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Thread: Less invasive surgery developed by Israel (Apifix implant)

  1. #31
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    Quote Originally Posted by Pooka1 View Post
    Verisimilitude of braces and VBS...

    A brace is a word that means holding something in a certain position.

    For scoliosis, there are braces that are used on the outside of the body (externally) to hold the spine in place such as hard and soft braces.

    Then there are braces that are used on the inside of the body (internally) to hold the spine in place such as growth rods (like MAGEC) and stables (VBS) and titanium ribs (VEPTR).
    Thanks, I didn’t know that not only VBS was named as internal braces, and certainly I see it more appropriated in something as Magec because at least as in brace, an immediate curve reduction when it is applied occurs (or my ignorance about those surgeries has not end?)
    I also didn’t know this was the meaning of the word ‘brace’. In Spanish spoken countries, we named it as corsť, having a different meaning.
    And certainly the definition I have always saw about orthopedics braces used in scoliosis, were even much more different, referring to external forces and at least some important authors as Rigo did in his book, referred as the 3 pressure points as a requirement for every brace. Certainly she mentioned all kind of braces up to the edition date and he also mentioned the Spinecor, but with the explicit clarification that is not a brace because not compliance the definition.

    Quote Originally Posted by Pooka1 View Post
    When talking about surgery, ANY surgery, the INCISION size is considered to be open (large) where the entire area is exposed or minimal (small slits) that they feed instrumentation through.

    Fusions can be done either open or minimally. VBS and Growth rods are done minimally due to their nature.

    As you can see, some minimal incisions result in fusion and some don't. All open surgeries tend to be fusion. There is no direct relation between size of incision (open versus minimal) and whether or not fusion is intended just as Gayle told you.
    Yes, the incision is minimal but a surgery is of course much more than the incision, which certainly is only the necessary procedure to do what the surgery is intended to do. Is as entering to a house.. opening the door even forcing it could be considered as a minimal ‘incision’, but nobody may refer as a ‘minimal invasion’ if then they steale and kill all what they see inside the house. It would have not any sense.

    I’m not sure if that hypocrite name to define extremely invasive surgeries with minimal incisions is used in every kind of surgery or at least in every country. I know that at least in mine in urology, surgeons talk about surgeries at ‘open sky’ and other term I’m not remembering now for those with minimal incision. Surely they cannot dare to say to someone that they will remove some organs with a minimal invasive surgery.

    Quote Originally Posted by Pooka1 View Post
    It is okay to have your own private vocabulary. But you can't communicate widely with it.

    Words have common meanings.
    It’s exactly what I’m saying. If effectively this is the surgeon vocabulary, they must to change it and not use preexisting
    words to refer something that has nothing to do with them. Surely they defined the meaning of surgery, but ‘minimal’ and ‘invasive’ has their own common meaning since before the first surgeon’s birth in the earth.
    Of course it could lead to serious confusions in people without knowledge about surgeon’s vocabulary and they have not to have it. In other forum I had to give the bad new to some happy parents about the absurd fact that the minimal invasive surgery that they were talking about was a fusion surgery!.
    Last edited by flerc; 07-22-2012 at 11:57 AM.

  2. #32
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    Quote Originally Posted by flerc View Post
    Yes, the incision is minimal but a surgery is of course much more than the incision, which certainly is only the necessary procedure to do what the surgery is intended to do.
    In surgery, the incision size is either open (= invasive though that term is not used apparently) or minimally invasive (one or more small incisions).

    In scoliosis surgery, the treatment is either fusion or fusionless. Fusion can be open or minimally invasive.

    Surely they cannot dare to say to someone that they will remove some organs with a minimal invasive surgery.
    Yes gall bladder removals for example can be done in a minimally invasion way. It is called laproscopic surgery. This shows that "minimally invasive" only refers to the size of the incision.
    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."

  3. #33
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    Quote Originally Posted by flerc View Post
    Well.. supposing that all of these minimal invasive surgeries (that is, without implicit fusion) achieve their respective purpose with the same effectiveness, VBS seems to be the best of all them.
    What I cannot understand then, is why an important surgeon refers to Magec as something revolutionary, incredible, never seen before as I’m sure I have read.. he have never heard about VBS?? Is not serious.

    I don’t understand why VBS is called as an internal brace. I don’t see any similitude.
    Braces uses external forces, having 3 pressure points.
    There is possible (and should to) achieve reduction in brace (the curve is immediately lesser when it is adapted.
    They support with that force, some percentage of the weight of the back.
    They are removed after growth.

    Nothing of all this seems to happen with VBS.
    Flerc,

    First of all, I think Gayle was simply asking that you educate yourself regarding VBS (fair enough in my view if you wish to discuss the topic) and I'm sure you, yourself, would like to have all the facts.

    VBS 'does' achieve reduction in most cases. Typically, some correction is achieved immediately in the OR and additional correction can occur as the child grows. I am basing this on the hundreds of cases I have personally followed, being a co-moderator of the VBS site, among other things.

    I'm just giving you one example above of an area where you might wish to learn more in order to be able to have informed discussions about it. I'm not attacking you or anything, just pointing out that you don't seem to have all of the facts where VBS is concerned. I, myself, always like to learn as much as I can and am assuming you do as well.
    mariaf305@yahoo.com
    Mom to David, age 17, braced June 2000 to March 2004
    Vertebral Body Stapling 3/10/04 for 40 degree curve (currently mid 20's)

    https://www.facebook.com/groups/ScoliosisTethering/

    http://pediatricspinefoundation.org/

  4. #34
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    Quote Originally Posted by Pooka1 View Post
    Yes gall bladder removals for example can be done in a minimally invasion way. It is called laproscopic surgery. This shows that "minimally invasive" only refers to the size of the incision.
    Yess!! minimal invasive refers to the size of the incision, not to those absolutely extreme invasive surgeries, to removes the bladder, ureters, kidneys and also the prostate in the same surgery as they uses to do in same kinds of cancer. So if they are not idiots (as I believe they aren't) they surely use another term to refers to those kind of surgeries (not necessarily needs to be the same I used) regardless the incision that may be used.

    Quote Originally Posted by Pooka1 View Post
    In surgery, the incision size is either open (= invasive though that term is not used apparently) or minimally invasive (one or more small incisions).
    Yes!, I know that and I agree with the terms used in INCISIONS!!
    And you are right, they should also to refers as invasive incisions.. a probably acceptable and minimal hypocrisy.

    Quote Originally Posted by Pooka1 View Post
    In scoliosis surgery, the treatment is either fusion or fusionless. Fusion can be open or minimally invasive.
    Fusion is Fusion, regardless the incision, the approach.. it refers to vertebral fusion!
    If they refers to all the procedure or treatment to get fusion, anyway they cannot refers to it as minimal invasive because it include FUSION!..it has not any sense to say 'minimal invasive fusion'!!.. otherwise in the same way everybody could name something refering only to some part.. judges could talk about minimal lethal murders..
    It's only a matter of common sense and honesty the election of right names. Something not used in this case.
    Last edited by flerc; 07-22-2012 at 08:00 PM.

  5. #35
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    Flerc,

    It's unfortunate that you don't agree with the current medical terminology, but, it is widely accepted by the medical community, even if you don't approve.

    Did you know they regularly do "minimally invasive" (read minimal incision) coronary bypass surgery, through a keyhole incision. They also do "minimally invasive" heart valve replacement surgery where they cut the heart apart to remove the diseased valve, and insert a new one. Seems maximally invasive to me, but nonetheless, it is considered "minimally invasive" since it is done through a minimal incision. Same goes for minimally invasive fusion, which could also be referred to minimal incision fusion.

    I'm not sure what your objection to fusion IS? None of us like the idea, that is for sure. Nobody loves being fused. But for some people it is the only currently available medical treatment for scoliosis. It really doesn't deserve to be vilified when used in appropriate patients. I guess I am wondering, since you seem to feel so strongly that fusion is a horrible thing, should fusion be abolished? What about for people with 100 degree curves that are life-threatening?
    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

  6. #36
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    Quote Originally Posted by mariaf View Post
    Flerc,

    First of all, I think Gayle was simply asking that you educate yourself regarding VBS (fair enough in my view if you wish to discuss the topic) and I'm sure you, yourself, would like to have all the facts.

    VBS 'does' achieve reduction in most cases. Typically, some correction is achieved immediately in the OR and additional correction can occur as the child grows. I am basing this on the hundreds of cases I have personally followed, being a co-moderator of the VBS site, among other things.

    I'm just giving you one example above of an area where you might wish to learn more in order to be able to have informed discussions about it. I'm not attacking you or anything, just pointing out that you don't seem to have all of the facts where VBS is concerned. I, myself, always like to learn as much as I can and am assuming you do as well.
    Mariaf, about what I said to leahdragonfly.. certainly to say someone that seems to be arguing for the sake of arguing is not simply asking for educate himself.
    I feel I reached some education here with the comments of all in this thread, of course including yours. Even it's a good new for me to know I was wrong saying that VBS not may achieve inmediate corrections. I don't lose (or I don't want to lose) at all the hope that someday, medical community wants to think about an acceptable solution to be used also after growth .. something as a combination of Vbs and Veptr at least to reduce the possibility of progression.. surely I would need more information to think about that.. something surely useless since I don't belong to that community so then.. what I can do?

    Regards.

  7. #37
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    i love to see the progress of minimally invasive surgery into other areas if the body that
    need surgery....
    i know what a blessing it was for me with ankle surgery....
    i know someone who described the huge difference to him between an old
    surgery with open incision for knee surery and a new operation with MI for knee
    surgery.....HUGE difference in reduced pain level....
    i was glad to see what Anand can do with MI for scoli surgery....
    the patients i spoke to who had it, all over age 60, described less pain, less
    muscle damage, less blood loss, and relatively faster healing...
    ANYTHING that can lessen pain of surgery is something i believe should be celebrated....

    jess
    Last edited by jrnyc; 07-23-2012 at 11:46 AM.

  8. #38
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    Quote Originally Posted by leahdragonfly View Post
    It's unfortunate that you don't agree with the current medical terminology, but, it is widely accepted by the medical community, even if you don't approve.
    What is really unfortunate is that medical community has a terminology leading them to refers to some extreme invasive surgeries as minimal invasive surgeries and that some people aprove that.

    Quote Originally Posted by leahdragonfly View Post
    Did you know they regularly do "minimally invasive" (read minimal incision) coronary bypass surgery, through a keyhole incision. They also do "minimally invasive" heart valve replacement surgery where they cut the heart apart to remove the diseased valve, and insert a new one. Seems maximally invasive to me, but nonetheless, it is considered "minimally invasive" since it is done through a minimal incision. Same goes for minimally invasive fusion, which could also be referred to minimal incision fusion.
    Certainly are you who seem to be arguing only for the shake to argue. You believe it’s okay (you not agree with my questioning) to be considered minimal invasive although it seems maximal invasive for you..

    Is it considered or it is named "minimally invasive"? I’ll suppose you’ll agree that only an extreme idiocy could lead someone to consider that as minimally invasive. And this is not the worst example of a ‘minimal invasive’ surgery.
    Surely you’d think in other way if we'd not be talking about medical community. Suppose a thief entering to a home and killing all the family living there. What do you may think about a judge saying that it was a minimal lethal action, because the intrusion was minimal invasive, since he open the door without forcing it?

    I cannot believe that may be people defending something so much absurd/hypocrite.
    What would you and other people here says if braces would be considered/named as ‘comfortable and friendly device’ because it can be adapted (regardless what happens then) in a comfortable way?

    Quote Originally Posted by leahdragonfly View Post

    I'm not sure what your objection to fusion IS? None of us like the idea, that is for sure. Nobody loves being fused. But for some people it is the only currently available medical treatment for scoliosis. It really doesn't deserve to be vilified when used in appropriate patients. I guess I am wondering, since you seem to feel so strongly that fusion is a horrible thing, should fusion be abolished? What about for people with 100 degree curves that are life-threatening?
    I have never suggested that fusion should to be abolished, as other people are continuously promoting in this forum that should to happen with braces. I would never try to eliminate a possible (good or bad) solution to someone with a serious problem. Not before something better that sure works in every case exists. But is unquestionable for me the need of something better and if I’m really want to abolish something is the idea that has not sense to claim for that.
    Last edited by flerc; 07-22-2012 at 11:24 PM.

  9. #39
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    Quote Originally Posted by jrnyc View Post
    i love to see the progress of minimally invasive surgery into other areas if the body that
    need surgery....
    i know what a blessing it was for me with ankle surgery....
    i know someone who described the huge difference to him between an old
    surery with open incision for knee surery and a new operation with MI for knee
    surgery.....HUGE difference in reduced pain level....
    i was glad to see what Anand can do with MI for scoli surgery....
    the patients i spoke to who had it, all over age 60, described less pain, less
    muscle damage, less blood loss, and relatively faster healing...
    ANYTHING that can lessen pain of surgery is something i believe should be celebrated....

    jess
    I suppose you are not thinking I may said something against that. Only a worrying insanity may lead someone to not agree with what you said.
    I will also celebrate the day that things be called by their real name.
    Last edited by flerc; 07-23-2012 at 12:05 AM.

  10. #40
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    Quote Originally Posted by flerc View Post
    I cannot believe that may be people defending something so much absurd/hypocrite.
    Fer, nobody here has a dog in that fight. There is no rational reason to give a hoot about the terminology surgeons choose to use. Their field. They get to decide, not us.

    I have never suggested that fusion should to be abolished, as other people are continuously promoting in this forum that should to happen with braces. I would never try to eliminate a possible (good or bad) solution to someone with a serious problem. Not before something better that sure works in every case exists. But is unquestionable for me the need of something better and if I’m really want to abolish something is the idea that has not sense to claim for that.
    Please consider that bracing may be as (in)effective as chanting or praying in terms of avoiding surgery for life. It could turn out that way given what is known now. They can't even cleanly show it is effective even to the point of maturity. It is needless in the majority of cases per at least two analyses. Scoliscore is bringing the number for needless brace treatments down already. Only evidence matters. Emotionally clinging to a treatment that hasn't been shown to work is not rational.

    Until they solve this, fusion unfortunately seems to be making the most difference NOW for people in range.
    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."

  11. #41
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    Quote Originally Posted by jrnyc View Post
    i love to see the progress of minimally invasive surgery into other areas if the body that
    need surgery....
    I know what a blessing it was for me with ankle surgery....
    I know someone who described the huge difference to him between an old
    surery with open incision for knee surery and a new operation with mi for knee
    surgery.....huge difference in reduced pain level....
    I was glad to see what anand can do with mi for scoli surgery....
    The patients i spoke to who had it, all over age 60, described less pain, less
    muscle damage, less blood loss, and relatively faster healing...
    anything that can lessen pain of surgery is something i believe should be celebrated....

    Jess
    Amen!!!!!!
    mariaf305@yahoo.com
    Mom to David, age 17, braced June 2000 to March 2004
    Vertebral Body Stapling 3/10/04 for 40 degree curve (currently mid 20's)

    https://www.facebook.com/groups/ScoliosisTethering/

    http://pediatricspinefoundation.org/

  12. #42
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    Quote Originally Posted by Pooka1 View Post
    Fer, nobody here has a dog in that fight. There is no rational reason to give a hoot about the terminology surgeons choose to use. Their field. They get to decide, not us.
    Sharon, is their field and they can give the name for their solutions that they want, but at least they should to give a warning saying that they usually gives a name that is exactly the opposite that what the preexisting name means, to avoid any confusion in people that are not obligated to know that strange terminology.

    Tell me sincerely, you would have never said nothing if instead of 'brace', they call them as 'perfect scoliosis solution' ?

  13. #43
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    Quote Originally Posted by Pooka1 View Post

    Please consider that bracing may be as (in)effective as chanting or praying in terms of avoiding surgery for life.
    If you believe that chanting or praying may have the same effectiveness (high or low) as braces, at least you should to show the principles behind those activities and give a rational explanation that, as happens with principles behind braces, they are extremely related with the relevant facts that should to be taken into account in order to give a non surgical solution to the scoliosis problem.

    Quote Originally Posted by Pooka1 View Post

    It could turn out that way given what is known now. They can't even cleanly show it is effective even to the point of maturity. It is needless in the majority of cases per at least two analyses. Scoliscore is bringing the number for needless brace treatments down already. Only evidence matters. Emotionally clinging to a treatment that hasn't been shown to work is not rational.
    Please!! not force me to repeat always the same in every thread of this forum, in order to reply again what you say again in just only a very little different way.
    We have debated about braces here http://www.scoliosis.org/forum/showt...752#post141752

    Quote Originally Posted by Pooka1 View Post
    Until they solve this, fusion unfortunately seems to be making the most difference NOW for people in range.
    Similar request..
    I just only was saying to leahdragonfly that I don't want to abolish fusion as you want to abolish braces and I only wish that medical community thinks in replace it for something acording to this century and not to centuries ago. I believe I was clear enough and not any comment was necessary.
    Last edited by flerc; 07-23-2012 at 12:16 PM.

  14. #44
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    Quote Originally Posted by Pooka1 View Post
    There is no rational reason to give a hoot about the terminology surgeons choose to use. Their field. They get to decide, not us.
    Yes, we cannot choose the name, only they.
    Certainly everybody should to give a hoot against the hypocrisy of naming something provoking a great damage or irreversible negative changes as "minimal invasive".
    If they cannot do something better, they should to refer to it as it really is, not as it should to be.
    Last edited by flerc; 07-23-2012 at 10:34 PM.

  15. #45
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    Quote Originally Posted by flerc View Post
    Yes, we cannot choose the name, only they.
    Certainly everybody should to give a hoot against the hypocrisy of naming something provoking a great damage or irreversible negative changes as "minimal invasive".
    If they cannot do something better, they should to refer to it as it really is, not as it should to be.
    I don't understand why you care about this.
    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."

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