws and too risky to use) and inserting some screws through her fused spine to try de-rotate her and also to extend her fusion down into her lumbar region. Very scary stuff as this will be no text book scoli surgery but a more complicated and I presume more dangerous procedure.

Am wondering if anyone has come across this before and what things I may need to be concerned about regarding a second surgery on my child.

Cheers
Del

gillespie
12-21-2008, 09:44 PM
OMG so sorry to hear that. Danielle as well had the thorasic done in the hopes that the lumbar was still flexable enough to straighten itself out. All is well so far just had surgery 4 weeks ago looking good. Although she has had her period for 2 1/2 years so hopefully that will be the difference. I can not imagine how you feel one surgery was enough poor thing. I will be thinking of you

Pooka1
12-21-2008, 09:53 PM
Oh geez, Del, I'm so sorry.

I'm guessing it is a good thing that only hooks were used previously. It just seems like it would be easier to revise than with screws but I don't know that.

I am so, so, SO tempted to email this question to our surgeon and report back but I don't think he will answer because it doesn't concern Savannah's case.

Good luck. Maybe it will stabilize. Or maybe stapling or some other option besides extending the fusion right away is still an option.

I'll be thinking of you.

Best regards,
sharon

Kitty
12-22-2008, 04:40 AM
I am so, so, SO tempted to email this question to our surgeon and report back but I don't think he will answer because it doesn't concern Savannah's case.




Sharon, maybe it would be worth asking your surgeon anyway, perhaps as a hypothetical. You can always play ignorant, pretending you don't know and you've heard this is a possibility whether it's relevant to your daughter's case or not. I just think it would be interesting to hear what he'd say and the I guess the worst he could do is like you say, not respond, but at least you've tried.

Cheers,
Lisa

Pooka1
12-22-2008, 08:20 AM
Sharon, maybe it would be worth asking your surgeon anyway, perhaps as a hypothetical. You can always play ignorant, pretending you don't know and you've heard this is a possibility whether it's relevant to your daughter's case or not. I just think it would be interesting to hear what he'd say and the I guess the worst he could do is like you say, not respond, but at least you've tried.

It's a good suggestion but unfortunately, I've already asked him about it because when we pulled the trigger on the surgery decision, Savannah's Risser was 0 or 1 (I can't recall exactly). He said crankshafting would not be an issue for Savannah but didn't say why.

I'm thinking either he suspected her Risser would rise enough by surgery or he just thought some other aspect of the bones would not predispose her to crankshafting, or something else. I don't know. Just guessing.

And again, he is batting 1000. At the 7.5 month checkup, her Risser had maxed out, her growth plates are closed, and she is done growing. And there was no change in the spine between a few days after surgery and 7.5 months.

It may be the amount of bone mass. Savannah has all screws except two hooks on the upper left that I think are there to anchor the large de-rotation they did where screws might pull out. And after reading something Ti Ed wrote, I think they are there for some kyphosis correction also.

WNCmom
12-22-2008, 10:08 AM
Del--

I'm so sorry to hear about this. My son was also fused at Risser 0. However, his fusion is already much longer than Elysia's. What is happening to her is something we all have or have had on our minds for our own children, and our hearts are with you. Please keep us posted.

Mary Ellen

Karen40
12-22-2008, 10:26 AM
What is crank shafting? Is that when the curve progresses outside of the fused area? So does that mean she may require a longer fusion?

I'm sorry that you have to deal with this.

Karen

Pooka1
12-22-2008, 10:35 AM
Crankshafting is when the spine continues to grow after fusion. Because the growth is uneven front to back, it results in twists and curves of the spine. It is only an issue with a low Risser because at a high Risser, little grow can occur to distort the spine.

I think that's close. Someone correct me if I'm wrong.

Pooka1
12-22-2008, 10:44 AM
http://www.pediatric-orthopedics.com/Treatments/Scoliosis/scoliosis.html

About 2/3 of the way down (or just search the page for "crankshaft."

Apparently, an anterior fusion is done to avoid crankshafting per a very cursory scan of this material.

It sounds fixable but it required taking down the posterior fusion, doing an anterior procedure and then redoing the posterior.

That's sounds like a revision I would want done by someone who has done several before.

WNCmom
12-22-2008, 01:45 PM
I'm confused. Is what Del is describing a new (or progression of the) curve in the unfused lumbar spine? Or is it curving of the fused portion of the spine in the anterior? It seems to me these are two different things. The first would result from (for whatever reason) not fusing low enough to begin with. The second would result from the anterior side of the fused section of spine growing, while the posterior side does not. Am I correct? Am I missing something? Can anyone clarify?

Mary Ellen

Pooka1
12-22-2008, 02:13 PM
My guess is you are correct... I think Del is saying Elysia has both issues, two different issues which may or may not affect each other. I think you can have crankshafting without curve progression and you can have curve progression (in unfused areas) without crankshafting.

Anybody know if that is correct?

txmarinemom
12-22-2008, 03:14 PM
Decompensation (curving above or below the fused spine) and crankshafting are 2 different things, but compensatory decompensation can result from crankshafting (and become structural without correction).

I don't think Elysia's issue is that she wasn't fused over a larger area, WNCMom ... it's that she was posteriorally fused (permanent fusion vs. expandable) at a Risser 0.

Crankshafting is a very real possibility when that much potential growth remains.

Hang in there, Del!

Pam

Kitty
12-22-2008, 07:15 PM
I believe this description may help clarify the phenomenon of crankshafting, which I copied from iscoliosis.com


This is what happens when you have a posterior spinal fusion at a young physiologic age with significant growth remaining. The posterior fusion acts as a tether to growth on the posterior part of the spine, while the anterior part ( the side of the spine facing the lungs in the chest and the intestines in the abdomen) continues to grow. The result is that the spine spins around the posterior tether like a crankshaft, causing the scoliosis to recur even though the spine has already been fused.



What I don't get is how they can separate front and back - I thought the spine just grew as one. And therefore if you've got rods anchoring the spine down, that should be that. But obviously it's not and my previous thinking on this was very naive, to say the least.

:confused:
Lisa

Pooka1
12-23-2008, 10:56 AM
Lisa,

As I understand this...

Only the back of the spine is fused in a posterior approach. The front of the spine is neither fused with new bone nor anchored by the rods and so is free to continue to grow.

Carmell
12-23-2008, 05:12 PM
Lisa,

Each vertebrae are a 3-dimensional object - front, back and sides. This is why scoliosis treatment is so complex - the vertebral bodies are complex. Add in the soft tissue surrounding the bone structure, and you have even more things to complicate matters. By fusing only the posterior portion (back side, closest to the skin on the back) you have risk of problems just like Elysia has developed. Her spine wants to grow vertically. The posterior part can't, since it's fused solid, but the anterior/front part still has growth potential/soft tissues to grow. If they grow too much, it can cause problems like crankshaft (rotation of the spine, asymmetry of the torso, even pseudoarthrosis (failed fusion)). This is not a common occurrence, but when its your child, it's a huge concern.

Your comment about the rods anchoring the spine are true - the rods are anchoring the BACK (posterior) part of the spine but the rods are not influencing the front portion of the spine. With a Risser zero, this is a chance many parents and surgeons must take when agreeing to posterior-only surgery.

HTH

laurieg6
12-25-2008, 12:56 AM
I've been gone for a while and am therefore a little late responding but wanted to add this: When Alexander's surgery was suggested, I was very concerned about the possibility of crankshafting occurring because of his young age (esp. because boys may have up to 10 years of future growth following a fusion at age 12). Three out of four of the surgeons we interviewed strongly recommended only a posterior fusion. They all insisted that the risk of crankshaft phenomenon was so small as to be barely there anymore with the new instrumentation. They said that the pedicle screws went in so deeply that they effectively prevented the crankshaft from being able to occur.

Maybe because Elysia's surgeon was only able to use hooks and not screws, she was at a higher risk for what, prior to pedicle screws, was a fairly common phenomenon with young fusion patients.

Regardless of the cause though, I am so sorry that Elysia may need surgery again. I really hope that her lumbar curve stabilizes on its own and the crankshaft mellows out too. I still approach each follow-up appointment practically holding my breath while we await the x-ray result so I can relate to what you're going through with this (6+ years of watching, waiting, bracing).

Best Wishes,

Kitty
12-25-2008, 02:55 AM
Carmel,
Thanks for that, but unfortunately I still don't get it :o
I have had a close look at the spinal cord and it joins front and back, there are no separate segments, so i still don't understand how if the posterior is anchored down with rods, then the front can still curve, unless it's pulling the rods with it, in which case what's the point of having the rods, if they're not going to hold a curve, whether that curve is moving front or back...and further to this, if it's the front of the spine that curves, why not just place the rods in front, or does that not make a difference?????

LIsa

Pooka1
12-25-2008, 08:49 AM
(snip)They all insisted that the risk of crankshaft phenomenon was so small as to be barely there anymore with the new instrumentation. They said that the pedicle screws went in so deeply that they effectively prevented the crankshaft from being able to occur.

Okay that makes sense. I didn't know why our surgeon was able to rule out crankshafting even when Savannah had a very low Risser. I think he knew he was able to us mostly screws with her and therefore crankshafting would be highly unlikely.

Pooka1
12-25-2008, 08:58 AM
Carmel,
Thanks for that, but unfortunately I still don't get it :o
I have had a close look at the spinal cord and it joins front and back, there are no separate segments, so i still don't understand how if the posterior is anchored down with rods, then the front can still curve, unless it's pulling the rods with it, in which case what's the point of having the rods, if they're not going to hold a curve, whether that curve is moving front or back...and further to this, if it's the front of the spine that curves, why not just place the rods in front, or does that not make a difference?????

LIsa

Imagine a balloon half blown up between two boards. You put a vise clamp on one end which keeps the distance between the two boards at that side constant. Then you blow up the balloon some more. The balloon will expand at the unclamped side and push the boards apart there.

The vertebra are the boards and the balloon represents growth at the top and both of each vertebrae which continue to grow at the non-clamped side because nothing is stopping it. The balloon/vertebrae don't continue to grow at the clamped/fused back part because the pressure of the fusion holding the vertebrae together doesn't allow it.

Anterior fusion is harder as I understand it and they collapse a lung. I don't think they can put rods on the anterior side... I think they put shorter segments on the side of the spine (and still call it anterior for some reason).

The fact that the spine crankshafts and doesn't just break the fusion in multiple areas tells you the rods/screws/fusion tend to hold very well. It's also why 95% of kids don't need any physical restrictions after fusion surgery.

Kitty
12-25-2008, 09:57 PM
Imagine a balloon half blown up between two boards. You put a vise clamp on one end which keeps the distance between the two boards at that side constant. Then you blow up the balloon some more. The balloon will expand at the unclamped side and push the boards apart there.

The vertebra are the boards and the balloon represents growth at the top and both of each vertebrae which continue to grow at the non-clamped side because nothing is stopping it. The balloon/vertebrae don't continue to grow at the clamped/fused back part because the pressure of the fusion holding the vertebrae together doesn't allow it.

Anterior fusion is harder as I understand it and they collapse a lung. I don't think they can put rods on the anterior side... I think they put shorter segments on the side of the spine (and still call it anterior for some reason).

The fact that the spine crankshafts and doesn't just break the fusion in multiple areas tells you the rods/screws/fusion tend to hold very well. It's also why 95% of kids don't need any physical restrictions after fusion surgery.

?????? Sorry, I still don't understand. It still does not make sense to me that the rods can't hold the spine in place (whterther front, back, side or whatever).

:confused::confused::confused:

Pooka1
12-25-2008, 11:06 PM
http://www.iscoliosis.com/faq.html?intFAQID=81&txtFAQ=What%20is%20a

Kitty
12-26-2008, 02:10 AM
http://www.iscoliosis.com/faq.html?intFAQID=81&txtFAQ=What%20is%20a

sharon, that is the site i quoted in my earlier post, but they DO NOT explain the inability of the rods to prevent the crankshafting.

tonibunny
12-26-2008, 05:56 AM
Back in 1986 (at the age of 10) I had an anterior release and fusion followed by a posterior fusion with a Harrington Rod implanted two weeks later, to correct my thoracic curve. This was done to prevent crankshaft phenomenon, and my thoracic spine has been rock solid and stable ever since.

I'm very surprised to hear that younger children don't routinely have anterior procedures in order to prevent crankshaft. If the growth plates aren't affected then the front of the vertebrae can continue to grow despite the fact that the backs are tethered - it's simple really. Mine were removed so the fronts of the vertebra fused together as well as the backs, and my thoracic vertebra look quite small on x-rays because they're the same size that they were when I was 10.

NB I did spend 6 months in a post-surgical plaster cast and then 6 months in a TLSO which must have aided the uninstrumented anterior fusion process. These days I guess that anterior instrumentation would negate the need for this.

Pooka1
12-26-2008, 09:47 AM
sharon, that is the site i quoted in my earlier post, but they DO NOT explain the inability of the rods to prevent the crankshafting.

Oh sorry. My memory is not what it used to be. :o

sharon

Aussiemum
01-19-2009, 07:00 AM
Thanks everyone for the input!!! Been a little while since I checked back in.

But after exhaustive research into crankshaft - YES - it is definately happened because Elysia was Risser 0 at time of surgery and surgeon was unable to use the new Pedicle screws and had to use hooks because her pedicles were just too small.

The million dollar question is why the heck doesn't pedicle size show up on X-rays, cat scans, MRI's - he obviously did not know that he would come across this problem prior to having her opened up on the operating table. Perhaps the best thing to have done would have been to close up and come back another day and perform the double surgery of Anterior Release and then the Posterior fusion.

Very depressing to watch this re-run of the last 18 months of our lives - not to mention poor Elysia and how this all will affect her, but I guess we'll all live through it again.

But - not to put anyone off from having the surgery - just one of those things to be sure and investigate thoroughly with your childs surgeon if they are Risser 0 or 1 before agreeing to the surgery and then everything should be fine for them.

I'll check back in after our next appointment in June and fill the forum in on what Elysia's progress is then.

Cheers and regards to everyone
Del

Pooka1
01-19-2009, 08:52 AM
Del,

Are you saying the surgeon didn't know ahead of time that he couldn't use screws?

I thought they can get very accurate sizes of thing from the radiographs these days using an x-ray opaque standard scale but maybe I'm wrong.

Wishing you and Elysia the best.

sharon

RugbyLaura
01-19-2009, 09:01 AM
Oh Del! Somehow, I missed this before. My heart goes out to you and Elysia. What a dreadful shock, just when you thought it was all behind you.

Immi's surgeon has always said he wants her to be as near to maturity as possible before he operates - she's still a dot so it looks like we'll have a few more years of Spinecor (hopefully). What has happened to Elysia will definately keep me asking questions.

Thinking of you!

Laura xx

Pooka1
01-19-2009, 09:05 AM
(snip) she's still a dot [...]

:) Made me chuckle.

Susie*Bee
01-19-2009, 04:22 PM
Dell- I was really sorry to read your post too. Keep us up to date on what goes on. Hugs, Susie

Aussiemum
01-19-2009, 05:45 PM
Yep that's right Sharon!! He Obviously had no idea!!! I want to ask him at our next appointment why pedicle size doesn't show up on x-rays - but what's the point now??? Or perhaps it DOES show up but he didn't think to check it - maybe he's never come across very tiny pedicles before!!!!

Plus I know that there is surgical techniques in the states that allow surgeon's to use special instrumentation to allow for tiny pedicles - Dr Betz at Shriners does this! I've seen it on his website.

Thanks everyone for your good wishes and prayers - Just when we thought it was safe to go back in the water!!!!!


Del

rtremb
01-20-2009, 02:38 AM
Del:

I am so sorry to read about Elysia. She has already been through so much and so bravely too. It makes me very sad to read that this has happened to her.

Ruth

FixScoliosis
01-20-2009, 04:03 AM
Kitty

crankshaft phenomenon occurs because the anterior parts of the spine keeps growing despite the rods in the back. Now the spine cant go on forever in a lordosis (as will happen if the anterior parts keep growing), the body will resist that and thereofre the spine begins to buckle sideways. (there is an exception, a rare condition called 'prune belly syndrome')

Now the rods are holding the posterior part in place and the front wants to keep growing. what happens? It has been shown in idiopathic scoliosis that the pedicles itself grow/develop different lenghts between the left and right side and we end up with deformed vertebrae.

The pedicle screws are a major breakthrough in scoliosis surgery as they don't allow the pedicles to grow to different lengths..

Pooka1
01-20-2009, 09:25 AM
Yep that's right Sharon!! He Obviously had no idea!!! I want to ask him at our next appointment why pedicle size doesn't show up on x-rays - but what's the point now??? Or perhaps it DOES show up but he didn't think to check it - maybe he's never come across very tiny pedicles before!!!!

Del, after you wrote this I spent some time trying to find information on whether surgeons can accurately access pedicle size from appropriately scaled radiographs.

I haven't found anything definitive but I can tell you I came across a site that said if there is any doubt, use hooks. They added an exclamation after each time they said that. So there is a high caution factor when it's a close call between hooks and screws.

That, however, doesn't answer the question of whether he went in there KNOWING he would have to use hooks. Your daughter had a very low Risser and the curve was in the high 40s*, is that right? I don't know how fast the curve was moving.

I re-read your blog and note that Dr. Cree mentioned the possibility of crankshaft. What I would like to know are the actual numbers of crankshaft cases in the patient population with a Risser of zero who were fused with all hooks. It may still be a small percentage in which case other factors may have been used in decided to operate when he did. Let's hope that is the case. I'm having a hard time imagining that he would go in there even with the possibility of having to use all hooks if the likelihood of crankshaft was high.

FixScoliosis
01-20-2009, 09:45 AM
regarding crankshaft phenomena I found this paper published in 1995.

Posterior arthrodesis and instrumentation in the immature (Risser-grade-0) spine in idiopathic scoliosis
says the following:

"Patients less than
ten years old, and older premenarchal patients who
have a Risser grade of 0 and open triradiate cartilages,
are likely to have progression of the curve after a posterior
arthrodesis; thus. we recommend an anterior
arthrodesis for these patients."

Pooka1
01-20-2009, 09:58 AM
Hey FS,

Do you know if radiographs can have a scale factor to accurately size the pedicles? I think they can do this. I'm sure there are close calls but maybe some cases can be clearly shown ahead of time to be too small for screws.

When I asked about the possibility of crankshaft with my daughter (Risser = 0 at that time though 3 at surgery), the surgeon responded very quickly and positively that there was almost no chance. Now I don't know how he was so sure but I now suspect it's because he saw the size of her pedicles and knew he could use all screws if he wanted to. (He used two hooks on the top left I think for the kyphosis and to de-torque her rotation where screws might pull out).

We don't know the particulars in Elysia's case but it would be edifying for parents to figure out what the surgeon knew and how he made his decisions.

Snoopy
01-20-2009, 02:59 PM
Del,

My heart goes out to your family. I would question your surgeon as to why he didn't know the size of Elysia's pedicles going into surgery and here's why:

Jamie had a CT scan before surgery for just this purpose--to check the size of her pedicles. The report reads in part: "COMMENT: As requested, pedicular diameter was assessed at T1 through T4 as well as at T12 through
L5. Measurements are as follows" and it goes on to say T1 Right-.6cm Left-.6cm. Hers ranged from .1 cm to .6 cm. Not that I know what that means.

The report from her surgery states: "We had recommended doing Smith-Peterson osteotomies to help correct posterior her kyphotic deformity unable to use pedicle screw fixation due to the narrowed pedicles."

Hang in there and know we are all here for you.

Mary Lou

FixScoliosis
01-23-2009, 01:03 AM
Hi Pooka1

I could not find any really good papers on x-ray measurement and pedicle size.
there was some papers suggesting that a CT should be performed...
however, abstract for: Pedicle Morphology In Thoracic Adolescent Idiopathic Scoliosis: Is Pedicle Fixation an Anatomically Viable Technique? (http://journals.lww.com/spinejournal/Abstract/2000/09150/Pedicle_Morphology_In_Thoracic_Adolescent.5.aspx) says
"Measured dimensions from the CT scans showed the actual pedicle width to be 1-2 mm larger than would have been predicted from the plain radiographs."

and these papers might provide more/better understanding.
Placement of pedicle screws in the thoracic spine. Part I (http://www.ejbjs.org/cgi/reprint/77/8/1193)
Placement of pedicle screws in the thoracic spine. Part II (http://www.ejbjs.org/cgi/reprint/77/8/1200)

Aussiemum
01-23-2009, 05:37 AM
Hey thanks!!! That paper made very interesting reading. I guess I'm glad our surgeon didn't RISK IT by TRYING to use the screws and then perforating her pedicles or entered into the spinal canal! So I'm thankful for that.

I don't think he knew that her pedicles would be so tiny Sharon - but in hindsight I wished he had just closed her up and came back another day for an anterior release before the posterior fusion.

I guess this is informative for all those going into surgery, to ensure that the Dr has done everything in his power to ensure that he knows pedicle size - ESPECIALLY on the Risser 0 children.

Cheers
Del

Karen E.
03-05-2009, 08:09 AM
Hi. I had posted a similar question in the section dealing with scoliosis due to other causes...neuromuscular in our sons case (Cerebral Palsy). I didn't think to check in the other section but was doing a search on line and this thread popped up. I guess I figured what our son was going thru was directly related to the severity of his cerebral palsy and that it wasn't as common in children dealing with scoliosis alone.

Our son went into puberty and developed sudden onset scoliosis. Within a years time he went from a good looking spine to an 82 degree curvature. He has spastic quad CP but his trunk area has always been very floppy...never sat up on his own and even when assisted he could not really sit up straight. At age 13 surgery was done. They were only able to do a posterior surgery in his case due to the high risk of doing anterior surgery...opening up the chest, collapsing a lung in order to put hardware in front of the spine. Based on his xrays they hoped that if he grew anymore it would be minimal. Unfortunately that wasn't the case. He continued to grow and the curvature increased. It has now leveled out at about 72 degrees...it's hard to tell...one measurement said 78 but that's xrays taken trying to sit him up with support so the most recent xray isn't all that great looking.

I did all sorts of research on line and was trying to understand what was happening. I didn't understand why the anterior wasn't done until it was explained that he was already high risk for the posterior surgery which also included going in from the side to do repair of the lower vertebrae...a couple were pretty messed up. The result has been that the vertebrae continued to rotate when he grew so now the front left side of his rib cage (standing behind him) protrudes pretty bad. The right rib cage is pushed back causing an elongated hump on the back right side.

I don't know how it works with children dealing with just scoliosis. I would think that corrective surgery would be easier? For our son two surgeons have said that further surgery would be risky respitory wise...and that's even with him not having any real issues at this point...that they can't do anterior and in the end even if they got some correction in the curvature they cannot repair the resulting ribcage deformity. For us it is now just monitoring....will see a pulmonologist to see if there is any impact at this point on the lungs and continue to check on the curvature. As long as it remains stable then we should be ok.

Like I said...I didn't check the section that dealt with just scoliosis but after reading the posts it added to my understanding of what happened with our son and his surgery. He looked so good after the surgery and like I told his surgeon...I think I thought it would just stay that way. I didn't really understand I guess that it was a gamble and due to the CP the odds weren't in his favor. Hope that for those of you dealing with it with your own kids that the outcome is much better.

Karen

pmsmom
03-06-2009, 07:12 AM
Dear Del,

I'm just finding this thread now. Know that you and Elysia will be in my thoughts and prayers. Please do keep us posted as to how both she and you are doing!

Marian

Aussiemum
03-15-2009, 09:42 PM
Big Sigh of relief!!! SIGH!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Went and had a second opinion with another surgeon and it appears that Elysia is not in "Full Crankshaft Phenomenom mode". It appears that what has happened (according to THIS surgeon) is her L1 Vertebrae (bottom of her fusion) has tilted and the thoracic has "sprung" back and rotation has occured! ??????? Mr Lumbar is now being naughty and will have to be put into chains and shackles to match Mr Thoracic! She was 46 going into surgery - 10 after surgery and is now back to 26 - that sounds all sooooooo odd to me!!!! We were told there is always SOME degree of springing back to the orginal shape - but wowwwww!!!!! That's some tough back this kid has got!

So we were told it's a "kind of crankshafting" - not the kind that happens in very very young children.

We were advised that it will be a piece of cake to open her up and extend her fusion down into her lumbar area!!! Wow!!!! It sounds like soo much fun - I can't wait and either can Elysia!!! WTF?? Piece of cake? Who the hell for??? LOL - oh a sense of humour must prevail or I'll go insane!!!

I guess what he REALLY meant was ..... piece of cake to kind of repair her than the nightmare of surgery if she was fully crankshafting!!!

So dear Scoli folks and folkettes - I guess we'll just sit tight and wait for the next installment in the fun and games of life and the next Photo and info session in June (aka x-ray and appointment) - Elysia always wanted to be a model, she never knew it would be of her insides!!!!!

And.... let me tell you right now peoples, for all those that followed the happy saga first time around...... she AINT getting another pet out of this surgery!!!!!!!

Alt3
Del

Pooka1
03-15-2009, 10:22 PM
Del,

I am glad and relieved to hear that the next surgery will be far more limited than the first.

These guys are amazing... they can fix anything it seems.

I would like to nominate your post for most humorous post in the face of further surgery. I especially liked the "not another pet" and the "folkettes"! :D

I won't tell you to hang in there because you obviously are already doing that!

Best regards,
sharon

rtremb
03-16-2009, 12:32 AM
Del:

I have been wondering how Elysia was doing. I am sorry to read she will need another surgery. I sense a lot of pain behind your humourous post.

On the one hand it is reassuring the doctor thinks he can fix this - I hope he is right. I'd seek at least one other doctor's opinion if I were you just to be sure the right surgery is done this time.

Thinking of you often.

Ruth

laurieg6
03-17-2009, 11:09 AM
I am so sorry that Elysia probably has to have another surgery. Is it definite or is the doctor waiting a few months to see if there's a chance her spine will settle down? Can you wait a while to do the surgery or do they think it should happen really soon?

I wish you all the best and hope that Elysia will soon be done with surgeries forever!

Aussiemum
03-17-2009, 10:11 PM
Hi Laurie,

We are now waiting for her June x-rays and appointment to see what the prognosis is, but really her body shape looks to me just like it did now prior to her surgery!! Her Rib hump is no where near as bad as it was prior to her initial surgery but major problems with her breasts. Because of the rotation happening now (or is it the "springing back???"), she has 1 breast vastly different from the other.
At our appointment last week for our 2nd opinion, he suggested a Breast implant to balance her out when she's finished growing.

So we play the waiting game now until June and even then I guess we'll wait it out as long as we can. The good news was that we were told she's now Risser 2 or 3.

That's the funny thing about all this, our surgeon told us she had heaps of growing left to do - and then our 2nd opinion told us he thought she was almost done!!! WHAT EVER I say!!! I wish they would get together and have a coffee or something!!! I'd shout them!! LOL

Cheers
Del

Aussiemum
07-07-2009, 09:10 AM
Hi everyone,

Thought I had better quickly post here cause my initial post might have put the frights into a few parents out there who are still contemplating surgery.

Saw our Surgeon in June and Elysia's lumbar curve has stabilised. She does have the return of her rib hump and would seem that with a very flexible spine and a full on growth spurt - that her spine 'sprung' back way more than normally expected.

She is risser 3 - so it's all good news - and our surgeon doesn't think she will have problems with back pain in the future. She is very lopsided still - in both hips, chest area and back hump is looking awful - but..... he said any further surgery would be for cosmetic reasons only. Well folks - that aint gunna happen!!!!! He would be extending her fusion down to L3 and this would reduce movement in her lumbar region.

I personally think a little lopsidedness - in exchange for a more flexible back - is the way to go. Unless things start moving again over the next 5 months - he aint touching the kid.

She's fused now - and that's that - life is full of disappointments - such a shame that the rib hump is back after the Thoracoplasty - but I gotta be happy - she's healthy and relatively pain free! Well not for long - she gets her wisdom teeth out and braces in 2 weeks - so more hooks and wires for the kid and more $$$ flying out of mums and dads pocket!!! Interestingly - surgeon said most kids with scoliosis - seem to need braces as well????

Hope all my old friends are doing well and their wonderful offspring!!!!

Keep smiling
Del

xxxx

Pooka1
07-07-2009, 03:08 PM
Del,

I am very relieved to hear Elysia is stable! And so glad to hear she is almost done growing.

It's a long road. All we can do is stay as strong as our kids obviously are. :)

Best regards,
sharon

Snoopy
07-07-2009, 04:59 PM
Del,

What a relief it must be to know that Elysia is stable. What does she say about the appearance of her back?

Wisdom teeth---ugh! I had mine at when I was 14 and both of my daughters (one with Scoli and one without) needed their wisdom teeth out at age 14 as well. Jamie (the daughter with Scoli) said that getting 8 teeth out, yeah her mouth is so small they had to remove 4 wisdom teeth plus 4 others before putting her braces on, was nothing compared to having a spinal fusion! Her dentist wanted her in braces long before she ever got them, but at the time she was trying to wear a Milwaukee brace and she said there was no way she was going to wear a brace for Scoli and braces on her teeth!

Mary Lou

Aussiemum
06-30-2010, 08:59 AM
Hey there everyone,
Well that's kind of sad reading through my old posts! Relatively pain free I said! Well things are taking a turn for their worse I fear - pain is getting a bit out of control these days.

Elysia was a mess at school yesterday, the pain became unbearable! The days like this are becoming closer together, lower lumbar pain and constant rib pain and difficulty breathing. It's so frustrating as there is nothing anyone can do except for me to let the surgeon have his way! There is no point in taking her to a GP - did that recently and got sent to some quack specialist who wanted her to do these weird excercises 5 times a day which involved bending back and looking up at the roof!!! A muscular skeleton professor - You guys would have been laughing seeing what he thought was going to help her. Although he did pin point where her pain was..... give the man a medal, I could poke her in the back and say tell me where it hurts!

Sigh, looking at her standing now, she's almost back to pre-surgery shape! Rib hump is back and staying... as he's already said he can do nothing about her rotation now as it's too dangerous on a fused spine.

I'm so dam confused as he said she had done growing, if that's the case why is her dam back giving her so much trouble??? Has the tilted L2 slipped it's disc or something???

Anybody know how much Ibuprofen or Panadol is a safe level to take and for how long - the boxes say if your pain persists after 48 hours see your DR - pfffttttt - it's going to be longer than that! I'm now telling Elysia she has to dose up on some pain killers from now on so she can stop being so grumpy with her pain all the time, she's very anti drugs for some reason, but I think not taking something makes things worse by you stressing and tightening your muscles up more.

We see the surgeon on 2nd August but I'm going to get her x-rays done much sooner than that so I can see for myself what's gone on since December last year.

Cheers
Del

Susie*Bee
06-30-2010, 09:58 AM
Del-- I am just so sorry to hear your news. I was hoping no news was ok news, but apparently not. I believe the adult maximum dose is 4 grams per day, but you're not supposed to take it for very long. It can really do severe damage to your liver. You should check out other pain relievers. There are some that are not narcotic and that aren't Nsaids...

Hoping and praying that you'll be able to find a good solution for poor Elysia. That just is not the way it should be for her. She went through enough just with the surgery itself. Cyber hugs to you all.

JenniferG
06-30-2010, 05:55 PM
Saddened to hear of Elysia's outcome. Was your surgeon well-recommended, does he do a lot of scoli surgery on teens? I am wondering if a second opinion might be warranted.

I can highly recommend a surgeon, but he's in Brisbane.

Pooka1
07-01-2010, 10:24 AM
Del,

Thanks for writing. I am extremely saddened to hear of this news.

I like your approach. Something else to consider at this point is to get a consult with a revision specialist. Long term meds don't seem like the answer. Hopefully there is a surgical solution to this. It seems beyond PT but I don't know that.

If her pain is coming from the L1-L2 disc then why wouldn't that go away if it was fused? If it is coming from the lumbar then why can't that be fused?

You might also start calling/emailing specialists in your country and other countries questioning the ability to revise a rotated fused spine. I'm just saying I think folks with seemingly more compex cases have been helped but I don't really know that.

Good luck, Del. This is a hard road for you and your family. Life is very unfair.

Aussiemum
08-02-2010, 10:56 PM
Just to keep those interested in the know....

Had our appointment yesterday. My head is going to explode today!!
Elysia will be having the 2nd surgery 30th November. We're in Australia so that is 2 weeks after her final exams for the year.

Our surgeon will be taking out the old rods, fusing L2 and L3 and inserting longer rods, he will also be performing ANOTHER thorocaplasty and trying to derotate her again! Funny, I thought last appointment he said he couldn't do that on a fused spine??

He can't guarantee that this will eradicate the pain that she's constantly in... he just said, if she's straight there shouldn't be the strain on her back muscles that there is now. This time I will DEFINATELY be following up on some post op Physio of some description - last time I was just too scared to do anything other than what we were told to do.

He's even said she can play sport again by March next year... Yikes, that's scary, she plays a sport similar to your basketball, lots of contact in some games.

She broke down in tears, don't know if it was regarding the surgery, the talk of another MRI or the thought of KNOWING this time what she's up for.

By the way Sharon, after all those talks years ago about Epidurals..... yep, she's having another one for this surgery! It's just so she's as pain free for the first couple of days, she'll basically sleep for 48 hours!
Also... there is no such thing as a revision surgeon here in Australia - we only have a dozen or so scoliosis surgeons in the whole country!

So not much more to add to the story other than he has now confirmed she has definately crankshafted through the thoracic. There was some debate whether she had or not! I guess the only lucky thing is she has done growing so the crankshafting can go no further. I've also been told by another medico that pedicle screws won't stop crankshafting and neither can Anterior and Postieror surgeries give a 100% guarantee either.

All I want to do now is scream FIRETRUCK - omitting the 2nd,3rd,4th and 5th letter!!!

I'll post later if anything more to add to the saga!!!

Cheers to all
Del

Lorraine 1966
08-03-2010, 12:14 AM
Hi Del, Yes I know there are no revision surgeons in Australia, if only!!!!
I would not worry about her being fused down lower and not having much flexibility. As you can see by my signature I am fused town to L3 and have quite a lot of movement. Sorry but need to say this, but it may not happen to you. The discs that were not fused have done all the work for the back so to say, and that is why I am in a bit of trouble now with pain. But also in saying that, my operation was done years and years ago and things are just so much better now. I can see her playing sport again, truly, I had no hassels at all even back then. No problems with pregnancy, everything was normal I led a normal life and did everything I wanted, just in case you were worrying.
All the very, very best to you and your daughter. You will be so glad in the end that the decision was made.

Regards
Lorraine.

Pooka1
08-03-2010, 07:29 AM
Del,

Thanks for the update.

I think you and your daughter need answers and hopefully you are getting them.

Life is ridiculously unfair.

Best regards,
sharon

Singer
08-03-2010, 08:53 AM
Sorry to hear this, Del. I hope and pray this second surgery does the trick.

However, I love the "firetruck" comment and will have to use that soon...!!! Yell away, if it will help!!

Aussiemum
11-30-2010, 08:45 PM
Hi one and all,
I've come back to where it all began - back to where the people with PHD's in Scoliosis reside!!! Well, it does feel like it sometimes doesn't it?

Elysia was scheduled to have her 2nd Surgery yesterday at 1.00pm!
She had developed a UTI overnight with burning and blood and we DID inform the nursing staff on our arrival at the hospital at 10.00am.

They took samples, sent them off to pathology and told me THEY were going to inform her surgeon. Well...... Elysia is all scrubbed up, robed up, bawling her eyes out, worse than the first time around as she knows what's next... when in walks the Anethetist! I tell him about her UTI! He has been told nothing.... he phones the surgeon who's by her side in 5 minutes.... He cancels the surgery!!!
Can't take the risk! OMG!!!!!!!!!!!!!!!!!!!!!!!! After all the emotional roller coaster, just as your about to be wheeled into theatre and then this????????????

I had a feeling they would't proceed, but thought maybe they have some new antibiotics they would put her on after the surgery to counteract any nasties! But no!

Now they are trying to do a "unplanned" surgery for just her on a Saturday, the 11th December! Trying to get all team members availability to proceed! If not, who knows when!

So.... firstly.... shouldn't it be the norm to do a urine test BEFORE surgery if it's so important not to have nasties in your system.... if Elysia hadn't spoke up and told me about it.. everything would have just gone as planned!

Secondly.... How exactly does nasties in your urinary track, which are obviously in your blood stream affect the spine? So a bug is a bug regardless of where it originated???

Sigh... all fun in the sun here for us, poor Elysia!

For anyone interested, I've attached a pic, not a good one, of before her surgery 2008, 6 months after her surgery, perfectly straight, and six months after that, all pear shaped!

Please pray for her that God will somehow lead us to the right path for this child and for this surgery!

Del
xx

Pooka1
11-30-2010, 08:58 PM
Del - good to hear from you.

Poor Elysia. What a roller coaster!

That's an amazing change from the surgical correction immediately post op to now. I think that's called "adding on" and it seems to be at the top and the bottom. Not sure though.

Is she done growing? I assume her pedicles are still too small for screws.

I'm surprised they canceled. I didn't realize UTIs involved the blood. While antibiotics (molecules) can travel from blood to the bladder, I don't think bacteria (cells) can travel from the bladder to the blood but I don't know that.

Stay strong. They will fix this.

Best regards,
Sharon

scoliboymom
12-03-2010, 03:35 PM
Hi Del,
Guess I missed some of your posts along the way and didn't realize till now what your daughter has been going through painwise and another upcoming surgery!!! I am so sorry for her and your family.
You may remember Patrick, my son, has crankshafting too but fortunately no pain at the moment. He has a major rib hump again which was pretty much gone after surgery and he just looks so deformed to me(I don't say anything to him about this and he seems okay as far as self estemm is concerned). He has had his last appointment with the childrens hospital so in the future he will go to an adult surgeon for any care he may need. I fully expect he will need futher surgery someday.
I do hope that your daughter becomes painfree with this second surgery. I am also curious as to how they derotate once she has been fused or will they break the fusion although that soundl unlikely. My thoughts are with you and please let us know. Hope they can reschedule you soon.

Ramona

laurieg6
12-14-2010, 08:12 PM
Hi Del,

I haven't been on this forum for a long while and I just read about what's been happening with Elysia. Was she able to get the surgery last weekend? I hope so because I can only imagine how excruciating the waiting must be in addition to dealing with all the other stresses related to this, especially poor Elysia's pain!

Please let us know what's going on when you get the chance.

My son, Alexander, has no pain now but I'm sure he will have it one day because his posture, despite seeing a physical therapist after his surgery, as well as many other appointments and activities to correct it, has remained problematic. He still tends to lean on one side, unless he's thinking not to. He's only around 5'1/4" when he's standing straight and tall and when he's leaning, he can appear to be around 4'9 or 10".

Good luck with everything!!! I'm really hoping that Elysia has a very successful 2nd surgery and can be done with thinking about scoliosis for a very, very long time, if not forever!

Laurie

jrnyc
12-14-2010, 08:20 PM
hey Del
so sorry to hear of all your poor daughter has been through! i hope the surgery finally takes place and she gets the relief she so deserves!

i am pretty sure that an infection is an infection is an infection, and surgery is cancelled if there is one present anywhere in the body...it can cause a temperature, the immune system is then already fighting off something, and going into surgery in that condition is simply not allowed...that is what i was told some years ago, when foot surgery was cancelled...postponed, actually....for me...and it was rescheduled some weeks later...

best of luck with getting this taken care of, and hopefully finished, once and for all!
jess

Aussiemum
12-26-2010, 11:24 PM
Hi everyone,
Just thought I'd quickly touch base to say that Elysia's surgery is now over! Performed 21st December. Took down part of the previous fusion from T11 to L1 - took out the hooks from these sites, took out the previous rods, inserted screws and longer rods now down to L3. Bits of ribs were removed for the fusion and to derotate her as much as he could.

If anyone remembers the debate from the first time around, she once again had an Epidural, this time it did not work, or if it was of minimal help! She also had the morphine drip but even it wasn't taking the edge off the pain.

We spent Xmas in hospital, obviiusly... and are still here trying to get her pain under control with oral meds now! Today, Monday 27th, not so bad, slowly getting there! I really don't think the nimwits gave her enough meds yesterday! But we had nurse wonderful again on duty last night and she has been a blessing! Had a picnic lunch in her hosptial room for Christmas Lunch with the relo's and family.... luckily for us being a private hospital, they had shut down an entire wing, only 12 patients in the whole place. Lucky as on Xmas Day Evening.... we had a light in her room that wouldn't turn off so here was the nurse and myself with everything out in the hallways as we moved everything (and there was a lot of crap, xmas trees, balloons, flowers..etc etc) into another room!!!! I was so grateful that the place was deserted! Never wanted her first surgery at this time of year for fear of no staff around to look after her, but has been wonderful, most nurses sweet, except for the odd dragon or two thrown in, like the one who took her PCA off her, said she was too spaced out!! I could have punched her, gave it right back to her the minute she walked out!

Last yucky thing to do now is to get the dressing off.... she is not looking forward to that as it hurt like hell last time! Can't wait to get her home and into one of our recliner chairs as the hospital chairs are meant to DRIVE YOU OUT OF THE PLACE... so uncomfortable, that she's taken to sitting on my fold out day bed!!!!!

We had the usual reaction to the surgery same as last time, an enourmous swelling in the catheter site, I mean enourmous, Elysia's quote: "I think I've grown balls" - she sooo still had her sense of humour through all of this. Our Dr came and saw her yesterday and said wasn't a latex reaction, that in fact prob the entire half of her was swollen, just that part of your body is more noticeable!!!

So Folks and Folketes, lets just hope that this has solved all her problems, that she'll be a healthy and happy girl from here on!!!!
Hopefully we'll get this pain under control and head home in a day or two.... better be before my older daughter and husband kill each other, I hear it's pretty rough at home!!! LOL - ahhhh to be appreciated!!!

Hugs
Del
xx

jrnyc
12-27-2010, 12:00 AM
how wonderful the surgery is over...i hope the pain subsides quickly and she can heal and recover without too much suffering, poor girl!
but she sounds tough...and funny...which is great...

wishing you and your daughter a happy, healthy and pain free New Year!

jess

Pooka1
12-27-2010, 07:22 AM
Del,

Great that you have come through again! Good work.

My one daughter had a very hard time with the bandage removal also but the second daughter did not. I think the bandage experts have made great strides in adhesives between our daughters' surgeries in 2008 and my other daughter's surgery in 2009. (smiley face)

Best regards,
Sharon

Singer
12-27-2010, 08:38 AM
Thanks for the update Del -- I certainly hope that this is IT for your daughter, who, along with her mother, is a real trooper. Best wishes for a swift recovery!!

Aussiemum
01-17-2011, 08:50 PM
Hi one and all,

Well it's 4 weeks from surgery today! Whilst Elysia is moving about nicely now, the pain in her shoulder area is constant! Her lower back only gives trouble after using it too much. Think we might venture into some physio even though surgeon hasn't suggested that. We see him Thursday so shall ask.

Very disappointed with her x-rays.... obviously he was unable to correct the top Thoracic region... but his gives her pain constantly, looks like something she will have to live with for the rest of her life! The T4 T3 look awful!!!! I've attached the x-ray if anyone would like to look and make comment.

It's a before and after shot from the first surgery. I can't speculate on anything anymore, it's just one of those things that has happened to my child and I feel for her having to deal with this now forever. Shoulder pain will not settle..... it was like this before surgery! Lumbar probably will settle over time! Hard to keep a positive outlook on things when the first time around was such a breeze in comparison. She starts back at school in 2 weeks, I have no idea how she's going to cope sitting there all day!

Cheers
Del

Sherie
01-17-2011, 09:32 PM
Hi Del

I'm so sorry to hear about Elysia continuing pain, it is so unfair. It doesn't appear that he went any higher, is that right? I wonder if he should have gone up a few more vertebrae to get more correction in T area? But that would probably require him to break the fusion, maybe that's why there's no more correction on top. It could still be post op pain too, hopefully the pain will subside with time.

Sending Elysia my best!

laurieg6
01-20-2011, 12:29 AM
I was really hoping that Elysia's surgery would alleviate her pain and I'm very sorry to hear that it hasn't done so yet. Maybe over time her shoulder pain will diminish... Maybe some PT to help with muscle strength and calm some of her nerves in that area. I've had ultrasound and Alexander and I have had laser treatments to help with back pain as well as massage.

I'm sending positive thoughts and energy that this will all improve and that Elysia will get a break from pain and go on to be a relatively carefree and happy teenager with a great deal of strength and determination. She sounds like a wonderful and amazing girl!

All the best for a complete recovery!

Pooka1
01-20-2011, 06:35 AM
Hmmm... I posted a response, successfully I think yesterday and now it is gone.

I said that you might want to give the shoulder pain more time as my daughter's did not subside for a while after surgery. Also, the nerves serving the shoulder blade area I think come out of the spine much higher than the top of her fusion. So either it isn't nerve pain (which is what I'm guessing based on my daughter's case) or there is something higher up.

Don't lose hope on this pain thing.

Also, since someone said there are no revision specialists there, maybe you might consider going elsewhere for a consult.

Good luck, Del. Scoliosis is a crime.

Aussiemum
01-25-2011, 06:23 AM
Thanks for the well wishes.... any prayers... keep those coming!

Elysia still has the pain going down her right arm and now pins and needles in her hand? Any thoughts on what that can be? Do I need to start getting real nervous or relax and let time and healing work it's magic?

Ahhhh - stop the planet and let me off at the next stop please!!!

Pooka1
01-25-2011, 06:50 AM
Del, the arm think sounds like it might be a nerve issue high up, somewhere near the top of the back or bottom of the neck. Maybe there is some imbalance that is putting pressure on that nerve? I have no idea what I'm talking about. You should tell the surgeon about these issues. They sounds very annoying. Elysia needs to catch a break here.

Here's what wiki has...


Brachial plexus (C5-T1)
Further information: Brachial plexus

The last four cervical spinal nerves, C5 through C8, and the first thoracic spinal nerve, T1,combine to form the brachial plexus, or plexus brachialis, a tangled array of nerves, splitting, combining and recombining, to form the nerves that subserve the arm and upper back. Although the brachial plexus may appear tangled, it is highly organized and predictable, with little variation between people. See brachial plexus injuries.

Lorraine 1966
01-25-2011, 10:08 PM
Hi Aussie mum, wow you and Elysia have been through a horrid time of it, so sorry. I do not know much about medical jargon but I do think that Sharon may be right., I have had pins and needles down my right arm before and it has come from the cervical spine.
I would definately ask your surgeon or your GP that is for sure. After my operation I was left with a thoracic hump on my right side which was where it was anyway. It is not any where near as bad but have had it all my life and have not had any problems. Of course I am having problems now but you are right there are no revision doctors here in Australia.
The doctor in Queensland that Jennifer talks about is excellent though from what I have heard. Have spoken to them and not a lot they can do for me, but definately worth the call and they were just lovely.

I really, really hope things settle for you all.

All the best
Lorraine.

jrnyc
01-26-2011, 02:10 AM
hey Del
i once had a surgeon in NYC tell me that "numbness and tingling always indicate nerve involvement"..
so i agree with Sharon...to talk to her doc about this...

i hope she gets some relief...you both deserve a break! so much to deal with!
i hope 2011 is Elysia's year to resolve all problems with this!

jess

Lkershner
05-16-2011, 11:23 PM
Hi Aussie mom
Do you have any updates on your daughter?
I have been terribly worried about crankshaft and your posts have been such a wealth of information for me.

(they want to do surgery on my 10 year old daughter I am very concerned about crankshafting)

Thank you for any updates and your daughter is in all of our thoughts.

Aussiemum
05-17-2011, 12:06 AM
Hi there,
Lucky I have auto updates turned on so I get any requests to comments on my posts through my email.
Life is hectic so not on the forums very much any more, but always feel free to contact me through email or online here.
Elysia has come through her second surgery very well, success in straightening out her lumbar region, upper Thoracic looks awful though, am hoping it doesn't present any problems in the future for her! Surgeon doesn't talk much but I know the crankshaft has caused her problems in her T5 and upwards that the surgeon thought too risky to try to fix. My words not his, but my gut feeling tells me this.
Hmmmm - 10 year old full fusion? Well, my wonderful Scoliosis friends on here Marie and Cara told me about a DR here in Australia who is doing a new technique called Vertebrae body stapling and I put a cyber friend here in Australia onto him, her daughter was also 10 and looking at full fusion before this, she is going fantastic now and will only have full fusion once she's finished growing. Not many Dr's in Australia do this but in the States I presume there would be a lot more.
Full fusion on a 10 year old doesn't sound right to me, unless there is some other complications that I'm not aware of from your post. 2nd and 3rd opinins needed there I would say.
Try looking into the VBS - There is quite a lot about it on the net so read up and get some information and go with that in hand to your surgeon. I know the child would have to qualify - meaning certain things like Risser 0 and a few others that I'm not sure about.

All the best and hello to old friends!
Alt 3
Del
xxxx

laurieg6
05-23-2011, 02:59 AM
Hi Del,

It's great to hear that the 2nd surgery was successful for Elysia's lower spine. I hope her pain is now gone. How is she feeling these days?

Laurie