Just what defines a " Good outcome from scoliosis surgery."

[bluestone]

hi bluestone...
so sorry you are in such pain....

what about just screw removal...???
i think, if you type in "screw removal" at top of page where it says "search" you will find some patients who did well after having one or more screws removed...especially the screws that are in hip area...
"Admoul"...Annne...is one patient who had screws removed by Dr Lonner,
the surgeon in Manhattan who did her original surgery...i believe she did
great after she healed...
perhaps you could investigate whether just taking out some screws might
relieve some pain...

best wishes...
jess

I have mentioned in previous threads that unfortunately screws removal for me isn't possible.
The system my surgeon has used means that to remove the screws the rods have to come out first.....if only I could just have the protruding screws out. This is why its such a dilemma.

[jackieg412]

My Dr and I talked about removing some screws--but ended up adding to fusion. For me it is easier than before. but it is hard to be in pain and hope for relief. My Dr wants me to cut pain meds even more. Since I don't really take much--he's like use heat{I DO ALL OF THE TIME!} and use advil{THEN I Bruise}. So I good question is ----is it alright to use some pain control and stay as active as possible--or no pain control and lay down more?
Still being in some pain after 2 years is hard. Or is it like Linda says it is harder to adjust to a new pain than have to one you are use to?

[jrnyc]

sorry, bluestone...i didn't see any other thread so i didn't know you
can't have screws out without all the hardware being removed...
i was looking for positive results from hardware removal, and the most
positive ones i read were the ones where just screws were removed...

i really was under the impression that once the spine was FUSED...once
the bones were FUSED...that it couldn't re-curve...
i've read of folks who had bones that fused by themselves, without any
surgery...and it sure never sounded like their bones could un-fuse, or
curve in any direction besides whichever way they "naturally" fused.

jess

[rohrer01]

Jess,
I thought that, too, about once the spine is fused. If you think about it, though, whatever forces are at work that caused the curve to begin with are still there working on the fused spine. Our bodies constantly regenerate and remodel. I know a woman who progressed again after Harrington rod fusion. It perplexed me until I reminded myself of the ongoing remodeling and restructuring that our bodies are constantly going through.

IF I ever have surgery, I would have to have enough pain reduction after healing to go off of daily narcotics AND I would expect better than 50% correction. I do not want to be fused in a crooked state even though I realize that they can't get all of the curve out. That would be my criteria for "success". Oh, I would want my shoulders and hips to be even, too. I don't care about scars.

[bluestone]

Jess,
I thought that, too, about once the spine is fused. If you think about it, though, whatever forces are at work that caused the curve to begin with are still there working on the fused spine. Our bodies constantly regenerate and remodel. I know a woman who progressed again after Harrington rod fusion. It perplexed me until I reminded myself of the ongoing remodeling and restructuring that our bodies are constantly going through.

IF I ever have surgery, I would have to have enough pain reduction after healing to go off of daily narcotics AND I would expect better than 50% correction. I do not want to be fused in a crooked state even though I realize that they can't get all of the curve out. That would be my criteria for "success". Oh, I would want my shoulders and hips to be even, too. I don't care about scars.

Yes its what caused my spine to curve so badly that concerns me and my worry is that without that scaffolding it might have a go at re curving-maybe badly.

I'm using the same pain meds that I used before my surgery and pre surgery I had a wheat bag on my back every evening-I don't think about using that now so to me that's a plus. I have also have an amazing straight back and no rib hump which makes the pain I'm left with now a little easier to bear

[Doreen1]

Since my #1 goal was to stop the progressing curves by having surgery, mission accomplished in my case. The reduction of pain was pure gravy as I am no longer bedridden with pain.

[LindaRacine]

While the spine will continue to curve after implant removal, it is at a snail's pace, unless there is an area or areas that aren't solidly fused.

[rohrer01]

My doctor told me that if I had the surgery I would be committing myself to two surgeries because of how high the fusion would have to go. He said that because I'm so thin the hardware would protrude and be visible. But since my progression has been at a "snails pace" I wouldn't be worried too much about having hardware removal in my case.

[jrnyc]

can they not use pediatric size hardware for some adults who
are small boned...or those who are quite thin...???????
???????????????

i am very thin as well...always figured i might need hardware removed later
if i had the surgery....

jess

[rohrer01]

I wondered that, too. But since I'm not having surgery I guess it's a moot point. If I do ever come to the point of having surgery I will definitely ask. I wonder, though, if the hardware isn't as strong. Kids are very limber and much easier to fix that us ..hem..hem... older folks.

[jackieg412]

I am also small boned and thin. My Dr said that it was a complication---he said it is harder to work on small boned adults. He fractured one level and I fractured another. He said that it is hard to find the screws big enough to do the job and not too big as to fracture the bone. Since he did one --I quess it can and did happen. Now he told my daughter that he would rather have done this surgery on a 300 lb man than ever on a person my size. And as of right now being a small boned,older adult---my bone strength is reading at 110 % of an average female of my age and 95% of general population. So , since I do not take any meds for the bones, I feel good about it. He said the fractures were a complication of surgery and not of bone strength.
The screws are a bother at times because they have nowhere to hide!! I think I'll leave then there. Seems like my ribs want to turn anyway.

[bluestone]

My surgeon has told me on a number of occasions that the reason I am having pressure and pain in the middle of my back where the protruding screws are is because I have no fat in that area. It makes sense I guess-there's nothing to 'cushion' it all.

[rohrer01]

Doctor's are constantly hounding even the slightly obese population to lose weight for back health. So now it's a complication to be thin? I'd almost guarantee that if we forcefully made ourselves slightly overweight, they'd be telling us that our pain is from that! I'm obviously not fused, but as you can see, my thinness is a complication that scares my doc away from doing surgery on me, not that I want it right now anyway. It's actually good for me to talk to other thin people who HAVE had the surgery.

BTW, the person that I know that has progressed STILL HAS her Harrington rods IN. They bent with her. I hope the rods they use now days are stronger than that. But in defense of the hardware, her curve was so bad that they could only straighten her up to about 60* at best. That amount of curvature alone leaves one with progression risk. She is still happy she had the surgery even though she's in her early 50's and is dying. She said at 18 years old it was surgery or death. I'm not sure how large her curve was. Her custodial parent refused treatment for her as a child/infant. Her noncustodial parent got her the surgery when she turned 18. Sad...=(

[jrnyc]

i was told the opposite...
Dr Neuwirth, in Manhattan, told me he liked to operate on thin
patients...he said the bone is right there...easy to get to...
he also said he would discuss pediatric size hardware if i
got serious about the surgery and was going to book a date....
which i never did....

jess

[Confusedmom]

My goal for surgery was to stop progression of the curve. As far as we can tell at this point, that goal was achieved. Therefore, I have to call the surgery successful.

Secondary goal was a straighter back. That was achieved, though my ribs aren't perfect. (Still protrude and more noticeable than right after the surgery since muscles atrophied.)

A third goal was no increase in pain. Pain reduction wasn't really a goal since I didn't have much. Fatigue from standing has been reduced. Other positions are more uncomfortable than pre-op (sitting, laying). So, I'll call the pain/discomfort issue a wash to a slight negative.

Final goal was no major complications. So far, so good -- thank God!