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Thread: 2nd Annual UCSF Scoliosis Multidisciplinary Patient Conference

  1. #31
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    In terms of peri-op complications, it's mostly the bleeding issues, but there are just generally more risks the longer one is under anesthesia. In terms of post-op complications, you can simply do the math. For examine, if there is a 2% risk of a pseudarthrosis in patients with 6 fusion levels, there is probably somewhere in the neighborhood of a 4% risk in patients with 12 fusion levels. I don't know whether the study that Dr. Deviren mentioned controlled for patient age. On average, the older you are, the larger the number of fusions needed. So, it could simply be a matter of age = higher peri-op complication risk.

    Ed, Dr. Hu had to leave because her daughter had some school function. Although she works pretty long hours, I think she generally tries to not let work take over her life. Dr. Berven was on call this weekend. He had to do an emergency surgery Saturday afternoon, and again after we finished around 6PM Saturday night. When I left work around 7 tonight, he was still there, with one emergency surgery still left to do, after having been awake and operating or seeing patients since 4PM on Sunday. If he's lucky, he'll be able to get home and pack before a 1AM flight to the other side of the world. I frequently tell people that he's a super hero, with his super power being that he never has to sleep (with the exception of a few moments when a patient won't stop talking ;-)

    --Linda
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Dilbert
    I'm sarcastic... what's your super power? --Unknown
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    If you've signed up and are having trouble posting, please check your spam folder. An email was sent to the email address which you subscribed. You have to follow the instructions in that email. Done that and still having trouble posting? Contact Joe O'Brien at jpobrien@scoliosis.org.

  2. #32
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    how much of a risk is post op infection...?
    i still think of Joy (Joyful) now and then, wonder if she got any better...

    jess

  3. #33
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    Linda

    You work with some incredible people. They are all great. I had many questions, but didnít want to over tap the resources. lol Some questions really are hard to answer in under 60 seconds. For the correct answers it takes many hours of reading and many books and studies.

    I did have a chat with Dr Burch in the hallway and he seems like a great person. Its nice to get surgeons cornered for a few minutes.....wow, you have to think fast to get your answers.

    I donít know if you overheard my question about SI joints eventually fusing, Dr Burch mentioned that they do fuse with pelvic screws. I guess this proves that SI joints do move somewhat, just enough, to keep from fusing before surgery.

    Once again, great conference. Taping next year would be a good idea. I thought that it was being taped, but didnít notice since I was up front. Thanks for getting the better room with the nice seating.

    Ed
    49 yr old male, now 58, the new 53...
    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

  4. #34
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    Quote Originally Posted by jrnyc View Post
    how much of a risk is post op infection...?
    i still think of Joy (Joyful) now and then, wonder if she got any better...

    jess
    Spine (Phila Pa 1976). 2011 Apr 20;36(9):E593-7.
    Scoliosis research society morbidity and mortality of adult scoliosis surgery.
    Sansur CA, Smith JS, Coe JD, Glassman SD, Berven SH, Polly DW Jr, Perra JH, Boachie-Adjei O, Shaffrey CI.
    Source
    University of Maryland School of Medicine, Baltimore, MD, USA. csansur@smail.umaryland.edu
    Abstract
    STUDY DESIGN:
    A retrospective review.

    OBJECTIVE:
    To obtain an assessment of complication incidence using the largest known database of adult scoliosis and to determine whether the rate of complication depends on various clinical parameters.

    SUMMARY OF BACKGROUND DATA:
    The Scoliosis Research Society (SRS) morbidity and mortality database has previously been used to assess complication rates in adolescents undergoing scoliosis correction. To better understand complications in adults, degenerative and idiopathic adult scoliosis (AS) cases were studied.

    METHODS:
    The SRS morbidity and mortality database was queried to identify cases of AS from 2004 to 2007. Complications were identified and analyzed on the basis of patient type of scoliosis (degenerative vs. adult idiopathic), age, use of osteotomy, revision surgery status, and surgical approach. Age was stratified into less than or equal to 60 and greater than 60. Surgical approach was stratified into anterior only, posterior only, and combined anterior/posterior.

    RESULTS:
    A total of 4980 cases of AS were submitted from 2004 to 2007. There were 521 patients with complications (10.5%), and a total of 669 complications (13.4%). The most common complications were dural tear 142 (2.9%), superficial wound infection 46 (0.9%), deep wound infection 73 (1.5%), implant complication 80 (1.6%), acute neurological deficits 49 (1.0%), delayed neurological deficits 41 (0.5%), epidural hematoma 12 (0.2%), wound hematoma 22 (0.4%), pulmonary embolus 12 (0.2%), and deep venous thrombosis 9 (0.2%). There were 17 deaths (0.3%). There were 2555 patients with degenerative and 2425 patients with adult idiopathic scoliosis. Complication rates in these two groups were not significantly different (11.0% and 9.9%, respectively, P = 0.20). Age was not associated with complication rate (P = 0.32). Significantly higher complication rates were identified in osteotomies, revision surgery, and/or combined anterior-posterior surgery (P = 0.0006, 0.006, and 0.03, respectively).

    CONCLUSIONS:
    The overall complication rate for AS treatment is 13.4%. Complication rate is significantly higher when osteotomies, revision procedures, and combined anterior/posterior approaches are used. Complication rate is not influenced by scoliosis type or age.
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Dilbert
    I'm sarcastic... what's your super power? --Unknown
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    If you've signed up and are having trouble posting, please check your spam folder. An email was sent to the email address which you subscribed. You have to follow the instructions in that email. Done that and still having trouble posting? Contact Joe O'Brien at jpobrien@scoliosis.org.

  5. #35
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    Quote Originally Posted by titaniumed View Post
    Linda

    You work with some incredible people. They are all great. I had many questions, but didnít want to over tap the resources. lol Some questions really are hard to answer in under 60 seconds. For the correct answers it takes many hours of reading and many books and studies.

    I did have a chat with Dr Burch in the hallway and he seems like a great person. Its nice to get surgeons cornered for a few minutes.....wow, you have to think fast to get your answers.

    I donít know if you overheard my question about SI joints eventually fusing, Dr Burch mentioned that they do fuse with pelvic screws. I guess this proves that SI joints do move somewhat, just enough, to keep from fusing before surgery.

    Once again, great conference. Taping next year would be a good idea. I thought that it was being taped, but didnít notice since I was up front. Thanks for getting the better room with the nice seating.

    Ed
    Hi Ed...

    I did hear the conversation. I believe he said that they fuse "across the SI joint", but that the joint is typically not fused. Iliac bolts have a tendency to break because there's no fusion at the SI joint. I think he said that the SI joints are stabilized in the process, but I'm not sure what that means. I'll ask him the next time I"m in clinic with him.

    I don't know if it's permanent, but I had issues with what I think was right S-I joint pain on and off for 20 years. After my January fusion with iliac screws, I have not had a single episode of that pain. I suspect that the S-I joints may become less mobile with iliac screws.

    --Linda
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Dilbert
    I'm sarcastic... what's your super power? --Unknown
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    If you've signed up and are having trouble posting, please check your spam folder. An email was sent to the email address which you subscribed. You have to follow the instructions in that email. Done that and still having trouble posting? Contact Joe O'Brien at jpobrien@scoliosis.org.

  6. #36
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    Most of the presentations are now available online:

    http://orthosurg.ucsf.edu/node/833
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Dilbert
    I'm sarcastic... what's your super power? --Unknown
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    If you've signed up and are having trouble posting, please check your spam folder. An email was sent to the email address which you subscribed. You have to follow the instructions in that email. Done that and still having trouble posting? Contact Joe O'Brien at jpobrien@scoliosis.org.

  7. #37
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    There is valuable info here, even without audio

    Thx Linda
    Ed
    49 yr old male, now 58, the new 53...
    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

  8. #38
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    Quote Originally Posted by LindaRacine View Post
    Sorry, here's the correct URL:

    https://orthosurg.ucsf.edu/patient-c...ister.cfm?js=1

    This is a conference for patients and parents. Last year, it was just for adult patients. It's a series of talks about various treatments (including surgery, yoga, Pilates, injections, etc.). The most likely agenda will include adolescent/teen treatment options in the morning, cross-over topics mid-day, and adult options in the afternoon.

    --Linda
    Linda, I was out of the country for the conference. Was it taped? Sounds like just what I need and I really regret not being able to attend. Thanks, Susan
    Adult Onset Degenerative Scoliosis @65, 25* T & 36* L w/ 11.2 cm coronal balance; T kyphosis 90*; Severe disc degen T & L stenosis

    2013: T3- S1 Fusion w/ ALIF L4-S1/XLIF L2-4, PSF T4-S1 in 2 surgeries
    2014: Hernia @ ALIF repaired; Emergency screw removal surgery for Spinal Cord Injury at T4,5 sec to PJK
    2015: Revision Broken Bil T & L rods and no fusion: 2 revision surgeries; hardware P. Acnes infection
    2016: Ant/Lat Lumbar diskectomy w/ 4 cages + BMP + harvested bone + prayer

  9. #39
    Join Date
    Sep 2003
    Location
    Northern California
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    Not recorded, sorry.
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Dilbert
    I'm sarcastic... what's your super power? --Unknown
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    If you've signed up and are having trouble posting, please check your spam folder. An email was sent to the email address which you subscribed. You have to follow the instructions in that email. Done that and still having trouble posting? Contact Joe O'Brien at jpobrien@scoliosis.org.

  10. #40
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    May 2008
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    reno,nevada
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    Linda

    Any thoughts on a 3rd meeting?........

    Susan. If you take me along to Mexico, I WILL carry your suitcases..... Some destinations really are helpful for scoliosis therapy, Mexico is one of those places. (smiley face)

    Ed
    49 yr old male, now 58, the new 53...
    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

  11. #41
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    Sep 2003
    Location
    Northern California
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    Ed...

    Probably September or October 2013.

    --Linda
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Dilbert
    I'm sarcastic... what's your super power? --Unknown
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    If you've signed up and are having trouble posting, please check your spam folder. An email was sent to the email address which you subscribed. You have to follow the instructions in that email. Done that and still having trouble posting? Contact Joe O'Brien at jpobrien@scoliosis.org.

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