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  1. Replies
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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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    I'm just curious, but my understanding is that...

    I'm just curious, but my understanding is that once the spine is actually fused (not the operation; when the bone actually forms where the discs used to be), it's not likely to curve again -- it's...
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    I had a slipped disc at C6-C7 that was causing...

    I had a slipped disc at C6-C7 that was causing nerve pain in my arm a year or two ago and it was excruciating. I could lay on my right side OK, but any other position and it would be so painful. I...
  21. I'm actually curious. Is it common for rods to...

    I'm actually curious. Is it common for rods to break before fusion is complete? My understanding is that you'd be talking about a 3-6 month window there, at least if you are talking about...
  22. The theory I've heard is that there is...

    The theory I've heard is that there is remodulation that occurs even in adults -- i.e., if you pull the spine straight for a long time, it will stay straight even if/when tethers break. I've seen...
  23. Discectomies don't necessarily require fusion. ...

    Discectomies don't necessarily require fusion. Especially in the back with the bigger vertebrae, sometimes they can just remove the portion of the disc that is causing the pain (in cases of...
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    Our ortho/ped goes to South America a couple of...

    Our ortho/ped goes to South America a couple of times a year (I think Chile but am not certain). He said that he routinely treats people there with 100+ degree curves.
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    Just to chime in

    My understanding is that it's not uncommon for (some) studies to show modest curve improvement with bracing (less than 5 degrees) in some adolescents at cessation, but that this improvement almost...
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