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Thread: Check out this correction and comments

  1. #1
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    Check out this correction and comments

    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  2. #2
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    What I think is most interesting about this is that the xray technician shielded her reproductive organs. Why do they do that sometimes and not others? Every time I ask for it they say it will get in the way of seeing the curves. But as you can see from this Xray, the shield is below the pelvis! I feel like I've been exposed to a lifetime of radiation with scoliosis Xrays since age 11 with no particular regard for my organs!

    Evelyn
    age 44
    80* thoracolumbar; 40* thoracic
    Reduced to ~16* thoracolumbar; ~0* thoracic
    Surgery 3/14/12 with Dr. Lenke, T4 to S1 with pelvic fixation
    Not "confused" anymore, but don't know how to change my username.

  3. #3
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    Quote Originally Posted by Confusedmom View Post
    What I think is most interesting about this is that the xray technician shielded her reproductive organs. Why do they do that sometimes and not others? Every time I ask for it they say it will get in the way of seeing the curves. But as you can see from this Xray, the shield is below the pelvis! I feel like I've been exposed to a lifetime of radiation with scoliosis Xrays since age 11 with no particular regard for my organs!

    Evelyn
    Evelyn...

    I think you may need to find a new specialist. The recommendation for scoliosis films is that they be taken with shields, and lateral films should be taken P/A (meaning the back is toward the machinery).

    --Linda

  4. #4
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    A lot of x-ray techs are unfortunately extremely sloppy and lax about shielding. I nearly always have to request/insist on proper shielding for my daughter, who started having scoliosis x-rays at age 6. You have to be very vigilant about insisting the shielding is applied properly and consistently.

    I have noticed though that now, at the age of 43, my ovaries are not shielded--I am assuming because I am past my child-bearing years.

    Evelyn, I'm not sure about your comment on the shielding of Dr Hey's patient. That looks like very good placement, actually. You can find a lot of info online by googling "gonad shielding." There are even articles with photos of proper shield placement.
    Gayle, age 50
    Oct 2010 fusion T8-sacrum w/ pelvic fixation
    Feb 2012 lumbar revision for broken rods @ L2-3-4
    Sept 2015 major lumbar A/P revision for broken rods @ L5-S1


    mom of Leah, 15 y/o, Diagnosed '08 with 26* T JIS (age 6)
    2010 VBS Dr Luhmann Shriners St Louis
    2017 curves stable/skeletely mature

    also mom of Torrey, 12 y/o son, 16* T, stable

  5. #5
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    Thanks, Linda. Actually, this unfortunately has been true at a variety of offices (latest was Dr. Bridwell in St. Louis). I ask for the shielding when I remember, but it seems like when I forget they just leave it off. Or at least I don't see anything blocked on the Xray. (Aren't they supposed to try to block breasts, too?)

    Gayle, I think my writing was unclear. I also meant that the referenced xray looked like good shielding--what I would ideally want. As you note, perhaps they've decided that they don't need to shield me anymore since I'm 38--unlikely to have more children. But still....

    Anyway, I'll be more demanding from here on out, thanks!
    age 44
    80* thoracolumbar; 40* thoracic
    Reduced to ~16* thoracolumbar; ~0* thoracic
    Surgery 3/14/12 with Dr. Lenke, T4 to S1 with pelvic fixation
    Not "confused" anymore, but don't know how to change my username.

  6. #6
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    Quote Originally Posted by Confusedmom View Post
    Thanks, Linda. Actually, this unfortunately has been true at a variety of offices (latest was Dr. Bridwell in St. Louis). I ask for the shielding when I remember, but it seems like when I forget they just leave it off. Or at least I don't see anything blocked on the Xray. (Aren't they supposed to try to block breasts, too?)

    Gayle, I think my writing was unclear. I also meant that the referenced xray looked like good shielding--what I would ideally want. As you note, perhaps they've decided that they don't need to shield me anymore since I'm 38--unlikely to have more children. But still....

    Anyway, I'll be more demanding from here on out, thanks!
    I would definitely complain to Dr. Bridwell. I would assume he was part of the group that set the standard for taking scoliosis films.

  7. #7
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    Thanks

    OMG !
    I never thought of the girls needing to be shielded. Thanks for bringing this up!

    We are going to another doc at the end of the month. This time a real consultation 2-3 hours. We are meeting with the current ID and will be deciding whether to stay with the orthopod,next week.

    I had a retired phsycian friend read my narrative. He apologized for his profession and said he was embaressed. I think the doc is waiting for the residency program to start again with new residents. Because he was pushing for M. to enjoy the summer. Another Medical Social Worker agreed with this theory. He doesn't answer my phone calls- we only get answers when my husband calls. I don't know what I did wrong. Anyway. say prayers that we get this all worked out. M. is set on this Doc.

  8. #8
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    Does keeping your undies on classify as shielding? If not, yowser, yowser, I always had frontal xrays and side without any shielding. Interesting.............
    Wonder what the Aussie protocols are for these kind of xrays.
    Vali
    44 years young! now 45
    Surgery - June 1st, 2009
    Dr David Hall - Adelaide Spine Clinic
    St. Andrews Hospital, Adelaide, South Australia
    Pre-op curve - 58 degree lumbar
    Post -op - 5 degrees
    T11 - S1 Posterior
    L4/5 - L5/S1 Anterior Fusion

  9. #9
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    Quote Originally Posted by Vali View Post
    Does keeping your undies on classify as shielding?
    Not unless they're made of lead. ;-)

  10. #10
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    Dr Hey's own comments - Guestion abt surgical guidelines by age

    Hi there!

    A bit late, but I just ran into this by chance.
    You asked for comments.

    I have one about Dr Hey's own comments on his Blog.

    He said he used a special heavy duty correction technique (to do with type or placement of rods) because of this adolescent's "nasty 90 degree curve", remarking how much better it would have been to operate before her curves got this bad - "preferably below 50 degrees".

    Is this true mostly (only) of adolescent curves? With adults, especially older adults, it seems that the advantage of getting there sooner "under 50 degrees") is offset by other considerations. i

    I wonder if (and if so, how), Dr. Hey might have changed his recommendations if he had been speaking of an adult with the same curves and correction? To be more general (and more what I want to know), I'm sure there are standardized SRS guidelines for when surgery is indicated (factoring in degree and location of curves, pain, progression rate, diisability). These must differ by age group.

    Anyone actually know what these are?
    Not all diagnosed (still having tests and consults) but so far:
    Ehler-Danlos (hyper-mobility) syndrome, 69 - somehow,
    main curve L Cobb 60, compensating T curve ~ 30
    Flat back, marked lumbar kyphosis (grade?) Spondilolisthesis - everyone gives this a different grade too. Cervical stenosis op'd 3-07, minimally invasive

  11. #11
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    Note: if such guidelines are available (I'm sure they exist), I'm sure first time adult surgery candidates of all ages would love to have access to them.

    So maybe if someone (Linda! Haloo! ) has an answer to this important question, both question and answer belong in that forum where more can benefit from seeing them.
    Not all diagnosed (still having tests and consults) but so far:
    Ehler-Danlos (hyper-mobility) syndrome, 69 - somehow,
    main curve L Cobb 60, compensating T curve ~ 30
    Flat back, marked lumbar kyphosis (grade?) Spondilolisthesis - everyone gives this a different grade too. Cervical stenosis op'd 3-07, minimally invasive

  12. #12
    Join Date
    May 2008
    Location
    reno,nevada
    Posts
    3,556
    Amanda

    A persuader was used with my construct. Its one on the many different tools that Synthes manufactures. On their site, there is no end to what they have thought of... Amazing. They have tooling for every possible scenerio. I have their "Pangea system"

    Scroll down to page 15
    http://products.synthes.com/prod_sup...GUSSJ4437A.pdf

    Adults and kids with "nasty 90s" need persuasion sometimes...

    This little girls curve was up high and makes things difficult due to the ribs. She really needed surgery.... Its such a shock to just find out your kid has a severe scoli, and so young.

    I recommend deep breathing exercises for the parents.
    Ed
    49 yr old male, now 59, the new 55...
    Pre surgery curves C12,T70,L70
    ALIF/PLIF T2-Pelvis 01/29/08, 01/31/08 7" pelvic anchors BMP
    Dr Brett Menmuir St Marys Hospital Reno,Nevada

    Bending and twisting pics after full fusion
    http://www.scoliosis.org/forum/showt...on.&highlight=

    My x-rays
    http://www.scoliosis.org/forum/attac...2&d=1228779214

    http://www.scoliosis.org/forum/attac...3&d=1228779258

  13. #13
    Join Date
    Mar 2010
    Location
    Ottawa, Canada
    Posts
    21

    Question pedicle depth-synthes spinal fixation

    Ed

    Great attachment! Thanks

    Do you know how the surgeon gauges the depth/length of the pedicle screw; is xray imaging used during surgery?

    I've read articles where the screw has been too long and caused irritation requiring removal later and others where the screw insertion caused dural tears

    In cases where the spine has been rotated for some time, do you or others know, if some vertebrae are deformed and make placement of the pedicle screw difficult or impossible?

    Thanks
    [FONT="Comic Sans MS"]
    Spinal fusion 1961
    HR 1981 T3-L4
    Thoracic curve 75Cobb; post 40
    Present: Thoracic 60Cobb Lumber?
    [FONT]

  14. #14
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    May 2008
    Location
    reno,nevada
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    Pedicle screw placement inspection and procedures

    Hi Elizabeth

    Good to see you posting again.

    Placement of pedicle screws is challenging. On one of my levels, I was wedged, and in the hospital report, it said that a clear trajectory was not obtainable. One screw was omitted. A C arm was used.

    http://www.medical.siemens.com/sieme..._eng_DRUCK.pdf

    Ultrasound is used. Steinman pin or K wire used for depth check.
    http://www.medschool.lsuhsc.edu/neur...r/tlscrew.html

    http://www.ncbi.nlm.nih.gov/pubmed/9755762

    http://www.ijoonline.com/article.asp...8;aulast=Rajan

    Hope this helps
    Ed
    49 yr old male, now 59, the new 55...
    Pre surgery curves C12,T70,L70
    ALIF/PLIF T2-Pelvis 01/29/08, 01/31/08 7" pelvic anchors BMP
    Dr Brett Menmuir St Marys Hospital Reno,Nevada

    Bending and twisting pics after full fusion
    http://www.scoliosis.org/forum/showt...on.&highlight=

    My x-rays
    http://www.scoliosis.org/forum/attac...2&d=1228779214

    http://www.scoliosis.org/forum/attac...3&d=1228779258

  15. #15
    Join Date
    May 2008
    Location
    reno,nevada
    Posts
    3,556
    49 yr old male, now 59, the new 55...
    Pre surgery curves C12,T70,L70
    ALIF/PLIF T2-Pelvis 01/29/08, 01/31/08 7" pelvic anchors BMP
    Dr Brett Menmuir St Marys Hospital Reno,Nevada

    Bending and twisting pics after full fusion
    http://www.scoliosis.org/forum/showt...on.&highlight=

    My x-rays
    http://www.scoliosis.org/forum/attac...2&d=1228779214

    http://www.scoliosis.org/forum/attac...3&d=1228779258

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