Page 2 of 4 FirstFirst 1234 LastLast
Results 16 to 30 of 55

Thread: Disc Degeneration And Scolosis - Connected?

  1. #16
    Join Date
    Nov 2006
    Location
    North West England
    Posts
    4

    Smile Thanks For Reply

    hello

    Thanks for your reply.. it's nice to know i'm not alone

    Best Wishes
    x

  2. #17
    Join Date
    Mar 2006
    Posts
    14
    well nothing has changed in my situation only my wife has left as she was put off being with me by doctors saying they couldnt help with the pain. she couldnt deal with me being in pain all the time and said it brought her down. i miss my daughter terribly.

  3. #18
    Join Date
    Nov 2006
    Posts
    92
    Hi I just had surgery 3 months ago for several problems - one of which was disc degeneration below my original fusion.
    Sharon, I also had cauda-equina syndrome prior to this last surgery. What kind of symptoms are you having?
    Last edited by Cena75; 01-30-2007 at 05:02 PM.
    Cena
    Nov. 2006 - revision surgery
    Aug. 1992 - revision surgery for hook removal and pseudoarthrosis
    July 1989 - Cortrell Doubosett procedure - two rods and fusion T4-L4 (age 13)

  4. #19
    Join Date
    Jun 2005
    Posts
    105
    degenerative disc disease(DDD) is not linked to idiopathic scoliosis. I've researched on this subject, and I have yet to find one that pairs the two in connection with each other. But i have found countless of statements and research attributing DDD with spinal fusion in the segments below and above the fused vertebrae.

    DDD can happen to anyone regardless whether one has scoliosis or not. But having a scoliosis curve can wear and tear the vertebrae faster leading to DDD, but it seems spinal fusion can do just as bad if not worse.

    I'd like to know of any research or study as to whether having a large 50+ thoracic curve will wear the discs faster than if you had a thoracic curve spinal fusion up to L1 or L2 in the longrun. And if one does have DDD with a large idiopathic scoliotic curve, then will having disc replacement surgery or a laminectomy benefit him/her and prevent another onset of a deterioration, or would it be better idea to just fuse the spine instead?

    Opinions anyone?
    31 yr old male with non-progressive Idiopathic scoliosis

    15-37 degrees- upper thoracic ( w/ left shoulder trap higher, head tilted more to the right)
    45-52 degrees- mid thoracic (to the right, w/ rib hump)
    25-30 degrees- lumbosacral curve (to the left w/ lumbar hump, right pelvis is higher than left)

    currently doing schroth exercises and counter postural techniques("side shifting")
    using rib and lumbar support belts. still contemplative about surgery.

    >>My X-ray<<

  5. #20
    Join Date
    Jan 2008
    Location
    NC
    Posts
    9,196
    Hey. Once again, I think you have mastered the fact case. What you wrote is close to my understanding. Linda might know some of the answers to your questions.

    The only thing I will note is that, just reading testimonials, adults tend to have longer fusions than kids. That is just anecdote at this point unless Linda has data. But if that is generally true then it might mean compensatory curves are becoming structuralized in untreated large curves over time. In contrast, there is evidence that T fusions that end at T12 or L1 or so do stabilize the lumbar over at least two decades in false doubles and purported over a lifetime if the lumbar straightens and stays aligned as it did in my kid with that type of curve who now has no scoliosis anywhere in her back after her (T4-L1) fusion. She has a straight spine and I assume that is why the surgeon told her she is back in the general population for rate of back problems (meaning DDD in the unfused areas I assume which everyone gets if they live long enough). Of course we don't know that those lumbars would have become structuralized had these people not been fused. Again, I hope Linda knows something about this.

    Quote Originally Posted by Jinseeker View Post
    degenerative disc disease(DDD) is not linked to idiopathic scoliosis. I've researched on this subject, and I have yet to find one that pairs the two in connection with each other. But i have found countless of statements and research attributing DDD with spinal fusion in the segments below and above the fused vertebrae.

    DDD can happen to anyone regardless whether one has scoliosis or not. But having a scoliosis curve can wear and tear the vertebrae faster leading to DDD, but it seems spinal fusion can do just as bad if not worse.

    I'd like to know of any research or study as to whether having a large 50+ thoracic curve will wear the discs faster than if you had a thoracic curve spinal fusion up to L1 or L2 in the longrun. And if one does have DDD with a large idiopathic scoliotic curve, then will having disc replacement surgery or a laminectomy benefit him/her and prevent another onset of a deterioration, or would it be better idea to just fuse the spine instead?

    Opinions anyone?
    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."

  6. #21
    Join Date
    May 2009
    Posts
    3,745
    hi Jinseeker
    this is an old thread....

    as far as i know, as Linda Racine told me, a patient with a large
    scoliosis curve cannot just have disc replacement...
    i wanted to do that, but she said it makes the spine more unstable
    and cannot be done....one must have fusion at the same time of
    the discs being replaced...
    a surgeon in NYC offered to do mine with partial minimal incisions...
    the back would be fused with regular incision, but the discs would
    be done from side, with minimal incision....another surgeon in CA
    offered minimal incisions for both back and discs...
    but i have not had any surgery as yet.

    best of luck
    jess...and Sparky, the wonder puppy

  7. #22
    Join Date
    Jun 2005
    Posts
    105
    Quote Originally Posted by Pooka1 View Post
    Hey. Once again, I think you have mastered the fact case. What you wrote is close to my understanding. Linda might know some of the answers to your questions.

    The only thing I will note is that, just reading testimonials, adults tend to have longer fusions than kids. That is just anecdote at this point unless Linda has data. But if that is generally true then it might mean compensatory curves are becoming structuralized in untreated large curves over time. In contrast, there is evidence that T fusions that end at T12 or L1 or so do stabilize the lumbar over at least two decades in false doubles and purported over a lifetime if the lumbar straightens and stays aligned as it did in my kid with that type of curve who now has no scoliosis anywhere in her back after her (T4-L1) fusion. She has a straight spine and I assume that is why the surgeon told her she is back in the general population for rate of back problems (meaning DDD in the unfused areas I assume which everyone gets if they live long enough). Of course we don't know that those lumbars would have become structuralized had these people not been fused. Again, I hope Linda knows something about this.
    2 decades may not be enough reason for anyone to have spinal fusion immediately. It still seems like an accelerated progression of the wear and tear process on the discs. So in other words doesn't really add any real benefit to having no surgery at all even with a large curve on the deterioration of the discs. I have heard from multiple doctors that some people don't ever get DDD or any significant wear on their discs all the way to their 90s, and that osteoporosis are more linked to kyphosis not scoliosis. Just like any disease it is a natural selection.
    Last edited by Jinseeker; 01-24-2014 at 02:30 AM.
    31 yr old male with non-progressive Idiopathic scoliosis

    15-37 degrees- upper thoracic ( w/ left shoulder trap higher, head tilted more to the right)
    45-52 degrees- mid thoracic (to the right, w/ rib hump)
    25-30 degrees- lumbosacral curve (to the left w/ lumbar hump, right pelvis is higher than left)

    currently doing schroth exercises and counter postural techniques("side shifting")
    using rib and lumbar support belts. still contemplative about surgery.

    >>My X-ray<<

  8. #23
    Join Date
    Jan 2008
    Location
    NC
    Posts
    9,196
    Quote Originally Posted by Jinseeker View Post
    2 decades may not be enough reason for anyone to have spinal fusion immediately. It still seems like an accelerated progression of the wear and tear process on the discs. So in other words doesn't really add any real benefit to having no surgery at all even with a large curve on the deterioration of the discs. I have heard from multiple doctors that some people don't ever get DDD or any significant wear on their discs all the way to their 90s, and that osteoporosis are more linked to kyphosis not scoliosis. Just like any disease it is a natural selection.
    At least two decades for a false double (which you do not appear to have). The study was small but all the patients were doing well as I recall. These people, like my one daughter, have two large curves but only one is structural. My daughter's lumbar is now in the mid twenties, below the "magic" 30* mark for long term lack of progression. Had she not been fused, I could see that large lumbar becoming structuralized over time and her having disc problems and having further progression. But her T curve was larger than yours and her lumbar curve was larger (eyeballing your radiographs) while she was still growing so your case is very different... reaching 50* at some point and hanging there. my daughter's curve hit the high 50s* and she was still growing. Something had to be done. There is widespread agreement among surgeons about fusing large, progressive T curves in adolescents. There is not so much agreement for other curve types.

    You appear to have a curve like my other daughter who was hyper-corrected. Her lumbar now has NO CURVE. To the extent long term disc health is a function of alignment (and that her fusion ended at L1), that seems to be why the surgeon said she was back in the general population on risk of future back problems and it would be one-stop shopping for surgery for her for scoliosis.

    Based on our surgeon's comments and Boachie's comments, a fusion no lower than about L1 with lumbar alignment is expected to stabilize folks for life.
    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."

  9. #24
    Join Date
    Jan 2008
    Location
    NC
    Posts
    9,196
    Quote Originally Posted by Jinseeker View Post
    2 decades may not be enough reason for anyone to have spinal fusion immediately.
    You are not an emergency case by a long shot. You shouldn't do anything immediately in my opinion. :-)

    Your questions are great. You could ask a surgeon about long-term lumbar disc health at the angle it is now, if it progressed, and if it was corrected (or hyper-corrected). Since your T curve does not appear to be progressing, your are able to shift your focus to possible damage to the lumbar if the T curve is untreated. Those would be the bulk of my questions to a surgeon were it me.

    Good luck.
    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."

  10. #25
    Join Date
    Jun 2005
    Posts
    105
    My doubt is it would be unnecessary to ask a surgeon about what a large T curve would do to my lumbar spine as it is impossible to really tell. Just the fact that some large curves do not have pain while other small curves do proves my point that it is completely arbitrary and there is no link between disc degeneration and scoliosis whatsoever.

    What I'd like to know though is if you have any references or documented proof of spinal fusions that fall above L1 disc can stabilize the spine for life. I have yet to find any articles or documented research supporting this. In fact most research i have found tend to lean on the documented evidence that discs do wear out below or above the fusion over time.

    Most surgeons cite the reason for not fusing below L1 is to preserve some flexibility for the patient, they don't claim anything else otherwise.
    Last edited by Jinseeker; 01-24-2014 at 07:32 AM.
    31 yr old male with non-progressive Idiopathic scoliosis

    15-37 degrees- upper thoracic ( w/ left shoulder trap higher, head tilted more to the right)
    45-52 degrees- mid thoracic (to the right, w/ rib hump)
    25-30 degrees- lumbosacral curve (to the left w/ lumbar hump, right pelvis is higher than left)

    currently doing schroth exercises and counter postural techniques("side shifting")
    using rib and lumbar support belts. still contemplative about surgery.

    >>My X-ray<<

  11. #26
    Join Date
    Jan 2008
    Location
    NC
    Posts
    9,196
    Quote Originally Posted by Jinseeker View Post
    My doubt is it would be unnecessary to ask a surgeon about what a large T curve would do to my lumbar spine as it is impossible to really tell. Just the fact that some large curves do not have pain while other small curves do proves my point that it is completely arbitrary and there is no link between disc degeneration and scoliosis whatsoever.

    What I'd like to know though is if you have any references or documented proof of spinal fusions that fall above L1 disc can stabilize the spine for life. I have yet to find any articles or documented research supporting this. In fact most research i have found tend to lean on the documented evidence that discs do wear out below or above the fusion over time.

    Most surgeons cite the reason for not fusing below L1 is to preserve some flexibility for the patient, they don't claim anything else otherwise.
    Fusing to L1 is done when the structural curve ends there to my knowledge. On bending, my kids were able to level L1 so that's where their fusion stopped. That's my understanding. Had they not been able to level L1 then it would have gone lower. That's my understanding. Stopping at L1 is not arbitrarily done to preserve flexibility because not fusing all of the structural curve will create problems later. The exception seems to be kids who have L curves who seem to have their fusions stopped at L3 or so arbitrarily to preserve some flexibility because surgeons seem loath to fuse kids to pelvis. I don't know the long term on that. You have a T curve, not an L curve.

    Here is evidence from a top surgeon that your lumbar can be stabilized for life given the conditions specified... it comports with what our surgeon told us...

    http://www.hss.edu/professional-cond...l-stenosis.asp

    If you fuse a 13-year-old to L4, 20 to 25 years later, at the most, he or she is going to have problems at L4-5 and L5-S1 levels. So I tell them to take it easy a little bit, and avoid excessive high impact, rotational sports and activities, no other things that will cause early degeneration. But if you fuse them to L1 or T12, they can do very well for the rest of their lives, provided the remaining lumbar spine is properly aligned and has not shifted.
    So I am assuming this applies MORESO to an adult who has less years remaining than an adolescent but there may be other issues I don't know about. There probably are.
    Last edited by Pooka1; 01-24-2014 at 10:32 AM.
    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."

  12. #27
    Join Date
    Jun 2006
    Location
    Euharlee, Georgia
    Posts
    449
    I know what you are going through. I have ddd also. My doctors have told me it is because of the wear and tear on the discs due to being fused. We have less usable discs it our back so they wear out quickly. I have RF ablations to control my pain.
    T12- L5 fusion 1975 - Rochester, NY
    2002 removal of bottom of rod and extra fusion
    3/1/11 C5-C6 disc replacement
    Daughter - T7 - L3 fusion 2004

  13. #28
    Join Date
    Jan 2008
    Location
    NC
    Posts
    9,196
    Quote Originally Posted by rainbow2010 View Post
    I know what you are going through. I have ddd also. My doctors have told me it is because of the wear and tear on the discs due to being fused. We have less usable discs it our back so they wear out quickly. I have RF ablations to control my pain.
    Jinseeker, Rainbow2010 has an L fusion, not a T fusion. Disc degeneration associated with the fusion is expected in the L5-S1 disc and perhaps above the lumbar. Compare and contrast that with Boachie's comments about T fusions ending at or above L1. Apples and oranges.
    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."

  14. #29
    Join Date
    Mar 2010
    Posts
    2,755
    Sharon (Pooka1), I know YOUR doctor said "one stop shopping". I can't say that I agree with this because of what I see in my DIL. At age 23 she is having lumbar pain. She has a T fusion. The problem here, as I see it, is that the cushion that is provided with the thoracic discs is no longer there. This seems very logical because there is more stress on the lumbar discs because they have to take the shock absorbance for the WHOLE spine. So even if there isn't much movement in the T-spine, those discs DO absorb the every day impact of normal movement like walking. So I can see that the lumbar discs WOULD indeed tend to wear out faster with fusion than the "normal" population. With that said, an unfused progressive T-curve WILL eventually cause a lumbar curve. This would also wear out the lumbar discs at an accelerated rate. It's a lose lose. Perhaps, as in the situation of your daughters, the T-fusion would definitely SLOW the progression of DDD in the lumbar spine by way of properly aligning the lumbar spine, therefore REDUCING wear and tear on the lumbar. Either way, though, I can't see this fitting into the rate of spinal degeneration as the general population.

    If you look at MY x-rays, my lumbar looks great and straight. However, it's not as great and straight as it looks. I have some twisting in the lumbar and my pelvis isn't perfectly straight. I have very painful DDD in the lowest disc (L5/S1) along with SI joint dysfunction. Is this caused by my scoliosis? In my opinion it likely is at least aggravated by the scoliosis. But BECAUSE of my scoliosis I feel uncomfortable with having a disc replacement or fusion there for fear of destabilizing the rest of my spine. On the other hand, my dad had some significant DDD in his lumbar for which he had to wear a support belt and he had no scoliosis at all. So my DDD could be totally unrelated to my scoliosis. As the scoliosis is creeping into the lumbar region as I get older, I expect more DDD issues to crop up a little sooner than most people. I've been having significant lower back pain since my late 20's. That's NOT normal.
    Be happy!
    We don't know what tomorrow brings,
    but we are alive today!

  15. #30
    Join Date
    Jan 2008
    Location
    NC
    Posts
    9,196
    Quote Originally Posted by rohrer01 View Post
    Sharon (Pooka1), I know YOUR doctor said "one stop shopping". I can't say that I agree with this because of what I see in my DIL. At age 23 she is having lumbar pain. She has a T fusion.
    Where does her structural curve end? My daughter's ended at L1.

    Where does her fusion end? My daughter's ended at L1.

    My one daughter fits into the situation Boachie is addressing which agrees with what our surgeon said.
    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."

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •