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  • #61
    Question for Sharon re this thread

    Originally posted by tampamom View Post
    Do you think boys might be more at risk for Lumbar issues when stopping at L1 and having a false double, given they tend to continue to grown more in high school and college? Does growth also cause just rotation?

    It seems pretty consistent that girls growth hormones slow down after their menstrual cycle.

    And thanks for all your input!
    Sharon & Linda (or anyone else with info/knowledge on this) - What are your thoughts on this question in regards to boys? Jacob was fused to L1 & as you saw in the initial xray, the lumbar curve looked to be 10* or less. However, after 3 major falls & gaining several inches more in height, his L curve is now 28*. The bottom of one of the rods came off the screw & we have been monitoring it for further movement since the end of Dec.
    Last edited by LSKOCH5; 04-22-2013, 03:32 PM.
    Mom of 14yo son diagnosed Oct 2011
    Surgery 1/3/12 w Dr. Geof Cronen,
    Tampa General Hospital T3 to L1
    Jacob's pre surg curves: T58 & L31 12/28/11
    photos & xrays in "First-Time Surgery" thread "Before & After"

    Comment


    • #62
      Originally posted by LSKOCH5 View Post
      Sharon (or anyone else with info/knowledge on this) - What are your thoughts on this question in regards to boys? Jacob was fused to L1 & as you saw in the initial xray, the lumbar curve looked to be 10* or less. However, after 3 major falls & gaining several inches more in height, his L curve is now 28*. The bottom of one of the rods came off the screw & we have been monitoring it for further movement since the end of Dec.
      As I responded to tampamom, this is really a question for an experienced surgeon.

      Given that most of these patients have no significant change in the lumbar over decades, I am a little surprised to hear Jacob's lumbar has gone from ~10 to 28*, falls or not. Did the thoracic change? As I recall, he was hyper-corrected to <10*T, no? It sounds like he might have grown before he fused. My daughter's thoracic "slipped" a little from 16*T a few days post-op to the final angle of 20*T post fusion although that is still in the noise.

      There are esoteric issues about selecting the correct lower instrumented vertebrae and if you don't do this correctly, you can get adding on or whatever. I don't think it means that the lumbar is stuctural. But I don't think adding on is what you are seeing.

      What were his L measurements before the falls? So now does he still have a virtually straight T spine and a 28* L? There is no reason the growth in the lumbar should not be normally straight given the straight T spine. Is there rotation? I bet not!

      Can you post the radiograph? It's all pretty strange because the L was clearly compensatory (since it came straight) and I don't see how it could possibly magically become structural after the T curve was hyper-corrected. I think older people do have single T curves becoming double majors but that is because the curve was untreated for so long. That is not the case with your son.

      My best guess is he is curving away from the pain and once that settles, the lumbar curve will go away. Dr. Hey wrote about a case where a guy had a functional scoliosis from bending away from the exquisite pain associated with a badly herniated disc. If Jacob was in one-sided pain for a long time, that might explain a functional curve of 28* perhaps. I really don't know.

      Also, you can check those two papers I posted to see if there are males in the study groups.

      I suggest asking the surgeon. Did he comment about the increase in the L curve?

      Good luck.
      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."

      Comment


      • #63
        Originally posted by LSKOCH5 View Post
        Sharon & Linda (or anyone else with info/knowledge on this) - What are your thoughts on this question in regards to boys? Jacob was fused to L1 & as you saw in the initial xray, the lumbar curve looked to be 10* or less. However, after 3 major falls & gaining several inches more in height, his L curve is now 28*. The bottom of one of the rods came off the screw & we have been monitoring it for further movement since the end of Dec.
        I forget what type of T curve Jacob had? Wasn't it a pure T curve and not a false double? If so then this is even stranger!
        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."

        Comment


        • #64
          Originally posted by Pooka1 View Post
          I forget what type of T curve Jacob had? Wasn't it a pure T curve and not a false double? If so then this is even stranger!
          Okay I found it. Jacob's curve looks very similar to Thing One's curve which was straight thoracic to my knowledge.

          Now I have read where selection of the lowest instrumented vertebra is critical in this type of curve if in fact I am correct that our kids have this type of curve. Adding on is a concern if the wrong vertebra is selected but I think adding on just sort of lengthens the original curve as opposed to increasing a compensatory curve. Not sure.

          Is the Lumbar curving in the same or opposite way as the residual T curve?

          I AM NOT A SURGEON AND DON'T HAVE A GOOD HANDLE ON ANY OF THIS!

          I just wanted to point that out again!
          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."

          Comment


          • #65
            You might ask your surgeon about this...

            http://www.ncbi.nlm.nih.gov/pubmed/22322370

            Adding on doesn't change the direction of the compensatory curve as I suggested earlier. It is the lengthening of the instrumented curve below (or perhaps above) the fused levels because the fusion length is too short.

            Is the curve curving right under the bottom of the fusion like this...

            http://www.healio.com/orthopedics/pe...e-1a-scoliosis
            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."

            Comment


            • #66
              Sharon, thanks for your response. The L curve is the opposite, just as in the link to the Lenke 1A that you posted. It is still considered compensatory & is being closely monitored; the surgeon does not believe there will be any further increase. The T is straight & beautiful. I had to look up your term "adding on" but am at a loss as to "false double." And the study group that I saw was purely females. Jacob is still growing, having caught up w me last fall & having surpassed me already this year. Still having shoulder issues but pain goes away every time he swims as well as usually when works out.
              Last edited by LSKOCH5; 04-23-2013, 08:05 AM.
              Mom of 14yo son diagnosed Oct 2011
              Surgery 1/3/12 w Dr. Geof Cronen,
              Tampa General Hospital T3 to L1
              Jacob's pre surg curves: T58 & L31 12/28/11
              photos & xrays in "First-Time Surgery" thread "Before & After"

              Comment


              • #67
                I don't think Jacob has a false double.

                A false double is an S curve that looks like a double major (2 structural curves) except one of the curves is not structural. So it is a "false" double major curve.

                That's my understanding.
                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."

                Comment

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