thoroscapy

[jc3]

hi
sorry if i spelt thoroscapy wrong, but i have a question for whomever had this done. As some of you know already my daughter is having this done along with the rods. A question that i never asked the surgeon and it dawned on me today, is this done in the same incision as the rods or will she have a separate scar from it???? I didn't even ask, i just assumed it was the one incision and i'm really worried now that it's not.
thanks
jennifer

[LindaRacine]

Hi Jennifer...

It's a thoracoplasty. And, it can be done from the front or the back. It's usually not a separate incision, but you should check with the surgeon to be sure.

Regards,
Linda

[jc3]

thanks linda on the correct spelling of thoracoplasty. I couldn't remember how to spell it and didn't feel like looking it up. I am a bit releaved that it can be done without having another incision made, he did not mention another incision so i am assuming it will be done from the back, but i will ask. thank you
jennifer

[Carmell]

Jennifer - will your daughter be having posterior-only surgery? or anterior and posterior surgery? At least two incisions are done when doing an A/P surgery.

I'll be interested in hearing how the thoracoplasty goes for your daughter. That may be something we will be looking into for Braydon at a later date.

Best wishes!

[jc3]

hi carmell
she will be having her surgery done posterior and i will definitely let you know how it goes. She is only 14 and her rib hump is pretty severe looking. I wish she didn't need it, but she does. I hear that causes alot of pain afterwards. I am very nervous. Monday she has pretests and next thursday blood donatation and then surgery is 2 weeks away. I am starting to get butterflys.
jennifer

[Peggy]

Hi Jennifer,
My daughter had a thoracoplasty with her spinal fusion. She complained of her ribs hurting while in the hospital when she tried do her breathing exercises. For about 2 weeks after she came home she mentioned sometimes when she was turning in bed that it hurt. It was a soreness more than a sever pain. After that she never complained. She had a pretty severe rib hump prior to surgery and after it was not noticeable at all. It is really amazing. Some surgeons do it in seperate surgeries but I would recommend getting it all over at once. Good Luck and try to think positive. I feel for you and the place you are in right now. Try and take all these positive experiences to heart and hang in there. Your daughter will soon be on her road to recovery and this unnerving time will be behind you.

[jc3]

hi peggy,
thanks for writing. It is so comforting when i hear others who did so well. It really gives me hope. My daughter is having the procedure done at the same time, but i recently saw a picture of someone's scar from surgery and they had two scars, one by the ribs and one down the back. I really should call the drs office, because now i am worried that she will have two scars, i thought there would only be one. Does your daughter have one or two?
please write back when you get a chance
jennifer

[mumof5]

My daughter had a double fusion from T4 to L4. (5 months ago)Her scar is just over 21 inches long and I would say about 1/4 of an inch wide. She also had thorocoplasty done at the same time, with no extra incision. I have posted quite a bit on this but if you have any questions I am happy to try and help.
Best wishes.
Cheryl.

[jc3]

hi cheryl
i will try and find some of your earlier posts to read. I am worried that there will be two scars because i saw a picture of a girl who had two scars. I am really hoping they only have to make 1 incision. I will try and find out this week from the surgeon.
thanks jennifer

[Amymichele]

Jennifer,
Lacey also has a large hump on her right upper back/shoulder area. From my reading here, i knew of the procedure of which you speak. So, I asked our Dr. what he thinks and how it would be done.
He said, since her posterior incision will not be near enough to the rib hump, she WOULD need a separate incision. He explained what others have voiced here, another site to heal from, more pain, possible lung puncturing, possible breathing problems for an extended time...
He dissuaded us. She already will have 2 very major incision sites healing at the same time, due to taking her bone graft from her pelvic area. The 3rd would be just too much.
I asked what to expect post surgery, as far as the hump goes. He explained that the hump would correct in conjuction with the curve. So, if her curve is at 10-20 degrres eventually, her hump willl be much improved.
We MAY have gone ahead with the thoracoplasty tho, if it were going to be thru the same incision. I think that's important to find out for sure huh?
Hang in there, Jen! :)

[LindaRacine]

Amy...

I'd encourage you to get a second opinion. My understanding is that the pieces of ribs are removed close to the spine, not at the peak of the rib hump, so there should be no need for a separate incision. Most scoliosis specialists don't perform thoracoplasties, at least on a routine basis. If the cosmetic result is important to you, I'd encourage you to find a doctor who routinely performs thoracoplasties.

Regards,
Linda

[jc3]

amymichele,
that is very interesting what your dr. said. I think i'm going to call the office to find out what correction she would have without having the ribs removed. I'm like a wreck about this now. Just another thing to add to the list. I know that instead of using the bone from the hip he said he would be using it from the rib instead so if they do need to my another incision for the rib that would only be 2 incisions. I shouldn't say only, 2 is quite enough.
I'm going to look into this further. I'll let you know what they say.
jennifer

[jc3]

hi linda,
thanks for your input on this. My daughter as i have previously posted is having surgery by dr. boachie, whom i know you have heard of. I am assuming he performs these routinely?? I hope! I guess i should call him, because of amymichele's post i am nervous now about all the complications she mentioned from her dr.
jennifer

[LindaRacine]

Hi Jennifer...

Wow. I'm really surprised that he said she'd need a separate incision. You can't get much better than Dr. Boachie, so I would definitely go by what he says.

Prior to surgery, you'll probably be asked to sign a disclosure that lists most of the potential complications. You can request to see that document early. While there are many many complications to such a big surgery, the vast majority of teen patients have no major complications. I have links to a bunch of published article abstracts that may be of interest to you, on my website at:

http://www.scoliosislinks.com/Outcomes.htm

Regards,
Linda

[mumof5]

Amber only had the one incision and she had 5 ribs done. The were done from the spine and at one of our check up visits the doctor explained to us about how they grow back. I had seen a bit of a lump in Ambers upper back near her shoulder blade. This was actually one of the ribs growing back.
Cheryl

[jc3]

Linda
No, i'm sorry if you misunderstood me, dr. boachie did not say he would be making two incisions. I was under the understanding that there would only be one because that is all he mentioned, then i saw a picture of someone who had two and i thought maybe i missed something when i spoke with him or that he just didn't mention that she would have two scars. So i started asking on the boards if they do two all the time. I am just hoping that he makes only one and then i got nervous from amymichele's post on all the complications on it.
Thanks for the link, i am going to go read it now.
Jennifer

[jc3]

cheryl,
That makes me feel better. So at least i know it can be done with making only one. I really don't want her whole back all scared up.
thanks
jennifer

[Amymichele]

jc,
So sorry that I alarmed you. That's the last thing i wanted to do. Just was trying to share what WE know about Lacey's procedure so far, and the words from our surgeon...to help you along the way in your decision making.
If your surgeon does this often, thru the same incision, I'm quite sure you'll have nothing to be concerned about! Again, I would never want to be perceived here as negative, so please forgive any insensitivity I may have shown.
Amy

[Amymichele]

Linda,
Lacey, her dad and I feel pretty good about the correction she may get to her hump. So, we opted to stay with the surgeon she has, since he has been very good to her, and comes HIGHLY recommended by many, including our family Dr.
I may not have completely understood the reason WHY he said there would need to be a separate incision for Lacey's thoracoplasty, but I do know that there would need to be one.
Guess each and every case comes down to what's important the individual child and family in these situations.
Thank you for your concern.
Amy

[LindaRacine]

Thanks Amy... If you ever get the chance, please ask the surgeon about the separate incision. I've never heard of that before.

If the cosmetic aspect isn't a big deal, that I would definitely recommend against a thoracoplasty. If it is a big deal, there is often good improvement to the rib hump just from the derotation done during scoliosis surgery. Unfortunately, most people complain that the rib hump returns over time.

--Linda

[jc3]

hi amymichele
No need to apologize at all, you were not being insensitive at all. You were just writing what your dr. had said.
Linda,
Can the rib hump return even after having the procedure for it?
Jennifer

[LindaRacine]

Hi Jennifer...

If your question is "can the rib hump return after having a thoracoplasty," the answer is I don't know. As far as I can tell, the people I know who had thoracoplasties haven't had their rib hump return, but I imagine it can happen. It's a good question to address with your surgeon.

Regards,
Linda

[jc3]

hi linda,
yes that was my question because i have heard if there is a rib hump and it looks better after surgery it can return later on. I will ask the dr.
thanks and i still have to find out if boachie makes only 1 incision which i am hoping he does.
jennifer

[LindaRacine]

Jennifer...

If scoliosis surgery is done correctly, the rib hump will be reduced without having a thoracoplasty. Many people complain that their rib humps have returned over time, but I've never heard that from anyone who had a thoracoplasty. Does that clear up the question?

And, I've never heard of anyone having a separate incision for a thoracoplasty, but I guess anything is possible.

Regards,
Linda

[jc3]

linda
if like you said if the surgery is done correctly then the rib hump would be reduced, then why do they need to even do this procedure at all then?
Just curious on your thoughts
Jennifer

[LindaRacine]

Jennifer...

Two reasons that I can think of (there may be more). 1) Derotation will only reduce moderate rib humps enough to make a big difference (I think large rib humps are still large have scoliosis surgery). 2) Rib humps reduced by scoliosis surgery tend to reoccur.

--Linda

[jc3]

Thanks linda
That is what i figured. It makes sense.
Jennifer

[mumof5]

I reply to the question about rib humps returning after a thoracoplasty. My daughter had was fused from T4 to L4, she had quite a bit of rotation but I don't know the degree, I was told that her L4 was 'quite oblique' which a friend told me means almost sideways. I could see that myself from the x-rays.
Her rib hump was quite large and she ended up having had 5 ribs done. The doctor told me that they removed about about 5 cms (2 inches) from each of them.
Around the 3 month mark I noticed a lump in her back between her spine and her shoulder blade. At her check-up we asked about it and were told ( the doctor even made me feel it so I would get a better idea) that it was one of the ribs growing back.
He said that sometimes when the ribs grow back after such a big hump the don't always grow straight or how we want them to. Sometimes they will grow back with a curve, though it won't be as large as the original one. The 'bad' rib in Amber's case is pushing on the bottom of her shoulder blade and making it stick out, making it look like the hump is bad. In reality when I look closely I can see that the hump itself is not very bad. They have told us that around the 12 month mark they could look at redoing that rib if she wants.
They also said that the only way to stop the ribs regrowing with a curve like that is to take them off at the front, but that is not a good idea because then there is no support and no 100% complete fix.
Cheryl.

[jc3]

hi cheryl,
That is basically what they are going to do to nicole. He said he would be removing part of 5-6 ribs. Nicole's is pretty severe looking. That is what bothers me the most about her having scoliosis. It's not so much the curve you notice on her, it's the ribs that are very noticable, especially in certain shirts she wears or in a bathingsuit.I just hate to have her go through this procedure and it doesn't make a difference after a while or like you said get it redone after the 12 month mark, i don't think we'd be doing that and if it was redone again i wonder if there's still a chance it wouldn't grow in like that again. How do her ribs feel now. Does she have any pain from that procedure anymore?
jennifer

[mumof5]

Amber occasionally says that her shoulder hurts or is sore. But those days are becoming fewer. When she is tired and/or has had a big day it is more noticable. Amber is actually becoming a little proud of it. She loves her scar and is dissapointed that it is starting to fade. If I comment on her shoulder she says 'yeah it does that when I've been up all day.' But she says it like 'isn't it good, people have to notice I've had a big op when they see it'. Maybe that's not what she means but it really seems that way. She wears it well and is proud of herself. Which makes me all the more proud of her.
I have spoken to Amber about everything to do with her back and shoulder. She is positive that she would have the thoracoplasty done again even with the 'bad' rib. She has said that she doesn't know if she wants to have it 'fixed' she wants to wait and see.
It has made a big improvement to the way it looks. If it had been any other rib either up or down I doubt it would have made much difference to the appearance, this one just happened to run into the bottom of the shoulder blade.
Not everyone will go through what Amber's ribs have done but of course there is the risk that it will.
All I can say is that Amber is glad she had it done and would have it done again.
Best wishes.
Cheryl.

[jc3]

cheryl
Amber definitely deserves to wear her scar proudly! She sounds like such a trooper. I hope one day nicole will be able to show off her scar proudly.
Jennifer

[spincon58]

Hi Linda,
With all this talk about rib hump returning..Is there any explaination reguarding this...Has anyone asked there dr. abut this....I would hate to see mine return..and I wonder with PT can I help it not return....Any input would be appreicated

[Peggy]

I'm sorry I haven't been back on in so long. Like the others, my daughter only has the one scar. It is from the top of her spine to the bottom but it has really faded i alot. It is definitely noticeable but has improved immensely since the surgery. Good Luck. Sending lots of prayers.

[mumof5]

Hi Peggy,
It's good to hear from you again. How is your daughter going?
Best wishes.
Cheryl.