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Thread: confused!

  1. #61
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    Quote Originally Posted by hdugger View Post
    I believe the thinking is that a 50 degree curve in an adult is likely to keep progressing, so why not do surgery while the patient is younger and healthier and the curve is smaller.
    Because progression could stop and if not, surgery techniques could improve at the moment that surgery will be needed, could be a reasonable answer.
    Quote Originally Posted by hdugger View Post
    I suspect, based on something Linda said once about there being a large number of patients who are 18 and 19, that there's a big group of people who do just that. Their curves progressed into surgical range as adolescents, but not so fast that they were forced into surgery as teens, and then they get surgery while they're still young even though they're not in pain or progressing.
    It's a very common criteria followed here. Surgeons always recommend surgery before 20'
    It's a very much reasonable decision, if it is supposed the (almost) impossibility to stop progression.

  2. #62
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    Quote Originally Posted by flerc View Post
    I have heard about a surgeon in Spain who always indicates surgery in curves >30.
    That's interesting. Are you sure?

    If true, maybe this surgeon is exploring early fusion in patients with high scoliscores as a way to save many levels.

    Outside of a definitive prove-out of scoliscore and that most/all high scores will become surgical, it appears impossible to test this hypothesis because most curves do not progress to become large curves.

    Still I wonder if there is any data out there to show that fusing say a 25* curve results in less than half the levels fused compared to if that curve made it to 50* on average. All curves are different but I'm talking about in the limit. It may be that somehow, some day they find that fusing 2-3 levels on small curves stops progression in most curves. That would completely change everything, at least for kids whose curves are caught early.
    Last edited by Pooka1; 03-04-2011 at 06:52 AM.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

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  3. #63
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    I really doubt that this surgeon takes scolioscores into account. I think that, as in USA 50 is the most accepted limit and 40 for few surgeons, maybe 40-45 is the most accepted limit in Spain and this surgeon is an extremist. But he may argue that he wants to avoid any possibility of progression, and I have heard about few cases progressing with so few degrees.

  4. #64
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    At 30 degrees, I think the risks of surgery outweigh the risk of pain or progression in adulthood. With no other symptoms, I'd be very, very hesitant to fuse a 30 degree curve.

  5. #65
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    Hi Flerc,
    Who is that surgeon? As you may know, Im Spanish and Ive never heard about this.
    In fact I think Spanish doctors are mostly conservatives regarding scoliosis.
    2004: Daughter diagnosed at 13 L38. Risser 0.
    Treatment: Cheneau brace
    2009: Brace free, 18 years old, Risser 5, L25

  6. #66
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    Hi Ailea, are not you a member of the Spanish forum? I just commented about this there http://escoliosis.org/escoforo/index.php?topic=1437.0
    I'm not sure about who talked about this surgeon, but without given the name, but why do you think they are mostly conservatives? I’m not very sure if I know what it means, but all people in that forum agree that is impossible for surgeon to not believe that >50 is a Sufficient condition for surgery.
    Last edited by flerc; 03-05-2011 at 09:22 AM.

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