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Thread: DD recently diagnosed -- any suggestions?

  1. #61
    Join Date
    Jan 2008
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    NC
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    By the way the Janzens seem to think that just because a kid is wearing a brace, the brace did something. They are not running a controlled study so they can't say how successful the treatment is. This is why controls are needed.

    The BrAIST study showed that about half the kids who didn't wear a brace were "successes" compared to 73% of the braced group. That means most of the "successes" in the braced group were not due to the brace. Then there were the bracing failures.

    I think they calculated that they had to treat about 4 kids just to get one "success" from bracing.

    Since some of the "successes" may have included kids with up to a 49* curve with up to 25% growth remaining, I think they should have also calculated the percent of kids who were "successes" at the end of the study but who will likely or almost certainly need surgery. That would be any kid with a >40* curve with no growth remaining or any kids with 35* curve or better with any growth remaining. Any kid with >30* curve at maturity is at risk of progressing to surgery in their life time.

    The main elephant in the room is what is the Janzeneseses base for calculating success rate? There is no way they are that successful when even BrAIST was not. There is something very funny here.
    Last edited by Pooka1; Yesterday at 02:55 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."

  2. #62
    Join Date
    Aug 2019
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    12
    Quote Originally Posted by Pooka1 View Post
    Since some of the "successes" may have included kids with up to a 49* curve with up to 25% growth remaining, I think they should have also calculated the percent of kids who were "successes" at the end of the study but who will likely or almost certainly need surgery. That would be any kid with a >40* curve with no growth remaining or any kids with 35* curve or better with any growth remaining. Any kid with >30* curve at maturity is at risk of progressing to surgery in their life time.
    This is only a minor quibble (I'm generally in agreement with Sharon that the BrAIST study didn't show nearly what the authors said it did), but I'd view postponing fusion on a teenager for a decade or two a success, especially for kids (like mine) with low lumbar curves that very likely would result in pretty big limitations if fused all the way down. At least personally, if bracing means that she gets to experience high school and college and early adulthood before being fused, I'm chalking that up as a win. (Plus, who knows what surgical techniques will be available in 15-20 years. Tethering is younger than that.)

  3. #63
    Join Date
    Jan 2008
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    NC
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    Quote Originally Posted by Concerneddad View Post
    This is only a minor quibble (I'm generally in agreement with Sharon that the BrAIST study didn't show nearly what the authors said it did), but I'd view postponing fusion on a teenager for a decade or two a success, especially for kids (like mine) with low lumbar curves that very likely would result in pretty big limitations if fused all the way down. At least personally, if bracing means that she gets to experience high school and college and early adulthood before being fused, I'm chalking that up as a win. (Plus, who knows what surgical techniques will be available in 15-20 years. Tethering is younger than that.)
    Oh hey I completely agree and I think surgeons do also. They sometimes seem to not fuse below L3 or L4 on kids because they just don't want to. Dr. Hey talked about a case where he stood on his head to remodel the vertebra just to shorten a lumbar fusion on a teenager. These are double majors or L curves that would likely get fused to the pelvis in a mature adult.

    I think they need to get tethering up to speed yesterday for lumbar curves in not just kids but everyone.

    Progression potential in L curves is less than in T curves to the point that if a study is stacked with L curves in the treatment group and T curves in the control group the results are guaranteed to be nonsense. I think there was at least one such study though the stacking was not deliberate. I don't know where double majors fall in terms of progression likelihood but they are less likely to progress than T curves as far as I know. Nothing is more likely to progress than T curves at least in AIS.
    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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