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    I talked to our doc about this in one of our...

    I talked to our doc about this in one of our first visits. He said that from what he's seen the kids that get growth modulation from tethers have retained that correction ten years later. It's why...
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    So I don't actually know the answer to this. I'd...

    So I don't actually know the answer to this. I'd guess it probably depends on the lumbar level -- L1 is high enough that I'd suspect they do, whereas L4-L5 not. But I don't know. I do know that...
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    This is secondhand, but I have heard that the...

    This is secondhand, but I have heard that the docs who have been doing tethering the longest will only do three procedures in a lifetime because it's too traumatic to come in from the side and...
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    Nope, he didn't say what the "fix" would be. ...

    Nope, he didn't say what the "fix" would be. Just that many women with this type and size of curves start noticing them in their early/mid 30s, but at that point they have or are having small...
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    Yes, he said two more xrays in 6 and 12 months to...

    Yes, he said two more xrays in 6 and 12 months to see where exactly it "settles" at 100% maturity, and then one more after that when she's 17 or 18 to see what it's been up to.

    It's funny. He...
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    Thanks! He specifically noted how balanced the...

    Thanks! He specifically noted how balanced the curves were and how her rotation made her look like her curves were a lot smaller than they really are. He said that he wouldn't be able to tell that...
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    Six month update

    Doc had curves at 39T/37L. I have about the same (38T/36L). Slight progression (1-2 degrees), but well within measurement variance. Both hips now Risser 4. Left hip completely capped. Right hip...
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    Oh, I was unclear. I'm not saying 50% need...

    Oh, I was unclear. I'm not saying 50% need revision -- I was saying that docs might understate the chances for those particular kids who have a relatively high chance. I was just using a 50% case...
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    I think a lot of ped-orthos are up front that...

    I think a lot of ped-orthos are up front that there is no guarantee that the lumbar won't eventually have to be fused unless they can get it straight (the figure I've seen is they shoot for less than...
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    Supine x-rays are supposed to be about 60% of...

    Supine x-rays are supposed to be about 60% of standing. It's just gravity.
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    I think it's an access thing. They have to go...

    I think it's an access thing. They have to go through the psoas muscle, which is tricky and can complicate recovery. I've also heard that going down to L4 can result in more noticeable mobility...
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    Our doc became a tethering fan because he hated...

    Our doc became a tethering fan because he hated fusing kids down to L4. He has said he just doesn't care about the top curve because he can fix that. The bottom one is the one that he's trying to...
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    Also: ...

    Also:

    https://www.scoliosisassociates.com/about-us/meet-dr-lonner/

    Those are the only ones I'm aware of in America who will do adult adults (there are a couple of others who will do skeletally...
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    Sharon is right. The only people who are going...

    Sharon is right. The only people who are going to be able to tell you whether you'd be a candidate for ASC (you wouldn't be one for VBT -- that's for teenagers and younger) are going to be the...
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    For kids I've heard the general rule is that...

    For kids I've heard the general rule is that supine x-rays measure about 60% as big as standing (so a 20 degree standing would be 12 on the table). I don't know if that's the same for adults.
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    Not that I'm aware of. The number of adult...

    Not that I'm aware of. The number of adult patients is tiny -- it's almost all parents (by design). I know that at least a couple of have done fusion-tether hybrid surgeries, but those were all...
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    She certainly should ask about tethering. The...

    She certainly should ask about tethering. The American docs tethering adult adults have online consult options -- though I believe one charges for it. I'd guess that they could tell her whether...
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    Yes, six months. We’re really hoping to see...

    Yes, six months. We’re really hoping to see curves below 40 (well lumbar for sure, if the top is a smidge over we won’t be too gutted) and a mostly mature spine.

    And yes, her determination is off...
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    OK. She's not really the type to care about the...

    OK. She's not really the type to care about the aesthetics of it, so that part is easy. It's not comfortable, of course, and we sometimes have to nag her, especially on the weekends where the...
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    I exchanged messages with the doc. He isn't...

    I exchanged messages with the doc. He isn't considering VBT because she would be a marginal candidate at Risser 3 anyway, and he doesn't want to gamble on a borderline surgery for a thoracic curve...
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    Thanks for the new rabbit hole to go down! My...

    Thanks for the new rabbit hole to go down!

    My daughter isn't super flexible (in fact, on the basketball court, she's generally known as the big, stiff, slow white girl -- the one who is deadly...
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    40 seems to be the norm. Some docs will do high...

    40 seems to be the norm. Some docs will do high 30s, *especially* lumbar. I think with my daughter, he didn't suggest it because (1) at Risser 3, she's probably outside the maturity criteria...
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    No, no bending x-rays. If the curves had jumped...

    No, no bending x-rays. If the curves had jumped to surgical territory I was going to ask for them today because that would matter for VBT. But they're still sub-surgical.
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    Yes, the only signs of the curves are the humps...

    Yes, the only signs of the curves are the humps when she bends over and her left hip is slightly higher. You'd have to be looking for it to notice.

    No, we don't know if one or both or neither is...
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    Update

    Four month scan (about 27 hours OOB). Thoracic curve grew a little -- this doc previously measured it at 32, he now measures it at 38. I previously had it at 34 (as did another ped-ortho, which...
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