RIP spinal fusions

[Pooka1]

"There is no good evidence it allows growing kids to avoid surgery. There is a reason most surgeons don't use Spinecor. A very good reason.

For adults, there is evidence it helps some people with pain but the muscles atrophy in the brace. So when they stop wearing it that have weaker muscles and may collapse.

For adults there is no evidence it corrects or even halts progression. That is why it is sold for pain only to adults."

Pooka1, do you mean that muscle atrophies or muscles imbalances lead to bone deformities? That is a good observation. Are you claiming that are the imbalanced muslces forces that make scoliosis progress further into adulthood?
It has already crossed my mind, but I think the genes play a bigger role.

All braces including Spinecor take over for muscle by restricting movement. That results in atrophy and to the extent muscle strength can hold a curve (which may not be much), that is lost.

At first the Spinecor developers said no PT was necessary because it allowed so much movement (which may explain why it doesn't work to hold a curve). But they later changed that and said the patent should do PT also maybe to avoid the atrophy. It still doesn't work to avoid surgery.

[Pooka1]

In adolescents, the discs are rarely removed during a fusion as far as I know. My daughters have all their discs. None were removed.

[richardis]

All braces including Spinecor take over for muscle by restricting movement. That results in atrophy and to the extent muscle strength can hold a curve (which may not be much), that is lost.

At first the Spinecor developers said no PT was necessary because it allowed so much movement (which may explain why it doesn't work to hold a curve). But they later changed that and said the patent should do PT also maybe to avoid the atrophy. It still doesn't work to avoid surgery.

why a muscle with normal tonicity tends to lengthen? That means that a lenghtened muscle in a resting position can exert more extra force than a shortened muscle? this seems counter intuitive.

If muscles are atrophied they are shortened in length, contract more, are more rigid and tense up, exert less force, etc, etc,.. Is that correct?

Does muscular atrophy cause pain?

[richardis]

Certainly, when reduction in brace is achieved, progression is halt while the Spinecor is used!. The problem is that CLEAR is not interested in achieve reduction in brace, this is the reason why many adults using it continues with progression.

CLEAR? don t mention that.

[Pooka1]

why a muscle with normal tonicity tends to lengthen? That means that a lenghtened muscle in a resting position can exert more extra force than a shortened muscle? this seems counter intuitive.

If muscles are atrophied they are shortened in length, contract more, are more rigid and tense up, exert less force, etc, etc,.. Is that correct?

Does muscular atrophy cause pain?

I have no idea.

[flerc]

All braces including Spinecor take over for muscle by restricting movement. That results in atrophy and to the extent muscle strength can hold a curve (which may not be much), that is lost.

At first the Spinecor developers said no PT was necessary because it allowed so much movement (which may explain why it doesn't work to hold a curve). But they later changed that and said the patent should do PT also maybe to avoid the atrophy. It still doesn't work to avoid surgery.

Spinecor is not a brace, people is confused because they decided to call it 'the dinamic brace'. A brace holds straight the spine applying forces in three dimensional points, so muscles might don't exists, they have nothing to do. To holds the spine straight with a rigid brace, they needs to stretch first the spine like surgery does, so if you put a rigid brace in a spine without stretch it before, none reduction in brace would be achieved and it could have sense to talk about muscular atrophy since almost no movement are allowed.
But if you put a Spinecor, the spine is not stretched before, the bands leads the body to stretch the spine by itself!. Surely the bands give some help to the muscles to holds then the spine straight but sure it could not remains straight without the muscle activity. It's a muscular solution, so is logic to recomends sports, any kind of sports as I know so is too much difficult to imagine some kind of atrophy of course.
And great reduction in brace are achieved, some doctors (no Clear doctors who seems to have not idea about how it works) removes the Spinecor if reduction in brace is under the 40%.

[flerc]

In adolescents, the discs are rarely removed during a fusion as far as I know. My daughters have all their discs. None were removed.

So how is the fusion achieved? Why they needs bone?

[Pooka1]

So how is the fusion achieved? Why they needs bone?

They fuse across the disc from vertebrae to vertebrae. This is obvious from every radiograph of every kid I have ever seen posted here.

[flerc]

They fuse across the disc from vertebrae to vertebrae. This is obvious from every radiograph of every kid I have ever seen posted here.

So discs are only covered by bone. Why then don't removes that bone, screws and bars? Why everyone around the world says that fusion is irreversible?

[Pooka1]

So discs are only covered by bone. Why then don't removes that bone, screws and bars? Why everyone around the world says that fusion is irreversible?

I assume they say that because then the curve will come back. There is no point to fuse and then unfuse.

[flerc]

But this would be absolutely incorrect. Irreversible means the impossibility to return to the previous state. The only possibility would be if muscles and or ligaments were cutted. But any way it could be reversed and change it for something as Vbt.

[Pooka1]

Nobody would want to return to the previous state. I don't think a surgeon can justify another operation ethically.

In terms of technical feasibility, if they didn't remove the discs, I am not sure why the fusion could not be revised. Maybe Linda knows.

[flerc]

IS full of people around the world wanting to return to the previous state but all of them are absolutely sure that is something impossible.

[Pooka1]

That is not rational.

[flerc]

No, they allways heard that is impossible.