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anterior release/posterior fusion

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  • #16
    Originally posted by scoliboymom View Post
    I remember talking to Patricks surgeon about anterior surgery becasue of the size of his curve and his lack of maturity but he felt in his case it wasn't necessary. In hindsight maybe I should have explored it more because Patrick's spine did in fact crankshaft. Despite that his instrumentation is solid and stable and has not moved or twisted at all. I think the twist was absorbed by the ribs as his ribhump has very much returned. So I can't answer any of your questions on anterior surgery. But I will say that Patrick was put into traction during his surgery which is a normal practise for his surgeon as far as I know. He had no pain whatsoever from the traction and the marks on his legs have virtually disappeared.
    I wish for your son that they could wait on the surgery until he has matured a bit more but with progression its a tough call. Our surgeon did try to put it off as long as posible but at 78 degrees it was time to go ahead.
    By the way how is your older son doing?
    Hi Ramona,
    Did your dr. think anterior wasn't necessary b/c of Patrick's age or did he grow more than anticipated? Has he had, or will he need additional treatment, and has this caused him any discomfort?
    I really hate to put Vince through this at such a young age. Our initial plan at last May appt. was to wait til this summer to do surgery. However at Nov. appt. dr. said we shouldn't wait that long, at the rate his curve is progressing he probably would be well into the 70 deg. range and the rotation is really becoming an issue. Vince has also been experiencing pain/soreness in the neck/upper back, esp. where the curve is. I really hate to wait until March, I'm afraid by that time he will need another level fused. :^(
    As for Joe (the post-surgery son) he is doing well. He still has a bit of a rib hump also, but doesn't seem to bother him. He is a sophomore in college, been living away on campus and doesn't seem to have any problems. He is pretty much back to doing any activities he was doing pre-surgery. He is on the archery team and did say that has to alter his stance a little, as he can't quite get into the "regular" position. He will have his 5 year post-op next week when he comes home, so will give a full report then :^)

    Renee

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    • #17
      Thanks for that info Renee. I wasn't sure how the growth thing worked but your explanation helps me to understand it all a bit better.

      Originally posted by flowerpower View Post
      Hi Elisa,

      Son that is going to have surgery is 12 1/2 and approx. 5'1". My older son that had surgery was same age and about the same height as your son. We did notice an increase in height post-surgery but he did lose a little growth in the fused portion of spine. I posted this in another thread but will post again here: the way our dr. explained, the vertebrae grow approx. 1mm per year. So each vertebrae that is fused will lose 1mm per year of remaining growth. For example, dr. estimated that Vince still has about 4 years left of growing, which means a loss of about 4mm growth per vertebrae fused and he will have 9 vertebrae fused = an over all loss of about 36mm growth/height.
      The plan usually is to let them grow as much as possible, but looking at the pics posted of your son's x-rays, I wouldn't be surprised if surgery was recommended sooner rather than later.

      Renee
      Son 14 y/o diagnosed January 20th. 2011 with 110* Curve
      Halo Traction & 1st. surgery on March 22nd. 2011
      Spinal Fusion on April 19th. 2011

      Dr. Krajbich @ Shriners Childrens Hospital, Portland Oregon



      http://tinyurl.com/Elias-Before
      http://tinyurl.com/Elias-After

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      • #18
        Hi Renee
        I think it was more he felt the instrumentation was enough to hold him in check. And it is true that the instrumentation hasn't moved at all. I did make the surgeon aware at the time that I expected him to grow more. But maybe it was the risk factors or that he was almost 15 at time of surgery, I don't remember if he told me such details as to why he was opting not to do anterior. We are all tall, big brother is 6'3". Patrick was 5'7" before surgery. He grew 2" in surgery and he is now 3 1/2 years later 5'11". I realize he has permanently lost height because of lingering curvature in his spine and fusion but I honestly think he is still growing even at almost 19. So don't know about the future. Day to day he has no pain, only on occassion when he does some repetitive things like playing aggressive badminton, or sitting or standing for long periods.

        If I had to do it again with Patrick I think I would have taken the same route and timing only because he was in severe discomfort. If he wasn't in discomfort I would have held out on surgery for as many months as possible even though his curves were already at 80 degrees.
        Maybe Vince's progression will slow by his next xrays to buy a bit more time. I sympathize with your situation, there's no straight forward answers.
        Glad to hear Joe is doing well!!!

        Ramona
        mom of Patrick, age 15 at time of surgery
        diagnosed July 2006 curves T58 L 38

        Nov. 2006 curves T72 L38
        also lordoscoliosis

        feb.2007 curves T79 L43

        Surgery May 16 2007
        fused T4 to L1

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        • #19
          I hear that word crankshaft a lot, what does it mean?

          Our doctors have always told us that he has large growth plates and large vertebrae in his lower back which mean he will be very tall. They say he will not stop growing until he is at least 18. Should I be concerned with the crankshafting? Maybe I'm misunderstanding what this means.
          Angie Romero, Mom to Alex, Dominic & Marissa.
          Alex was fused from T2-L2 at the age of 12 on Dec 22, 2010
          By Dr. Hanson at Texas Children's Hospital

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          • #20
            Long Time!

            Hi Renee,

            It's been a million years and you probably don't remember me. We talked a bunch when you first son and my daughter were going through surgery way back when. My daughter had a double major curve 70/40 and was fused T11 to L3. Her surgery was performed anteriorly and she had a chest tube and was hospitalized for 8 days. It sounds brutal and terrible when you're a mom, but just wanted to reassure you that after all was said and done, we don't regret trusting the doc and using the anterior approach. I will warn you that the pain is more, and the healing longer because the surgery is more invasive, but ultimately it was the right decision.

            Hope the whole family is doing great! Happy holidays.

            xoxo

            Susanna
            Susanna
            ~~~~~~
            Mother of a 17 year old daughter. Her "S" curve was 40 degree thoracic from T3 to T9, and a 70 degree rotatory thorcolumbar from T9 to L4. She was operated on March 9th, 2005 by Dr. Boachie-Adjei at the Hospital for Special Surgery in NYC. She was fused from T11 to L3, using an anterior approach, and the major curve corrected to 20 degrees. She's doing great!

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            • #21
              I just wanted to add a bit about growth after surgery. My son was 12 years and 3 months old at the time of his surgery. We were told he'd lose less than 2 inches of height due to the fused growth plates. However, he almost completely stopped growing after the surgery: he was 4'10 at the time of the surgery, gained about 1/2 as a result of the surgery and now is only 5'1/4". He's probably lost 6-7 inches off what would have been his final height. His pediatrician guesses that perhaps his pituitary gland went into some kind of shock after the surgery. We really have no other explanation for why his growth plates are almost fully closed now and why he's so short. The pelvic growth plates seemed mostly closed when he was just 13 and they'd been wide open right after his surgery when he grew those 2 inches.
              Laurie

              Mother of Alexander & Zachary:
              Alex is 16 years old and in the 11th grade. He has congenital scoliosis due to a hemivertebrae at T10. Wore a TLSO brace for 3 1/2 years. Pre-op curves were T45 & L65; curves post-op are approx. T31 & L34. Had a posterior spinal fusion from T8 to L3 on 7/12/07 at age 12. Doing great now in so many ways, but still working on improving posture.
              Zach is 13 years old and very energetic.

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              • #22
                Originally posted by susannajon View Post
                Hi Renee,

                It's been a million years and you probably don't remember me. We talked a bunch when you first son and my daughter were going through surgery way back when. My daughter had a double major curve 70/40 and was fused T11 to L3. Her surgery was performed anteriorly and she had a chest tube and was hospitalized for 8 days. It sounds brutal and terrible when you're a mom, but just wanted to reassure you that after all was said and done, we don't regret trusting the doc and using the anterior approach. I will warn you that the pain is more, and the healing longer because the surgery is more invasive, but ultimately it was the right decision.

                Hope the whole family is doing great! Happy holidays.

                xoxo

                Susanna
                Hi Susanna!

                Not sure if anyone else remembers you, but I sure do! Welcome back. Can't wait to do some catching up with you.

                Mary Lou
                Mom to Jamie age 21-diagnosed at age 12-spinal fusion 12/7/2004-fused from T3-L2; and Tracy age 19, mild Scoliosis-diagnosed at age 18.

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