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Thread: Startling statistics regarding scoliosis surgery

  1. #16
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    I have never had any hint of dishonesty from any surgeon I have ever met.....If anything, I had more problems with them being too honest. Its impossible for them to cover all complications....and its really hard for patients to accept the reality that medical science is that complicated and unforgiving should something happen. Surgeons have to deliver bad news to patients, this cant be an easy thing for them to do. We don't need Chiropractors reminding us of this on their web pages especially when some of us know we are surgical candidates.

    I don't know if its worth looking at stats on Hemi since the variations are endless....The only way to know is to have a Pediatric scoliosis specialist shoot CT scans and MRI scans to evaluate. They will also do a 3D print of the spine to show how they will proceed....There is no way a Chiropractor can do anything as far as this is concerned, and they should be forced by law to refer these patients off. They would have to be nuts to even proceed in any manner with a congenital scoliosis patient. They are not Medical Doctors.

    I am an old Chiropractic patient and used Chiro for over 22 years with approx 12 different Chiropractors. This was done for pain, and I was a lifelong skier. Of course I am a completely different case than your son, but wanted you to know. I have tried everything under the sun battling scoliosis over the years. Chiro will not correct scoliosis curves.

    My Chiropractors were also honest with me and told me that one day I would be fused. It was only after the adult degeneration took a foothold, that I realized that it was fruitless and then my scoliosis surgeon came to town. After 2-1/2 years of talks with him, I did my surgeries.

    The one thing you cannot do with kids with scoliosis is ignore the situation.

    If you need a 2nd opinion, you can pick out a surgeon off the SRS list. If not the right surgeon, that surgeon will refer you to the right people.
    https://www.srs.org/find/disclaimer.php

    You can also contact Shriner's
    https://www.shrinershospitalsforchildren.org/shc

    Linda and Sharon have done some good posts as always...

    Deep breaths

    Ed
    49 yr old male, now 61, the new 61...
    Pre surgery curves 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

  2. #17
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    Quote Originally Posted by titaniumed View Post
    They will also do a 3D print of the spine to show how they will proceed.
    MAY 3D print the spine.
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

  3. #18
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    Quote Originally Posted by Pooka1 View Post
    Adults had more lumbar curves than kids which obviously means they sometimes develop if you don't treat T curves.
    It might also mean that lumbar curves aren't detected until they become painful.
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

  4. #19
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    Quote Originally Posted by LindaRacine View Post
    It might also mean that lumbar curves aren't detected until they become painful.
    I mean cases where there is only a structural T curve in a child is a larger percentage of the total than adults where there is only a T curve as a percentage of that total. Specifically, in kids, pure T curves are the most prevalent but that does not seem to be the case in adults who were not fused as kids. Many adult AIS cases seem to have lumbar involvement. Young adults group more with kids as we have seen several cases here where they still only had a pure T curve.

    I fear that the degenerative curves account for some of those lumbars in adults and it may not be all new AIS lumbars.
    Last edited by Pooka1; 02-04-2020 at 07:43 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."

  5. #20
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    Current status of 3D printing in spine surgery

    Quote Originally Posted by LindaRacine View Post
    MAY 3D print the spine.
    Linda, You know, I pondered on using the word may.....(sigh) but 3D printing is the cats meow...The article explains below.

    Spine surgeons dealing with scoliosis are familiar with many of the inherent problems of these complex deformities encountered intra-operatively. Vertebral rotation, absent or dysmorphic pedicles and segmentation anomalies are all components of scoliotic spines and distort the anatomical landmarks for pedicle insertion. Current imaging modalities like CT scans or MRI have often been found to be inadequate. 3D printed anatomical models provide the ‘fourth’ dimension of tactile feedback to the surgeons which can help them anticipate the technical challenges that may be encountered intra-operatively. Almost as a testament to the popular adage – ‘the more you sweat in practice, the less you bleed in war’ - surgeons can practically carry out the entire surgical procedure and make a note of the technical challenges and the improvisations needed, before the actual surgery takes place.

    They also 3D print the drill jigs or screw guides See Figure 5

    Also, 3D print PEEK vertebral bodies after corpectomy,(that's vertebral removal) and custom spacers! (PEEK is a type of plastic used in spine surgeries)

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6128322/

    3D printed model of John Sarcoma's spine Dr Lenke example 1:35
    https://www.youtube.com/watch?v=gkfFMlPSIsI

    Hope this helps understand this technology

    Ed
    49 yr old male, now 61, the new 61...
    Pre surgery curves 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

  6. #21
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    Surgeons and surgical risk

    From Ed: I have never had any hint of dishonesty from any surgeon I have ever met.....If anything, I had more problems with them being too honest. Its impossible for them to cover all complications....and its really hard for patients to accept the reality that medical science is that complicated and unforgiving should something happen.

    My thoughts: I have had numerous surgeries and I felt that all surgeons were honest. Like probably most of us, I imagined that the #s did not apply to me. Hahahahaha. Famous last words. I remember after my first spine surgery, I was talking to Irina and said that I was glad "that I did not have to post on the revisions area". Again, famous last words. In my prior life, I spent a brief tour in Vietnam as a Navy nurse in late 1970. Like most soldiers, I did not believe that I would catch a bullet there. Surgery and soldiering are somewhat similar that way in that if you really thought seriously about the risks, you would never have surgery or go into battle/harm's way.

    As a Nurse Practitioner doing surgical/procedural counseling [or giving a patient possible risks with a biopsy procedure that I frequently did], few patients questioned the statistical risk number. I used to counsel patients for a surgical procedure that had a risk of 1/350 that the genetic results that they were given would be a false negative or cannot remember the # for a false positive. A rare patient understood the false neg/positive meaning which I explained in great detail. Some would ask, "How can there be a false positive or false negative?" I don't think that many really understood it.

    My advice to anyone having a major surgery: Something will go wrong or turn out differently than you planned on, so be ready for it. It could be fairly minor, but that's where an advocate is good. A friend's husband had major spine surgery and on my advice, she stayed with her husband the first night after surgery in the hospital. Well, ends up that nobody ordered pain meds post-op for Jim. After she realized it, the post-op unit nurse told her that the Neurosurgical Fellow was busy in the ER and that her husband needed to wait. My friend Ginger announced "There should be someone in this large university hospital somewhere who can order something now! Your answer to wait is unacceptable." The head nurse made some calls and got an order. Like I said, something generally goes wrong.

    I feel that I am the Poster Adult for what can go wrong with scoliosis surgery and many people's worst nightmare. In spite of all that has happened to me complication wise, I am still happy that I had the original surgery. I did every alternative therapy/treatment before accepting surgery. By the time I had surgery, I could only walk 1/2 block without sitting down from pain. I consulted with 2 very experienced deformity spine surgeons. When I asked one of them what my life would look like in 5 years without surgery, he commented "you will probably be in a wheelchair full time". I had surgery fully informed, the rest is history.

    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 2 surgeries
    2014: Hernia @ ALIF repaired; Emergency screw removal Spinal Cord Injury 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
    2018: Removal L4,5 screw

  7. #22
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    Quote Originally Posted by susancook View Post
    From Ed: I have never had any hint of dishonesty from any surgeon I have ever met.....If anything, I had more problems with them being too honest. Its impossible for them to cover all complications....and its really hard for patients to accept the reality that medical science is that complicated and unforgiving should something happen.

    My thoughts: I have had numerous surgeries and I felt that all surgeons were honest. Like probably most of us, I imagined that the #s did not apply to me. Hahahahaha. Famous last words. I remember after my first spine surgery, I was talking to Irina and said that I was glad "that I did not have to post on the revisions area". Again, famous last words. In my prior life, I spent a brief tour in Vietnam as a Navy nurse in late 1970. Like most soldiers, I did not believe that I would catch a bullet there. Surgery and soldiering are somewhat similar that way in that if you really thought seriously about the risks, you would never have surgery or go into battle/harm's way.

    As a Nurse Practitioner doing surgical/procedural counseling [or giving a patient possible risks with a biopsy procedure that I frequently did], few patients questioned the statistical risk number. I used to counsel patients for a surgical procedure that had a risk of 1/350 that the genetic results that they were given would be a false negative or cannot remember the # for a false positive. A rare patient understood the false neg/positive meaning which I explained in great detail. Some would ask, "How can there be a false positive or false negative?" I don't think that many really understood it.

    My advice to anyone having a major surgery: Something will go wrong or turn out differently than you planned on, so be ready for it. It could be fairly minor, but that's where an advocate is good. A friend's husband had major spine surgery and on my advice, she stayed with her husband the first night after surgery in the hospital. Well, ends up that nobody ordered pain meds post-op for Jim. After she realized it, the post-op unit nurse told her that the Neurosurgical Fellow was busy in the ER and that her husband needed to wait. My friend Ginger announced "There should be someone in this large university hospital somewhere who can order something now! Your answer to wait is unacceptable." The head nurse made some calls and got an order. Like I said, something generally goes wrong.

    I feel that I am the Poster Adult for what can go wrong with scoliosis surgery and many people's worst nightmare. In spite of all that has happened to me complication wise, I am still happy that I had the original surgery. I did every alternative therapy/treatment before accepting surgery. By the time I had surgery, I could only walk 1/2 block without sitting down from pain. I consulted with 2 very experienced deformity spine surgeons. When I asked one of them what my life would look like in 5 years without surgery, he commented "you will probably be in a wheelchair full time". I had surgery fully informed, the rest is history.

    Susan
    Very well said Susan.
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

  8. #23
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    Quote Originally Posted by titaniumed View Post
    Linda, You know, I pondered on using the word may.....(sigh) but 3D printing is the cats meow...The article explains below.

    Spine surgeons dealing with scoliosis are familiar with many of the inherent problems of these complex deformities encountered intra-operatively. Vertebral rotation, absent or dysmorphic pedicles and segmentation anomalies are all components of scoliotic spines and distort the anatomical landmarks for pedicle insertion. Current imaging modalities like CT scans or MRI have often been found to be inadequate. 3D printed anatomical models provide the ‘fourth’ dimension of tactile feedback to the surgeons which can help them anticipate the technical challenges that may be encountered intra-operatively. Almost as a testament to the popular adage – ‘the more you sweat in practice, the less you bleed in war’ - surgeons can practically carry out the entire surgical procedure and make a note of the technical challenges and the improvisations needed, before the actual surgery takes place.

    They also 3D print the drill jigs or screw guides See Figure 5

    Also, 3D print PEEK vertebral bodies after corpectomy,(that's vertebral removal) and custom spacers! (PEEK is a type of plastic used in spine surgeries)

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6128322/

    3D printed model of John Sarcoma's spine Dr Lenke example 1:35
    https://www.youtube.com/watch?v=gkfFMlPSIsI

    Hope this helps understand this technology

    Ed
    No doubt that 3D models are helpful, especially in really complex cases. However, I'm betting the vast majority of scoliosis surgeons don't have this technology easily available to them.
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

  9. #24
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    3D Printing technology video Barrow Phoenix

    Quote Originally Posted by LindaRacine View Post
    No doubt that 3D models are helpful, especially in really complex cases. However, I'm betting the vast majority of scoliosis surgeons don't have this technology easily available to them.
    Probably so..... Here is a video on 3D technology for scoliosis surgery.
    https://www.youtube.com/watch?v=toNXY8mHFdE

    Dr Juan Uribe
    https://www.barrowneuro.org/get-to-k...juan-uribe-md/

    Did you ever meet Dr Uribe? He is SRS

    They can model, and pre plan.... The jigs are designed and hole placements are exact with the spine "before straightening". I would imagine that they can tell you your exact Cobb angles before the operation is done.

    Before and after x-rays at 1:40..... Her curve looks like around an 80 degree which was corrected to 13 degrees.

    Ed
    49 yr old male, now 61, the new 61...
    Pre surgery curves 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

  10. #25
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    Yacolt, WA
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    I am having a R shoulder replacement and my surgeon will use a 3D image from my CT scan. I will ask her if I can see it during my preop visit.
    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 2 surgeries
    2014: Hernia @ ALIF repaired; Emergency screw removal Spinal Cord Injury 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
    2018: Removal L4,5 screw

  11. #26
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    Quote Originally Posted by susancook View Post
    I am having a R shoulder replacement and my surgeon will use a 3D image from my CT scan. I will ask her if I can see it during my preop visit.
    Susan
    Susan...

    There are 3D images:
    https://www.alamy.com/stock-photo-ar...-21202567.html

    And, there are 3D printed reconstructions:
    https://3dprintingindustry.com/news/67751-67751/
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

  12. #27
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    Location
    illinois
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    The images from the 3d are really unique. I know they are helpful to the surgeon. I've seen mine.
    The non nea!ing wound on my back, healed in 2 weeks after the piece of rod and 3 screws were removed. I guess we found the cause!
    T10-pelvis fusion 12/08
    Fractured t-9 six days out of surgery
    C5,6,7 fusion 9/10
    PJK at t-9
    T2--T10 fusion 2/11
    Removal of left side t6-t10. 8/14
    C 4-5 fusion 11/14
    Right scapulectomy 6/15
    Right pectoralis major muscle transfer to scapula
    To replace the action of Serratus Anterior muscle 3/16

  13. #28
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    Quote Originally Posted by jackieg412 View Post
    The images from the 3d are really unique. I know they are helpful to the surgeon. I've seen mine.
    The non nea!ing wound on my back, healed in 2 weeks after the piece of rod and 3 screws were removed. I guess we found the cause!
    Great to see some healing finally!
    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 2 surgeries
    2014: Hernia @ ALIF repaired; Emergency screw removal Spinal Cord Injury 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
    2018: Removal L4,5 screw

  14. #29
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    reno,nevada
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    This is good news Jackie....Are you still on antibiotics? What are you taking and for how long?

    Too bad there wasn't some way of determining infection with some sort of instant test or device. Like a digital thermometer only for infection. Someone needs to invent this device! We have all sorts of new medical technology these days, this is on the wish list. It needs to tell us to start antibiotic's right away. Like a fire alarm. (smiley face)

    Susan, On the 3D scan, have them burn you a disc, it would be interesting to see. Ask if they 3D "printed" your shoulder.

    They can 3D print just about anything these days. They even print hearts!
    https://www.youtube.com/watch?v=6MEz4SE-SU8

    Medical technology is getting better these days....Technology is advancing!

    Ed
    49 yr old male, now 61, the new 61...
    Pre surgery curves 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. #30
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    Location
    illinois
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    Susan have you seen your images yet? They are unique for sure. Let us know when you are having your surgery. Hopefully all goes well.
    An interesting thing about this wound is the only thing it ever tested was a moderate staph. I had 2 rounds of antibiotics but I'm not on any now.
    The wound healed quickly after the hardware was removed ( 3 screws and a piece of rod). It is around t 5 or 6 on the right side. I will find out for sure at my post op visit. This is also the area of muscle failure. It seems to be the answer for the wound.
    T10-pelvis fusion 12/08
    Fractured t-9 six days out of surgery
    C5,6,7 fusion 9/10
    PJK at t-9
    T2--T10 fusion 2/11
    Removal of left side t6-t10. 8/14
    C 4-5 fusion 11/14
    Right scapulectomy 6/15
    Right pectoralis major muscle transfer to scapula
    To replace the action of Serratus Anterior muscle 3/16

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