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ecnw
10-23-2009, 11:41 PM
I was just wondering if anyone who had chose stapling over a fusion has experienced any trouble with it.

My daughter had the staples put in a year ago after almost four years of growth rods. The rods were kept in for an additional 6 months then taken out. It went ok until about 4 months after surgery when I noticed her back was changing. The staples are still there but the curve has progressed. Now we are scheduled for a fusion.

Has anyone else experienced this? Or does anyone know of statistics for how successful the staples really are?

Thanks,
Emily

mariaf
10-24-2009, 08:56 AM
Hi Emily,

I'm sorry to hear your daughter's curve has progressed.

I'm a little confused and would like to understand, so can you clarify if you are saying that the staples were added after your daughter had had the growing rods for 4 years?

I've never heard of that so I was wondering if I misunderstood your post. But if I read it correctly, that's not the typical way the staples are used from what I understand. Maybe a better way to say it is that I have never heard of staples being added after a patient already had growing rods for a few years - that doesn't mean it's not done that way - just that this is the first I've heard of it :)

Usually, if a patient presents with a curve that is deemed too aggressive for staples, growing rods might be recommended. In fact, in Philly, they are using a combination of a hybrid rod (similar to VEPTR) and staples in certain cases - but again, not where the staples are added long afterward.

I guess I find it unusual that they added the staples so long after the rods, because if the rods couldn't hold one's curve (I'm guessing that's why they added the staples?), then the feeling would be that it's a very aggressive curve and would not respond to staples (I'm speculating).

I know that in Philly (where my experience has been) there are very strict criteria for who qualifies for stapling (they look at things like the size of the curve, how fast it is progressing, the child's flexibility, how much growth is left, etc.) - so, in answer to your question about success rates, I would say that at this point in time (with what they have learned about which patients make the best candidates) the success rate would be very good, once they determine a child is a good candidate.

Hope that makes sense and is helpful.

And best of luck to you and your daughter!

ecnw
10-24-2009, 01:53 PM
The doctor felt that we could do the staples after growth rods because we were still within the perimeters. He just kept the rods in for six months longer to make sure the staples were set before taking the rods out. Since not everyone chooses growth rods it is some what of a new progression in the treatment.

I had heard of the staples coming out and we were told there was a slight possibilty the wouldn't hold the curve.

I know not all proceedures work for everyone, we had been very successful with the rods, so this was our only set back.

mariaf
10-24-2009, 04:58 PM
Thanks for that additional info.

It does sound like the rods were quite successful for your daughter. Perhaps if they had not been removed, the curve would have held, I don't know. I'm not second-guessing the doctor for removing the rods - I'm sure he had his reasons - perhaps he was trying to avoid the necessity of the repeated surgeries with the growing rods? Or maybe he thought the staples alone would have held the curve? I'm still a little confused though about why, if the rods were working, he chose to do another surgery (stapling).

Again, I'm just trying to get a clearer picture of the situation. But I think if the rods were already there, it might have been better to leave them (and extend them when necessary) until your daughter was done growing and not even bother adding staples, especially since the rods were working so well.

In any event, I wish her all the best!

Carmell
10-28-2009, 12:39 AM
Your situation sounds very different than any other I've heard of. Not that I've heard many differences, a few though. Common sense says to me that removing growing rods after 4+ years and expecting staples to support the spine is not accurate. Your daughter's spine may have become dependent on the growing rods and this could have contributed to the curve progressing after the rods were removed. Like Maria, this is purely speculation on my part. I don't completely understand the methods here nor the time line. Best wishes to you in your future decisions.

leahdragonfly
10-28-2009, 08:32 AM
Hi,

I am sorry that your daughter is now needing a fusion. I have actually wondered how her staples turned out, because I remember your pre-op posts about planning for staples. I have never heard of the staples used in this way at Shriners Philly, where stapling was developed.

It does seem to me that the staples were used outside the established indications for your daughter, the main one being there is growth remaining, the other important piece is a curve under 35 degrees. And unfortunately it sounds like if they were taking out growth rods after 4 years maybe she was done growing and ready for the final surgery, which is traditionally considered fusion I think. This is all pure speculation on my part and I mean no disrespect to your choices.

I am really sorry she has to now undergo fusion. Best of luck,

ecnw
10-28-2009, 07:30 PM
Thanks guys, I know our situation is different because many people only staple and never deal with the rods. I believe we are one of the few that her doctor was seeing the progression from growth rods to staples vs. growth rods to fusion (or earthquake retrofiting as I call it).
I know Shelby will be happy to have it done with before starting high school next year (surgery would be a pain for her to miss that much school). She's bummed that she will miss opening night of "New Moon" which she had tickets for but she is excited for a month away from school, even if it is to recuperate.