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Thread: These are my X-Rays

  1. #1
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    These are my X-Rays

    Hello fellow scoliosis-mates,

    I really don't know what to say, just brought my x-rays and wish someone would help me with the decision

    28 years old with scolio-kyphotic deformity affecting mainly the dorsal spine with convexity to the left, this is what is written on the report

    Can anyone here estimate the degree or cobb angle for me please?

    And if anyone had a somewhat similar degree of curvature< what was your decision regarding the surgery?


    Thanks and sorry for this weird way of writing, still nervous after the doctor told me I have to do the surgery, he's not a scoliosis specialist but referred me to another hospital that's about 600Km from where I live
    Attached Images Attached Images

  2. #2
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    Welcome to the forum, Handy!

    While I'm not going to guesstimate the degree of your curvature, there are some things that, as a fellow "leftie", that I can tell you.
    Left curves are relatively rare and can come with their own set of problems. There is a much greater incidence of other neurologic problems with a left curve. These include things like Chiari malformations (brain herniation), Syringomyelias (fluid within the spinal cord), and spinal cord tethering (spinal cord being physically attached to adjacent tissues). So when you go to see your specialist, please ask him/her to rule these things out.

    It looks like the apex of your curve is mid-thoracic but extends up into the neck. I have a very high left curve that goes into my neck as well. The apex of my curve is much higher than yours, but my curve magnitude appears much smaller. I will post my x-ray so you can compare. I also developed a right thoracic compensatory curve that has turned into a structural curve. This means that I no longer have a single curve but a double major curve, although it started out as a single left thoracic curve. I hope this has been helpful. Here is my x-ray showing a 46* (top left thoracic) and a 38* (low right thoracic):

    2010 radiograph.jpg

    I hope this helps!
    Be happy!
    We don't know what tomorrow brings,
    but we are alive today!

  3. #3
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    Handy....

    Unfortunately, you're really the only one who can make the decision. Your curve is a bad one, and because it's so high, I suspect it will probably be pretty painful if it's not already.

    Scoliosis surgery is really major, and comes with a relatively significant risk of complications. You need to do some research. This is a good place to start, but I'd also like to recommend that you purchase and read the book Scoliosis Surgery: The Definitive Patient Reference (http://www.curvedspine.com/about.htm). Though no longer completely accurate, it can give you a fairly good idea of what to expect from surgery. Once you've met the new surgeon, I would also ask him/her for contact information for a few patients who have undergone similar procedures. They'll be able to give you an even better idea of what sorts of things to expect.

    Best of luck with your decision and your journey.

    Regards,
    Linda
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Dilbert
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    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation
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  4. #4
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    Yes, it looks painful....

    How long have you known about your scoliosis? Are you just finding out?

    I was a surgical candidate in 1975 and waited 34 years.....Iím not saying wait 34 years, but take your time to get all your ducks in a row so you can sort all of this out.....Reading the Wolpert book as Linda recommends is a good idea for a start.

    Your curve is in surgical range...if I had to guess, I would say you have a 60 degree plus Cobb angle....but its best to have a scoliosis surgeon measure them for you.

    If you have any questions, any at all, go ahead and ask them. I know your nervous, its completely normal to feel this way.

    Welcome to the forum

    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

  5. #5
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    Wow, thanks for all the support


    Quote Originally Posted by rohrer01 View Post
    Welcome to the forum, Handy!

    While I'm not going to guesstimate the degree of your curvature, there are some things that, as a fellow "leftie", that I can tell you.
    Left curves are relatively rare and can come with their own set of problems. There is a much greater incidence of other neurologic problems with a left curve. These include things like Chiari malformations (brain herniation), Syringomyelias (fluid within the spinal cord), and spinal cord tethering (spinal cord being physically attached to adjacent tissues). So when you go to see your specialist, please ask him/her to rule these things out.

    It looks like the apex of your curve is mid-thoracic but extends up into the neck. I have a very high left curve that goes into my neck as well. The apex of my curve is much higher than yours, but my curve magnitude appears much smaller. I will post my x-ray so you can compare. I also developed a right thoracic compensatory curve that has turned into a structural curve. This means that I no longer have a single curve but a double major curve, although it started out as a single left thoracic curve. I hope this has been helpful. Here is my x-ray showing a 46* (top left thoracic) and a 38* (low right thoracic):

    2010 radiograph.jpg

    I hope this helps!
    Thank you very much rohrer for the information regarding those complications specific to lefties and your x-ray for comparison, my current doctor told me that it isn't that bad because it doesn't have a sever curvature as the curve extends to form a C shape, I took note of what you mentioned and will ask the surgeon about them, although I had an MRI scan previously but they didn't mention anything apart from the curve.

    What are your plans about your curves? are you considering surgery?

    Thanks again,
    Ahmed

    Quote Originally Posted by LindaRacine View Post
    Handy....

    Unfortunately, you're really the only one who can make the decision. Your curve is a bad one, and because it's so high, I suspect it will probably be pretty painful if it's not already.

    Scoliosis surgery is really major, and comes with a relatively significant risk of complications. You need to do some research. This is a good place to start, but I'd also like to recommend that you purchase and read the book Scoliosis Surgery: The Definitive Patient Reference (http://www.curvedspine.com/about.htm). Though no longer completely accurate, it can give you a fairly good idea of what to expect from surgery. Once you've met the new surgeon, I would also ask him/her for contact information for a few patients who have undergone similar procedures. They'll be able to give you an even better idea of what sorts of things to expect.

    Best of luck with your decision and your journey.

    Regards,
    Linda
    Hi Linda,

    It's pretty painful in the neck region now, as you can see some Cervical vertebraes are rubbing each other

    I know my curve is bad but again hoping to avoid the surgery or delay it as much as possible, can't imagine what and how it will affect my life later, If I could get the curve reduced a bit to make the surgery unnecessary will be enough for me.

    Thanks for the book, I have just bought the kindle edition from Amazon!

    Quote Originally Posted by titaniumed View Post
    Yes, it looks painful....

    How long have you known about your scoliosis? Are you just finding out?

    I was a surgical candidate in 1975 and waited 34 years.....Iím not saying wait 34 years, but take your time to get all your ducks in a row so you can sort all of this out.....Reading the Wolpert book as Linda recommends is a good idea for a start.

    Your curve is in surgical range...if I had to guess, I would say you have a 60 degree plus Cobb angle....but its best to have a scoliosis surgeon measure them for you.

    If you have any questions, any at all, go ahead and ask them. I know your nervous, its completely normal to feel this way.

    Welcome to the forum

    Ed
    Hi Ed,

    I have known about it about 13 years ago, unbalanced shoulders and people thought it was just me not wanting to stand straight!!

    The doctors at that time told me I could live with it normally if I don't care about the hump, but things don't go as wished and I have been in a constant pain for about 2 years now from the cervical vertebraes rubbing each other.

    I do have some questions,

    1- How long will a surgery take on average?
    2- How long will you be in pain after the surgery? i.e. when will you be able to resume your normal life?
    3- Will I be able to play some sports like volleyball, basketball and football "soccer" after the surgery?


    Unfortunately one of the reasons that make me hesitant to have the surgery is that in my work I have been notified that I should resign if I opt for the surgery as the doctor informed them it will take no less than 6 months for recovery

  6. #6
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    Quote Originally Posted by rohrer01 View Post
    This means that I no longer have a single curve but a double major curve, although it started out as a single left thoracic curve.
    Hi Rohrer. If both your curves are in the thorax then I think it is a Lenke Type 2 - Double thoracic. Double majors (type 3) require a structural curve in the lumbar and you don't appear to have any curve, structural or functional, in your lumbar.

    http://spinal-deformity-surgeon.com/...for-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."

  7. #7
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    Quote Originally Posted by Pooka1 View Post
    Hi Rohrer. If both your curves are in the thorax then I think it is a Lenke Type 2 - Double thoracic. Double majors (type 3) require a structural curve in the lumbar and you don't appear to have any curve, structural or functional, in your lumbar.

    http://spinal-deformity-surgeon.com/...for-scoliosis/
    Thanks for that information. I'm just going by what the surgeon told me. Although my curve extends into the L2 region, the rib hump deformity is very high, starting just around the bottom of the right scapula. The left rib hump extends from under the left scapula into the lower neck making my traps look really big there.
    Be happy!
    We don't know what tomorrow brings,
    but we are alive today!

  8. #8
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    Quote Originally Posted by rohrer01 View Post
    Thanks for that information. I'm just going by what the surgeon told me. Although my curve extends into the L2 region, the rib hump deformity is very high, starting just around the bottom of the right scapula. The left rib hump extends from under the left scapula into the lower neck making my traps look really big there.
    I believe these are labeled according to the apex. You have no curve apex anywhere near your lumbar region which looks completely straight to me. If you look at the Lenke curve type chart, the surgeon clearly misspoke. You have a double thoracic, not a double major curve type, no?
    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."

  9. #9
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    Thank you very much rohrer for the information regarding those complications specific to lefties and your x-ray for comparison, my current doctor told me that it isn't that bad because it doesn't have a sever curvature as the curve extends to form a C shape, I took note of what you mentioned and will ask the surgeon about them, although I had an MRI scan previously but they didn't mention anything apart from the curve.

    What are your plans about your curves? are you considering surgery?

    Thanks again,
    Ahmed
    Ahmed, you are more than welcome.
    Your curvature isn't as tight as mine but is much more severe than mine. As far as having surgery, since you would also probably need fusion into the cervical spine, the same as me, I will tell you what my doctor said about it. He said that it would likely increase my pain. I am already on daily narcotics for pain, especially in my neck and upper spine. I have lower spine and shoulder pain from different issues. He also told me that it may interfere with my ability to raise my arms, and since I'm thin, the hardware would be visible from the outside and would cause pain to my muscles because the muscles that move the shoulder blades would rub across it. But, then again, since the apex of your curve is so much lower than mine, they may be able to stay out of your cervical spine (neck).

    However, now my neck is degenerating and I have a bone spur growing toward my spine at C5 and a bulging disc near the same area. I have sustained a pretty severe shoulder injury that my current doctors (not the scoliosis doctor) feel may have started as a result of my altered anatomy.

    The thing is, for us, we tend to "wear out" a little more rapidly than people with normal spines whether we have surgery or not. Pooka1's doctor told her that the type of fusion her twins had gave them the same odds of degeneration that the unfused population had. For the most part, this has not been what I've personally seen with people I know with fusions.

    It is such a personal decision to have surgery. To be honest, there were a couple of times that I really wanted to have the surgery and get it over with. Then I waiver back and forth. Right now I'm in the "I don't want surgery" phase. I'm getting help with my upper back pain from trigger point injections. My neck pain and resulting headaches are being helped by getting Botox injections to paralyze some of those very rigid muscles. So, really it's an individual choice. Some people can live with the pain, some find other ways to deal with the pain like I have, and some choose to have surgery.

    On the surgical forums there are "sticky thread". One is entitled "I'm happy I had surgery" and the other is something like "I'm sorry I had surgery". If you read those threads you will get an idea of how long recovery is and what some of the outcomes are. You are young, so you have that on your side. Some people are off of all pain meds within a couple of weeks to a few months, while others may take a year or more. Some people are never able to get off of the pain meds. I don't know if there's any way to predict pain outcome. Because your curve is over 50*, statistically your curve is likely to keep progressing. That's just something to consider.

    If you live outside the U.S. (I'm assuming you do because you used km instead of miles), I'm not sure what resources are available to you. It depends on where you live. We have people from all over the world that post here, so if you find someone from where you are from they may be able to help you in finding the best surgeon and answer questions about time off of work. Every country has different policies about whether or not you can keep your job for a prolonged recovery period and getting temporary disability benefits. It also varies from employer to employer. If your work is not very physically demanding, perhaps you could go back part time. If your work is physically demanding you may be able to go back to work on light duty doing paperwork or answering phones. I don't know what your situation is. Financial concerns are definitely factors in whether some people can take the time to have surgery. Consider your support network as well, whether you live alone or live with family or have friends that can assist you. It's all so variable. That's why no one but YOU can make this decision. Like Ed said, you have plenty of time to make this decision and get your affairs in order if you do decide to have surgery. There's no rush unless the doctor tells you that your organs are being affected. That usually takes a curve of >100* from what I've read, but your doctor will know best in your case.
    Be happy!
    We don't know what tomorrow brings,
    but we are alive today!

  10. #10
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    Quote Originally Posted by Pooka1 View Post
    I believe these are labeled according to the apex. You have no curve apex anywhere near your lumbar region which looks completely straight to me. If you look at the Lenke curve type chart, the surgeon clearly misspoke. You have a double thoracic, not a double major curve type, no?
    No argument here. My surgeon has been pretty inconsistent with me for the last five years. I don't feel comfortable with him anymore. My insurance won't let me see anyone different. So I'm stuck unless I really want to fight with them. I had to fight, fight, fight with them just to continue to see this surgeon! I had him previously when I had different insurance and liked him a lot at the time, but had only actually seen him twice over a period of 10 years. There is NO scoliosis surgeon in my HMO network.
    Be happy!
    We don't know what tomorrow brings,
    but we are alive today!

  11. #11
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    Hi again dears,

    I just met the surgeon and here is what I got from him;

    1- Curvature is at 60 degrees, exactly as Ed's estimate

    2- Also as roher guessed, I need to have a fusion along my cervical spine

    3-As a result for the fusion in the cervical spine; It will be much more painful than a full fusion for the thoracic and lumbar together, this pain will decrease as I recover, but it won't be less than now

    4- I won't be able to move my head freely, i.e. instead of turning my head only to look at something, I would have to turn my whole body to face it directly

    But on the bright side, he told me that I don't have to do it now nor in the near future, as Ed said, I could wait for as long as I wish to have my decision, he took a look into my MRIs and x-rays and found that there is no significant progression of the curve.

    He also suggested for me to try intensive PT if I wished , gave me a clinic in the UK to contact them which I am looking for now and will post results here if I tried it.

    And finally yes roher I live outside the USA; Saudi Arabia specifically :-)
    Last edited by handy; 06-27-2013 at 12:47 PM.

  12. #12
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    Ahmed,
    I'm not great with my geography, but isn't the UK quite far to go for physical therapy?
    I'm so glad that you got your consult with a surgeon. Now with the information that you have (pat ourselves on the back, we were pretty spot on!), you can make an informed decision about when or even whether or not to have surgery. The neck is a tricky place to extend the fusions to. I'm so sorry to hear that your pain isn't expected to get any better with surgery. It sounds a lot like what my doctor told me, although my degree of curve is in the surgical grey area.
    How do you feel about this news?
    Be happy!
    We don't know what tomorrow brings,
    but we are alive today!

  13. #13
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    Actually you are right Rohrer, UK is a 7 hours flight unfortunately, but I wouldn't mind trying the available options as suggested by the surgeon to see if anything would work for me.

    You and everyone here deserve a shoulder pat for the support I got here.

    About my feelings now, I had a relief by Ed's post that he had postponed the surgery for 34 years! and the rest is gone now after the surgeon assured me to take as long as I wish before going for the surgery, in his words "There won't be a day when all scoliosis surgeons suddenly vanish from existence". He asked me about the pain in my neck and shoulder and if I need any pain killers prescription from him, I told him that I don't like meds and that I got accustomed to the pain and we are much more friends now rather than enemies, but I took the prescription just in case.

    My plan now is to try to get an unpaid leave from my work to go for the suggested clinic in the UK which will take four weeks for the PT course, and maybe try the Scroth method later in Germany also, so that's an estimate of 12 weeks if I went for both.

  14. #14
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    Ahmed

    You have to realize that you donít have a standard kind of scoliosis.....its up high, and that makes it tricky. I didnít want to mention me waiting 34 years and have you thinking that you could get away doing the same thing.....We are all different and surgical timing varies in each case. We can talk about this later....curves, age, and timing. Surgery is ďusuallyĒ a last ditch effort, in your case, I think this is a correct statement.

    There is a high probability that your decision to have surgery will depend on your pain levels....Your Lumbar looks great, but as you go up the spine, your discs seem to get smaller as you go higher, and you can see that you are bone on bone or close to it in your upper thoracic and cervical area, a degenerative process that we sometimes have to deal with living with scoliosis. Your T1 is also inclined around 20 degrees which is the base for the neck......In the future, I can dig up examples of surgeries and their results in this special situation.

    You will become an expert at pain. We all become experts as we experience our aches and pains, but what happens as you get older is that you will experience alarming pain ďeventsĒ. These events can happen with a higher frequency, and has a tendency to tip the scales of decision. These pain events are signals that something is seriously wrong. Muscles can spasm, if you have not had this happen, chances are you will at some point, most likely in the neck. These spasm events are extremely painful, and I have found hot water immersion an easy way to deal with it. Having a non-steroidal anti-inflammatory (NSAID) around would be a good idea right now, ask your surgeon and see what he recommends. I am currently using Diclofenac for my neck as I have 2 herniated cervical discs. This medication works well. It lowers inflammation and reduces pain. NSAIDís donít affect the mind like OPOIDís do....We can talk about this later.....
    http://en.wikipedia.org/wiki/Nonster...lammatory_drug

    http://en.wikipedia.org/wiki/Diclofenac

    I have ALWAYS had an NSAID of some sort through the years available to me. These meds can be life savers.....I also wouldnít travel without them.

    As far as having surgery goes, we plan on it, and prepare for it. We spend many years thinking about it, reading many books and posting on scoliosis forums. Getting all your ducks in a row is a good idea, you have plenty of time to think about it. There are many questions.......

    Difficult spine surgeries can take 6-12 hours.....and donít guarantee any pain relief. Complications can happen which can also make things difficult. Recovery time is dependent on age, health, and procedure....It took me 2 full years at age 49 to recover. Surgeons can fuse you ďas-isĒ with no correction. Playing contact sports after a multi-level cervical fusion is probably not a good idea.

    I was diagnosed in 1975 and was a Luque wire candidate.....They used wires on bad cases during that period, and fused to the Pelvis also with this method. 1975 was a while ago, and surgery back in those days was a whole different story, we have come a long way since then. I lived my life knowing that someday I would have surgery. Every single doctor told me this. It was something that I had in the back of my mind, eventual planning for the big day......For now, you can think and plan......and maintain your pain....

    I think it would be a good plan to discuss your future physical therapy treatment here before committing to anything right now. I would not buy plane tickets or commit to any programs right now.....this is just my gut feeling.....youíre a newbie, and people will gladly take money up front.

    Let us know when you get done with the book.
    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

  15. #15
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    Ahmed, there may be some alternatives like injections or denervations that might help. I found that cold packs helped a lot. I second the use of NSAIDS like Ibuprofen. It is sold in a drug store.

    Best of luck to you! 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

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