ciropractic

[LindaRacine]

Paige...

A Boston brace is a type (the most common type) of TLSO. (It's like the difference between a Kleenix and a tissue.)

Regards,
Linda

[scoliosiscutie]

ooooo ok thanks well i dont know if mine is a boston they really didnt say all they said was TLSO! so thanks. im going to check out what mine is? it is just platered white and the velcrow is in the front? my other friend had kyposis and she got her brace off today!!!

[LindaRacine]

Hi...

You can see pictures of the brace here:

http://www.bostonbrace.com/

--Linda

[scoliosiscutie]

Thank you sooooooo MUCH!!!!

[scoliosiscutie]

wow. Thanks for your info. I don't know if my scoli has gotten worse. My chiro said that he thought it was but I can see my body acctually curve and that was the 1st time I had noticed it? My chiro is kinda weird. He thinks that he can help anything. He even thinks that he can get people off ADHD medicine? So I'm kinda like I don't believe him so yea. Do you have any other sugjestions?

[LindaRacine]

I know there are success stories prompting others how wonderful it is to have gotten surgery...think about all the people who had surgery and are not speaking out..they outnumber greatly the ones who are happy with the outcome...

Don't know where you got your information, but it's absolutely incorrect. You can find links to scoliosis surgery outcome abstracts here:

http://www.scoliosislinks.com/SurgeryResearch.htm

These studies show that at long term follow-up, the vast majority of patients are happy with their surgical outcome. If you can find a study that has a significant number of patients, and shows that the the people with bad outcomes outnumber those with good outcomes, I'm anxious to hear about it.

I never encourage people to have surgery unless they feel they truly need it, but statements like the above are meant as scare tactics, and should not be tolerated in public forums.

--Linda

[Karen Ocker]

Chiro:We've all heard this before.

Originally Posted by sportsdoc:

Having said that, there are specific technics geared towards spinal curvature correction and one should find a chiropractor doing these specific techniques... Pettibon and CBP...these techniques incorporate stertching, spinal manipulation and exercises

...

I haven't seen a single published study with permanent long term results with Pettibon in large groups of patients. In case I missed it, if their techniques or so revolutionary, why haven't other practitioners replicated the studies around the world demonstrating similar results--like the rest of the scientific community?

BTW, there are specific cases where curvatures were corrected...but in all cases, patients are told that the major goal is to arrest the curvature...attempts at correcting the curvature could be made but cannot be guaranteed...sometimes, these corrections are temporary and some are permanent..there's just no way to predict the outcome...I'd avoid anyone who's too optimistic.

.

We all here know the dangers/risks of surgery. What you have just described sounds like an expensive exercise in futility.

with curves 30-50 degrees...10 degrees is about the best one could hope for if at possible...we'll be just happy with avoiding the surgery though..with less than 20 degrees..i've seen cases where it's gone down below 10 or even near straight....the outcome is dependent on patients' age and degree of progression

...

This sounds awfully ambiguous.

As far as surgical options go.. if organ functions are being effected, i'd think it's a must..however, for merely cosmetic reason, one really needs to think about consequences...first...the correction gained by surgery isn't permanent either...in many cases, curves can still progress...

With the old form of surgery 40+years ago without hardware(Like in my case) that indeed did happen--but with the curve I had in 1956 I would not have reached a healthy adulthood without that procedure. However, with the new er hardware and techniques minimal settling occurs. I had a 50% correction 3 years ago at age 60(40 degree improvement). At my recent check-up I lost NO correction. We've heard this scare tactic before.

and second, when you do a fusion on spine...there are some issues that we see from disc herniation patients...often, scars tissues creat problems all on it's own...then there's the instability created on other neighboring segments due to loss of motion on fused segment...the likelyhood of need another surgery due to original fusion increases 12%/yr if I remember correctly and in a lot of cases patients have another surgery 5-6 years out...then another one, then another and so on...you can't expect to live your life doing a surgery all your life...for this reason, age of patient is a big consideration for fusion these days...

We all understand how the un-fused segments get more wear and tear; My original surgery lasted me 40+ years and I really had no pain until a couple of years before my revision.

I know coming from a person who's not afflicted with the condition saying this could sound harsh..but if the teen is having trouble coping with the curvatures, it's really a lifestyle issue..proper councelling should be sought rather than opting for surgery...of course surgery could arise as an option through councelling...

I hate to sound harsh myself. This is pure nonsense. No parent in their right mind rushes a child into surgery. Mild curves don't even show.

I know there are success stories prompting others how wonderful it is to have gotten surgery...think about all the people who had surgery and are not speaking out..they outnumber greatly the ones who are happy with the outcome...one should exhaust all conservative options before considering surgery unless it becomes major

health issue...

Why wait for it to become a major health issue?-- and then go into surgery deconditioned and more deformed. It's like waiting for an early cancer to become "a major" health issue" before opting for surgery.


Yes, surgery IS drastic; we all now that but it is the only thing we have-- besides early bracing in adolescents- that arrests/corrects curves with any degree of permanence.

Your whole post smacks of scare tactics and fear mongering --with no constructive alternative offered.

[gerbo]

sometimes a bit of courtesy towards "guests" rather than going for the jugular straight away, wouldn't be a bad thing.

One can be "critical" without being aggressive, I would have thought

[LindaRacine]

if someone came to me with a study that shows majority of scoliosis surgical candidate with your kind of sucess, now that would be impressive and I will not have an y reserver in referring my future patients to surgeons...

Here are just a few such studies:

Spine. 2003 Sep 15;28(18):E373-83. Related Articles, Links

Back pain and function 23 years after fusion for adolescent idiopathic scoliosis: a case-control study-part II.

Danielsson AJ, Nachemson AL.

Department of Orthopaedics, Sahlgrenska University Hospital, Goteborg University, Sweden. danielsson.aina@telia.com

STUDY DESIGN: A consecutive series of patients with adolescent idiopathic scoliosis, treated between 1968 and 1977 before age 21 years with distraction and fusion using Harrington rods (surgically treated: n = 156; 145 females and 11 males) were followed-up at least 20 years after completion of the treatment. OBJECTIVES: To determine the long-term outcome in terms of back pain and function in patients surgically treated for adolescent idiopathic scoliosis. SUMMARY OF BACKGROUND DATA: Few reports on long-term outcome of back pain and function have previously been presented for this group of patients. Results presented are not conclusive regarding effects on back pain and its correlation to a fusion extending into the lower lumbar spine. MATERIALS AND METHODS: One hundred forty-two (91%) of the patients were reexamined as part of an unbiased personal follow-up. This included a clinical examination and evaluation of curve size (Cobb method) and degenerative findings in full standing frontal and lateral radiographs. Validated questionnaires in terms of general and disease-specific quality of life aspects as well as present back and pain symptoms were used. One hundred thirty-nine had complete follow-up. An age- and sex-matched control group of 100 individuals was randomly selected and subjected to the same examinations. RESULTS: The deterioration of the curves was 3.5 degrees for all curves and eight (5.1%) of the patients treated with fusion had undergone some additional curve-related surgical procedure. The patients had significantly more degenerative disc changes than the controls. Lumbar pain, although mild (2.4 on visual analogue scale), was significantly more frequent among the patients than the controls (65 vs. 47%, P = 0.0079). Only 25% of the patients admitted daily pain, and analgesics were sparsely used. No major differences of back function and general health-related quality of life were noted between the patients or the controls. Except for having been on sick-leave ever because of the back (45% vs. 19%, P = 0.0040) no differences could be seen in sociodemographic variables between the groups. Furthermore, no differences could be found between patients fused to L3 or higher (n = 102) versus L4 or lower (n = 37). No correlation could be found between pain and its localization and various variables on the scoliotic curve, body mass index, or smoking. Persisting discomfort and/or sensory loss were noted significantly more often among the patients who had the autologous bone harvesting performed through a separate incision over the iliac crest (24.3%) than among those in whom this was performed through an elongated midline incision (4.6%, P = 0.0015). CONCLUSIONS: Minimal pain and no dysfunction occurred (mean) 23 years after fusion for adolescent idiopathic scoliosis compared with normal straight controls. Significantly more pain in the scar region occurred when bone graft from an incision over the posterior iliac crest was used for harvesting bone to the fusion compared with an incision performed as an elongation of the midline incision used for the scoliosis surgery.

Spine. 2003 Jun 1;28(11):1163-9; discussion 1169-70. Related Articles, Links

Functional and radiographic outcomes after surgery for adult scoliosis using third-generation instrumentation techniques.

Ali RM, Boachie-Adjei O, Rawlins BA.

Hospital for Special Surgery; New York, New York 10021, USA.

STUDY DESIGN: Retrospective radiograph and chart review of 28 patients with adult idiopathic scoliosis undergoing primary corrective surgery. Clinical and radiographic parameters were assessed before surgery, after surgery, and at a 2-year follow-up assessment. A self-perceived outcome questionnaire was administered to the study patients at a minimum 2-year follow-up assessment. OBJECTIVE: To assess patient outcomes after surgery for adult scoliosis using traditional radiographic parameters along with a self-perceived outcomes questionnaire. SUMMARY OF BACKGROUND DATA: The clinical and radiographic results and the outcomes for the surgical treatment of adult idiopathic scoliosis have not been established in the literature with respect to the use of modern third-generation instrumentation techniques. Most studies reviewing the surgical treatment of adult idiopathic scoliosis look primarily at Harrington instrumentation techniques. METHODS: Records and radiographs were reviewed retrospectively for all the patients (n = 54) undergoing primary corrective surgery for adult idiopathic scoliosis between December 30, 1994 and December 30, 1997. Of the 54 patients reviewed, 28 (52%) met the following inclusion criteria: age exceeding 20 years, primary surgery, fusion above the sacrum, availability of medical records along with preoperative, postoperative, and 2-year follow-up radiographs. Additionally, a self-perceived outcomes questionnaire was administered to these patients at a minimum 2-year follow-up assessment. RESULTS: All the patients were women (28/28). The indications for surgery were pain and progression in 54% (15/28) and pain in 29% (8/28) of the patients. The average preoperative major curve measurement was 65 degrees (range, 38-98 degrees ). The average postoperative major curve measurement was 24 degrees (range, 5-59 degrees ), for a correction of 64%. The average follow-up curve measurement was 27 degrees (range, 3-60 degrees ), for a correction of 61%. Whereas 71% of the cases were anteroposterior, 29% were posterior only. There was one intraoperative complication among the 28 patients and four postoperative complications in 3 of the 28 patients. The self-perceived outcome questionnaires were available for 83% (23/28) of the patients. Definite or probable relief of symptoms was reported in 74%(17/23). Improved ability to sleep was reported in 61% (14/23), and ability to return to their usual job was reported in 57% (13/23). Satisfaction with the results of surgery was reported in 87% (20/23). CONCLUSIONS: Surgery for adult idiopathic scoliosis using third-generation instrumentation techniques provides significant clinical improvement, scoliosis correction, maintenance of sagittal alignment, and patient satisfaction, with an acceptable complication rate.

Spine. 2002 Sep 15;27(18):2046-51. Related Articles, Links

A multicenter study of the outcomes of the surgical treatment of adolescent idiopathic scoliosis using the Scoliosis Research Society (SRS) outcome instrument.

Merola AA, Haher TR, Brkaric M, Panagopoulos G, Mathur S, Kohani O, Lowe TG, Lenke LG, Wenger DR, Newton PO, Clements DH 3rd, Betz RR.

Department of Orthopedic Surgery, SUNY Downstate Medical Center, Brooklyn, New York, USA. Andrew.Merola@att.net

STUDY DESIGN: A multicenter study of the outcomes of the surgical treatment of adolescent idiopathic scoliosis using the Scoliosis Research Society Questionnaire (SRS 24). OBJECTIVE: To evaluate the patient based outcome of the surgical treatment of adolescent idiopathic scoliosis. SUMMARY OF BACKGROUND DATA: A paucity of information exists with respect to patient measures of outcome regarding the surgical treatment of adolescent idiopathic scoliosis. To our knowledge, no prospective outcome study on this topic thus far exists. METHODS: Using the SRS 24 questionnaire, seven scoliosis centers agreed to prospectively assess outcome for surgically treated patients with adolescent idiopathic scoliosis. Data were collected before surgery and at 24 months after surgery. Data were analyzed using paired and independent samples t test for all seven SRS 24 questionnaire domains (Pain, General Self-Image, Postoperative Self-Image, Postoperative Function, Function From Back Condition, General Level of Activity, and Satisfaction) using Statistical Package for Social Science. The domains were analyzed with respect to the total cohort, gender, curve magnitude, and type of surgery using independent-samples t tests. RESULTS: A total of 242 patients were included in our analysis. A baseline preoperative pain level of 3.68 of 5 was found. This improved to 4.63 after surgery, representing an improvement of 0.95 points. Surgical intervention was associated with improving outcome when compared with preoperative status. Pain, General Self-Image, Function From Back Condition, and Level of Activity all demonstrated statistically significant improvement as compared with preoperative status (P < 0. 001). Overall, patients were highly satisfied with the results of surgery. CONCLUSION: Preoperative pain exists in our adolescent scoliosis population. Pain scores were improved in our study population at the 2-year postsurgical follow-up. Statistically significant improvements were likewise seen in the General Self-Image, Function From Back Condition, and Level of Activity domains. The present study demonstrates the ability of surgery to improve the outcome of patients afflicted with adolescent idiopathic scoliosis.

[csbaby]

Chiropractic not worth the investment of time or money

I agree with your orthopedic surgeon. Chiropractors can not correct curvatures. I am with Linda - if they have documented, published proof, let's see it.

It does make them a very good living from our insurance companies though by assuring you they can help.

Your curve is increasing? What does your chiropractor have to say about it?

Your curvature is getting to the degree that it needs surgical intervention. If you are young enough - try to get into a Shriner's hospital for at least an evaluation.

Your parents are scared - mine were too when my scoli was discovered at 15. Back surgery is a scary thing, but there is light at the end of the tunnel and help and support comes from everywhere.

God bless you for making a stand.
Christy

[LindaRacine]

You stated that the people who were unhappy with their outcomes outnumber those that are happy. I've found studies to contradict that statement. Do you have studies to support it?

--Linda

[LindaRacine]

http://todayschiropractic.com/archiv...dept_tech.html

anyway, if you like studies..go to above article and there's plenty of references..

If that's a response to me, I'm confused, as it has nothing to do with outcome of surgical patients.

[nikyergen]

Oh my, Oh my. That is all I can say. Another disagreement. But, you all know how I feel, so I don't even need to get into this one. You all are doing the job for me this time. I'm just enjoying the reading material. Thanks for the entertainment. Glad we are beyond this and a few weeks from being one year post-op. I know surgery was our best option to choose and our daughter agrees with it. It was actually her decision, not ours. We just supported her decision.

[gerbo]

noticed that the post by "sportsdoc" has gone, but not the reactions to it. Where is it?

[LindaRacine]

Don't know. He either deleted it himself, or someone reported it to the NSF and it was taken down.

--Linda