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  1. #15
    Join Date
    Jan 2008
    Quote Originally Posted by burdle View Post

    My feeling is that with more screening and VBT being done before fully grown maybe a lot fewer people will have a lumbar curve whether structural or compensatory- given that the most common curve is thoracic and the lumbar ones often come afterwards.
    I think most if not all T scolioses come with a compensatory lumbar curve as the spine strives to maintain balance. That is not a structural curve and will disappear some/mostly/completely as the T curve is straightened. There is no lumping functional and structural curves. They are completely different. If a person has a structural T curve and a functional L curve then they ONLY have T scoliosis. There is nothing wrong with their lumbar. If a person has a structural T curve and a structural L curve then they have a double curve. Only structural curves need to be fixed as the functional curves straighten themselves spontaneously to balance the straightened structural curve. This happened in both my daughters by the time of the first post-surgical erect radiograph on day 3 or 4 which is pretty good evidence that functional curves are only balancing a structural curve and are not real curves.

    Structuralizing a previously functional lumbar curve associated with a structural T curve can happen in several instances including...

    1. the T curve was never straightened surgically (i.e., went untreated)
    2. the T fusion extended past about L1
    3. the T fusion did not straighten the T curve enough to drive enough straightening in the initially functional lumbar curve

    I am not saying there is no success with lumbar or combination just that from what I read there seems to be more success with just thoracic.
    What do you mean by success? Success would include addressing both the T curve and protecting the lumbar. Certain cases of fusion can do that. I don't think they know yet if tethering can do both. They may be winning the battle of the thorax but losing the war of the lumbar.

    So no need to drive a lumbar straight if lumbar not involved.
    Yes there is. I posted a case study from Dr. Hey where a woman who only had a structural T curve went on to convert her previously only functional L curve to a structural L curve through no fault of her own... her T curve was below the surgical threshold. She was screwed and destined to have her L curve structuralized because her T curve never reached the surgical threshold. Had they lowered the threshold and straightened her T curve, maybe she never would have had her L curve structuralized. Who knows. The point is all T curves potentially endanger the lumbar if not corrected.

    That is why I consider T curves to be emergencies. The lumbar is in potential danger.
    Last edited by Pooka1; 05-24-2019 at 06:09 PM.
    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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