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  • Surgery not recommended?

    Hi

    About two and a half years ago I went to my specialist because I had noticed that I had a "Rib hump" and that my back started hurting if I would stand for more than 6/7 or so hours at a time.

    He measured my curve at around 51 degree's and recommended me for surgery due to the fact that I had stopped growing (I was 19 at the time) and the fact that my curve had gone from 35 to 51 since the last time he saw me. I was braced as a teenager but the brace was removed when I was about 17.

    I finally braved it and decided to start taking action on having surgery. I am getting more opinions, of course but I went to a doctor today and he measured my curve at 46 degrees and does not recommend surgery since it has not progressed in the last 2 1/2 - 3 years.
    He said there is sometimes a 5 or so degree measurement error and that perhaps he is on the low side, and my previous doctor is on the high side.

    Is this common? I am so confused.

    The doctor I saw 2 1/2 or 3 years ago said I absolutely had to have surgery and this one is saying that surgery is definitely not a wise option at this point.

  • #2
    Cass ...

    You previously posted under the topic "How come (most) health insurance does not cover spinal fusions? ".

    WHO are you seeing, and are you in pain?

    50° isn't the magical number, nor is a non-progressing curve. Any *reputable* doc would tell you so, I believe.

    Did you ever bother to get your mother involved in the insurance deal?

    I really think you could use some guidance.

    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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    • #3
      It's not unusual, in fact it is probably fairly common, for specialists to have somewhat different interpretations and recommendations on a particular case.

      Measuring the Cobb angle is a little tricky and establishing existence of progression is much trickier since the X-rays may have been taken under different conditions, such as time of day, different radiologist, different positions of camera and patient, different patient posture, and likely other factors.

      Also, Cobb angle is a two-dimensional representation of a three-dimensional problem -- a rotated spine -- and it doesn't take into account rotated vertebrae. It doesn't tell the whole story of a spine.

      Before deciding on surgery I would get an opinion from a Schroth-trained physical therapist. See the homepage of the NSF (which hosts this forum) for a list -- scroll way down. There doesn't have to be one in your home town -- you could send one or more of them digital files of your X-rays for diagnosis and recommendations. In virtually all cases, surgery can be avoided and your scoliosis-related pain and abnormal curvatures at least partially mitigated.

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      • #4
        Originally posted by Writer View Post
        In virtually all cases, surgery can be avoided and your scoliosis-related pain and abnormal curvatures at least partially mitigated.
        I think that’s stretching it. While I don’t doubt that Schroth may have some merit for those with small curves, for severe scoliosis that is obstructing internal organs, surgical intervention is the only solution. I seriously doubt that a Schroth exercise program could have lifted my rib cage off my pelvis.

        Comment


        • #5
          First, I think a good deal of people would feel pain/discomfort if they stand for 6+ hours. So I don't know I'd attribute that to scoliosis alone, or consider it a significant negative factor.

          Mine's not recommending surgery anytime soon, though my curve is not idiopathic so I will need it at some point, but as of now my major curve degree is 53.

          I start getting pain in less than an hour of standing, am frequently in discomfort doing everyday normal things with increasing frequency and intensity and want to wait as long as I can -- w/o waiting too long of course.

          I think you need to carefully think this through. It's not like after college you'll be uninsured forever, right? You have to remember, if you have complications from surgery and you are no longer insured it could cause financial hardship, and even when you are re-insured, you won't be covered for the surgery related complications unless you got reinsured with in 63 days of loosing the previous coverage.
          30 something y.o.

          2003 - T45, L???
          2005 - T50, L31
          bunch of measurements between...

          2011 - T60, L32
          2013 - T68, L?

          Posterior Fusion Sept 2014 -- T3 - L3
          Post - op curve ~35


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