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  • Curve Correction Achieved

    I saw my doctor and unfortunately the lumbar curve is 56* now. It has been growing about 2*/year over the past 5 years. He mentioned the percent correction in my case with surgery would be 40%-60%. I understand that curves can rarely be brought to total alignment. Since pain control is not the issue, the cosmetic result is important to me to consider surgery. Of course, stopping curve growth and preventing the risk of illness associated with scol when I am old is also important. I just can't imagine going through surgery with all it involves and note that the curve didn't improve much.
    Any thoughts based on your experiences? What are the factors that affect correction achieved? I would appreciate any answers via PM as well.

    Cheers,

    Maria
    _____________________________

    Diagnosed at 9, Boston brace during teenage years
    56* left thoracolumbar curve, slight rib hump
    Deciding on timing for surgery

  • #2
    Maria,

    I had surgery a little over 3 weeks ago. My thoracic curve was around 52 degrees and my right rib hump was prominent. I am 35 years old and this curve had become obvious only in the past year.

    This said, this was one of the reasons I had surgery. Don't get me wrong, I had a lot of pain, daily, as well. However, the deformity was really bothering me as well! A large part of my job consists of speaking in front of many people. Therefore, I was becoming paranoid and insecure that people were noticing this.

    My surgeon had told me that he wanted to help my curve at least 50 percent. I decided to have the surgery and I'm glad I did. The curve is now around 19 degrees and the hump is much less noticeable. I pray the pain that I've had the past year is gone; however, I am still on pain killers so there's no way to tell at this time.

    I hope this helps!
    Rachel

    Comment


    • #3
      Hi Rachel...

      I think cosmetic improvement is an important consideration. You might want to get another opinion, but beware of choosing a surgeon based on how much correction they say they can get. (It's actually possible to try for too much correction, which can cause damage.) More correction can usually be achieved by doing combined anterior and posterior procedures. The problem with that is that it's a lot of surgery, you end up with 2 big scars, and the anterior incision can cause other cosmetic problems.

      Good luck.

      Regards,
      LInda
      Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
      ---------------------------------------------------------------------------------------------------------------------------------------------------
      Surgery 2/10/93 A/P fusion T4-L3
      Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

      Comment


      • #4
        I'm in the same boat as you Maria. My curve is currently 46 degrees and I'll be having surgery in two and a bit weeks. I don't have any significant pain but my surgeon recommended that I have surgery as he said it is almost certain to progress and I'll have a much better result if I do it now than if I wait till I'm a bit older. I'm 23 and my main motivation is also cosmetic, although obviously not having it progress further is quite important as well. My doctor estimated that I'll get down to 15 degrees or so but I think you'll find doctors are usually conservative in their estimates.

        Linda, as I'll be having an anterior approach surgery, I was just wondering what are the cosmetic problems you mention with this type of surgery? Is it just that the scar is somewhat harder to hide? Thanks
        Diagnosed at the age of 18 (2004)
        46° curve
        Surgery scheduled for April 27, 2009 - Anterior fusion from T12 - L3

        Comment


        • #5
          Hi Linda,

          I am also interested in the significant anterior scar question you mentioned. My doctor actually said he'd go with an A/P approach. I have seen the scars on posterior surgery and honestly I am not as afraid of those as I am afraid of my increasing back deformity. Do you know where we can see pics of anterior scars? How bad is it? I wonder whether it is worse than a C Section.
          I'll get a second and perhaps a 3rd opinion on the correction level estimate, taking into account the damage issue as well. Thanks for the warning, I actually had read something about it but is good to know about potential danger.

          Thanks!
          _____________________________

          Diagnosed at 9, Boston brace during teenage years
          56* left thoracolumbar curve, slight rib hump
          Deciding on timing for surgery

          Comment


          • #6
            Maria,

            Good luck in your decision making process. It isn't easy to take that final step and say yes. I think we can all understand that. I will say this though... If you are progressing don't wait to get a plan into action. I am a firm believer that one's body heals better when it has not been in pain for years. I have spent the past 5 years in constant pain. Four of those years not realizing it was my scoliosis progressing. Do not loose your quality of life, it just is not worth it trust me :O)

            If I could go back to 5 years ago I would have taken care of it right away. Of course god has his plans and things always happen for a reason. I may never have had my third son if I had the surgery so for that I am grateful! It all works out in the end, I think making the decision to go ahead with the surgery is the worst part. I say this as I am counting down my time until this Wednesday to head on in and start this wonderful process of getting nice and straight!
            Susan

            Diagnosed at 10, Boston brace from 11-13 yrs old.
            50* Lumbar w/ 5 centimeter shift to the left and slight rib hump...
            Surgery Date: April 15 and April 22, 2009
            X-LIF approach for disc repair L5,L4,L3,L2
            Posterior Approach for fusions L5-T5
            Dr. Fox @ Naval Medical Center Portsmouth
            Nice and straight now!!!!!

            Comment


            • #7
              Mauxi,

              My curve was ±53° when I had surgery, and my surgeon estimated about the same correction for me (40-60%). It ended up being at the higher end, and I'm now 20° or less (I swear he drives me nuts on purpose ballparking the digi xray on screen and going "Eh ... about 20°" - LOL).

              He estimated about a 50% reduction in my rib hump, and achieved at least that or better. The cosmetics never bothered me at all before, so this was a small detail to me.

              Most importantly, he estimated about a 70% chance of significant pain reduction, a 30% chance of minimal or no change, and an almost 0% chance of increased pain (yeah ... that's how badly I hurt before surgery).

              BTW, I definitely fell in the 70% estimate. What minor, random, infrequent discomfort I have now doesn't even compare to pre-op.

              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

              Comment


              • #8
                Originally posted by Cimbom View Post
                Linda, as I'll be having an anterior approach surgery, I was just wondering what are the cosmetic problems you mention with this type of surgery? Is it just that the scar is somewhat harder to hide? Thanks
                Hi...

                I wasn't referring to the scar, although mine isn't exactly attractive. I was referring to an incisional hernia (also referred to as abdominal wall defect). Unless the surgeon meticulously sews each layer of muscle back, there is a significant danger of this issue. (Note, this is referring to anterior surgery only.) If you do a search for "incisional hernia" above, you'll find several discussions on the topic.

                Regards,
                Linda
                Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
                ---------------------------------------------------------------------------------------------------------------------------------------------------
                Surgery 2/10/93 A/P fusion T4-L3
                Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

                Comment


                • #9
                  Hi all, happy holidays! This thread really caught my eye, as I am very similar to mauxi in that my lumbar curve has really increased in just this past year, my surgeon is suggesting A/P approach also. I have not met with the team as of yet, but I did some investigation on the anterior approach, maybe I'm wrong, but I understood it to be kind of like laperscopy, and actually going in through the side. For those who have been through this approach, and until I do meet with the surgeons, have you ever heard of this? I was kind of psyched that it wouldn't be a long incision down my front, hopefully I didn't research some other kind of procedure.

                  Mauxi, I really do sympathize with you on the cosmetic side of this, through the years I noticed subtle changes in my body, but this year the changes really kicked in, pretty noticeable hump mid back, leaning to the right more and more, left leg seems longer than my right, and of course more and more pain from the sciatica. Even though I know and have read in this forum, I will not get 100% correction, at least I know what ever correction I get, the curve should not progress any longer.
                  Dolores A
                  June 4, 2009 Anterior L3 - S1
                  June 8, 2009 Posterior T4 - Pelvis
                  Mark Agulnick, MD FAAOS
                  NY Spine & Scoliosis Center

                  Comment


                  • #10
                    Hi All.
                    Thank you for all your responses….what a wonderful group of people
                    I really feel lucky to count on your experiences. I heard that with a big main lumbar curve an A/P approach is most likely. I'll sure discuss the "incisional hernia" issue when I get a second opinion and with the surgeon that does the surgery in the end. I guess one can just try to cover as many bases as possible 

                    Cheers,
                    _____________________________

                    Diagnosed at 9, Boston brace during teenage years
                    56* left thoracolumbar curve, slight rib hump
                    Deciding on timing for surgery

                    Comment


                    • #11
                      Hi Susan,

                      Thanks for your post. I'll be thinking of you on Wednesday. I am sure you'll do great!!

                      Best luck,

                      Maria
                      _____________________________

                      Diagnosed at 9, Boston brace during teenage years
                      56* left thoracolumbar curve, slight rib hump
                      Deciding on timing for surgery

                      Comment


                      • #12
                        Oh no, I'm scared now
                        Diagnosed at the age of 18 (2004)
                        46° curve
                        Surgery scheduled for April 27, 2009 - Anterior fusion from T12 - L3

                        Comment


                        • #13
                          A/P Approach

                          Ihad an A/P approach for my long fusion 10 months ago. My anterior scar is about 4 inches long vertical somewhat diagonal to the left of my bellybutton. It has faded over time. Still somewhat sore when I press on it. But overall not a horrible scar. I had 70' lumbar and 45' thoracic curves before surgery and after I am nearly straight. I do notice my left leg being shorter now. It is a HUGE decision but I have to say it did help my pain issues enormously. I did not have the surgery for cosmetic reasons although that is a nice side effect. It is such a life altering surgery in so many ways that you can't even know until you have it done. You won't know if you are a person who recovers quickly or like me feels like you got hit by a bus 10 month later!!
                          May 2008 Fusion T4 - S1, Pre-op Curves T45, L70 (age 48). Unsuccessful surgery.

                          March 18, 2010 (age 50). Revision with L3 Osteotomy, Replacement of hardware T11 - S1 , addition of bilateral pelvic fixation. Correction of sagittal imbalance and kyphosis.

                          January 24, 2012 (age 52) Revision to repair pseudoarthrosis and 2 broken rods at L3/L4.

                          Comment

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