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titaniumtough
03-29-2009, 04:07 PM
Ok.. Here is a couple of pics of me. I had surgery a year ago...do I look in balance to you guys?? My surgeon says that I am straight! Thanks for looking! :D

Pooka1
03-29-2009, 07:20 PM
There is a difference between "straight" and "straight with a list."

Your spine can be straight (i.e., no curve) and be perpendicular to the ground when looking from the back.

Your spine can also be straight but NOT perpendicular to the ground. I would call that "straight with a list." I would say you are in this category.

Is there an angle at the bottom of your fusion that your now straight upper spine makes with the lumbar? Is that what accounts for your present lumbar curve?

I have read a few testimonials on here of kids with a list after fusion. It seems most (not all) have had double curves but were not fused into the lumbar. That is, the fusion ended above the lumbar.

My kid had a thoracic curve and yet the fusion extends to L1. I'm just a lay yahoo but it seems that there is probably a good reason why surgeons go to L1 despite kids not having a structural lumbar curve... maybe it is to avoid this listing. Who knows.

That said, wearing a brace post-op is said to correct the listing. But I wonder if that works then why do surgeons ever go into the lumbar when there is no involvement there?

Good luck. Maybe you can ask about wearing a brace for a few months to see if that helps.

titaniumtough
03-29-2009, 08:08 PM
Hi!:D
Thanks for your reply! I have only had my thoracic curve fixed because they said that the lumbar curve would correct itself... Well I am year post op and I look worse than before surgery. I didn't have a brace afterward only presurgery. My lumbar curve decreased by 4 degrees and then increased by 4 degrees(after surgery) and we don't know if it has increased more or not since Jan. My surgeon says my gait is normal and that my spine is straight. Neither are though!! I wear a 3/4 in lift on my shoe to walk half way normal and when I don't have it in I look like I pack one leg. It sucks!! We are switching surgeons because we aren't convinced he made the right decision... We see him in April. We are afraid that I will have to go through another surgery to correct my lower spine to straighten me out. Thanks for looking and posting! :D

Pooka1
03-29-2009, 08:09 PM
Just another comment...

The fact that you still have a lumbar curve... does that mean that it was in fact structural at the time of surgery and not compensatory? Is that consistent with the list?

My kid had a lumbar curve but neither surgeon ever mentioned it I guess because they knew it was compensatory. And indeed, it has completely disappeared ever since a few days after surgery IIRC. I know for sure it was gone completely on the 6 week post-op radiograph.

Just trying to learn something here.

Pooka1
03-29-2009, 08:15 PM
Again, I think it is likely the case that the fused portion is STRAIGHT. So I don't think we can say the surgeon is dissembling there.

The issue is the junction between the fused and unfused portion and the curve in the lumbar.

What does he say about that?

I agree with your decision to go to another surgeon at this point.

It seems like the test for determining if a curve is structural or compensatory isn't very good given at least the few cases here where the kid had an S curve but the surgeon didn't fuse into the lumbar. I mean if they go into the lumbar with single T curve like with my kid, there must be some very good reason to do so.

I'm going to ask our surgeon about this business when next I see him (which won't be before the fall, though).

Again, good luck.

titaniumtough
03-29-2009, 08:16 PM
Original curves were thoracic 40 degrees, lumbar 35 degrees. Supposedly compensatory curve. If it is a compensatory curve though why do I still look like this and then it is increasing? We were told it was supposed to go down because it was a compensatory curve. That is why we don't think my original surgeon did the job right and will require another surgery.

Pooka1
03-29-2009, 08:19 PM
I agree with your thinking there.

But I don't understand why you were fused with those angles. They are sub-surgical as far as I know. I mean my unfused kid was measured as high as 40* (with a compensatory lumbar curve - don't know the angle - nobody ever measured it AFAIK) and she is definitely sub-surgical.

Very strange.

titaniumtough
03-29-2009, 08:27 PM
When they did surgery I was a 44 degree in the thoracic and a 32 in the lumbar. I wore the brace TLSO for 18 months during growth spurt. The last 4 months they allowed me out of the brace 6 hours aday. My upper curve went up 8 degrees and the lower curve stayed the same. (this was not disclosed to me) They removed the body brace within 4 months I gained another 4 degrees in the thoracic area. The lumbar at that time stayed the same. They did surgery because it was a 44 and would continue increasing. So, they did surgery then so I wouldn't have to deal with it long term and so I wouldn't be way crooked. I think they made the wrong decision regarding leaving the lower curve untouched.

Pooka1
03-29-2009, 08:37 PM
I think you are thinking straight. :)

I remain in shock that they operated when you were 44* (and pulled the trigger at 40*).

My one kid had a curve that was moving like a freight train and they still waited until it was near 50* to pull the trigger. About two months later she was 58* on the table.

Damn.

titaniumtough
03-29-2009, 08:42 PM
We are not quite sure what the degrees were when I hit the table. I was a 44 in Jan. and then I had surgery in March. So, I may have been higher. Right now (if nothing has moved since Jan. of 09) my thoracic curve after surgery is a 15 degree and the lumbar curve went back up to a 31 degree after it moved to a 27. So the lumbar curve is double the thoracic and that is tilting my hips which makes me look really crooked and worse than before surgery.

emma12
03-30-2009, 06:45 PM
I have posted elsewhere on these forums about my daughter's case--we are still waiting and watching at this time. However, looking at your first picture, it appears that you are bending your right knee somewhat (something my daughter does unconsciously--and that makes her appear straight--when she does not bend her knee is when her body looks tilted). There is some similarity to your pose and hers, she has been told she has a trunk shift--her bottom vertabrae does not line up with her top vertabrae--if you draw a straight line on her xray through the middle of her bottom vertabrae up through her skull, the line would go through her eye. She is about 1 1/2 years post surgery.

She is fused T2-T11, and there is some debate (we've had a few opinions now) on what would be the best option for her future "spine health". In support of your surgeon (and maybe he shouldn't have it), but there are many reasons why surgeons determine what to fuse. And, further fusion may not be the best thing for you. In my research, there is concern among some surgeons that very long fusions done relatively early in life can cause significant issues later in life.

At this time she has no complaints on appearance or pain. In her case, fusing to L1 would not have ever been enough, there had been discussion to fuse to L2 originally, but, she straightened up so well on the table they only fused to T11. I believe the surgeon made the right decision (again, I had had several opinions which all agreed), sometimes these things happen, and unfortunately we are one of those cases.

There have been some rather interesting recent posts concerning bracing after surgery for trunk shifting and that there may be some very positve results with that. We have tried pt, which didn't really seem to make a difference. She is now wearing a 1/2 inch lift in one shoe, this makes her appear straight. Have you been checked for leg length discrepancy?

Good luck, and get other opinions if you have doubts--keep getting them until you are completely satisfied.

titaniumtough
03-30-2009, 09:46 PM
Hi!
Top curve is now a 15 degree and then the bottom curve is 31 degrees. I didn't have my knee bent in the picture... I do know what you mean by compensating that way though. We have had my legs checked and they are the same. My pelvis is tipped, maybe because of the bottom curve. I do have a lot of pain, and am a year out of surgery. I am tipped because of my lower spine and the pelvis. My vertabraes have not shifted. I wear one shoe that is lifted 3/4 of an in. it could stand to be a little higher too. I am still crooked with the shoe, all it does is help my gait. That is why are afraid they will want to fix the bottom curve to straighten me out and eliminate muscle spasms and pain. Will know what is going on in April... Thanks for your post. :)