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Thread: 20 months - increasing flexibility of the spine, moving into bracing

  1. #1
    Join Date
    Jun 2007
    Posts
    16

    20 months - increasing flexibility of the spine, moving into bracing

    It seems that every facility, every doctor has a brace they prefer.

    My son is 20 months. We've done early intervention serial casting for the past 8 months and were informed that his spine is becoming too rigid and correction isn't being achieved.

    He is in his fifth cast and I'm wondering if there is anything we can do to increase his flexibility while in a cast. If this cast doesn't get us any correction, we will move into a brace. His doctor recommended using a local orthotist for a Providence, and I called Shriner's and spoke with them at length about it. They said Providence doesn't work because there is no spine load and for a baby, you really need all-day bracing. I believe they recommended the milwaukee? I can't remember now.

    I'd really appreciate any input on the type of brace and where we go from here. We are basically at a crossroad where can choose the physician based on the brace they recommend. Apparently, everyone has their own favorite, but Jack's curve is still in the 30s and I just know he's going to rebound.
    Action Jackson - no brace is going to slow me down!
    Diagnosed with a 70 degree thoracic curve 6/6/07
    MRI on 6/14/07 - comes back clean on 6/15/07
    Brace arrived on 6/20/07
    1st Cast applied by Dr. Mehta 8/1/07 at 70
    Yielded no results, back up to 70 out of cast.
    2nd Cast improved down to 40s, 3rd got us into the 30s, as did cast #4.
    At 20 months, in cast 5, correction isn't being achieved.

  2. #2
    Join Date
    Nov 2007
    Location
    Houston, TX
    Posts
    1,757
    I'm sorry I can't answer your questions, but I just had to say O.M.G.(!!) ... that baby is TOOOOOO cute!

    ( ... and he looks like he's hatching a plan - LOL ... )

    Best regards,
    Pam
    Fusion is NOT the end of the world.
    AIDS Walk Houston 2008 5K @ 33 days post op!


    41, dx'd JIS & Boston braced @ 10
    Pre-op 53, Post-op < 20
    Fused 2/5/08, T4-L1 ... Darrell S. Hanson, Houston


    VIEW MY X-RAYS
    EMAIL ME

  3. #3
    Join Date
    Dec 2007
    Location
    minnesota
    Posts
    100
    HE's so cute! All i can say is that it's sad to see that even toddler's must go through the bracing. I don't think you have many options, you can continue bracing, or maybe try the vertebral stapling? (sp) I believe theres a thread if you search, it may seem scary but it's much better than getting a full blown fusion Either way I wish you luck in the continuation of the curves staying the same!
    Danielle
    Danielle
    14 Freshwoman
    December 1st got no head the boston brace
    Pre Brace Curves:18C 25T 30L
    In brace curves: (1/23/08) 16C 20T 22L
    In brace Curves: (5/21/08) 19C 19T 15L
    We're Bringing CURVY BACK

  4. #4
    Join Date
    Oct 2003
    Location
    Utah
    Posts
    1,010
    I'm glad Jack is doing as well as he is. He has had a great correction from where he started. Rigid spines do not have an easy solution. Hopefully the ortho you choose has excellent experience successfully treating toddlers like Jack. I do know that some kids who have been braced (and/or casted) tend to have underdeveloped ribs when they are older. This is because for the ribs to grow and develop, they need the constant motion of breathing. Restriction of the ribcage can sometimes prevent optimal rib growth/development. The only reason I mention this is because if he were to ever need surgical intervention (ie, VEPTR) its best done with healthy, strong ribs. Kids with weak/underdeveloped ribs tend to have more migration problems with the rod placement, etc. Not trying to downplay Jack's experiences, just maybe offering information that may not have been discussed yet. I'm very happy to see how well he's doing. He is adorable - the look of mischievousness says it all.
    Carmell
    mom to Kara, idiopathic scoliosis, Blake 19, GERD and Braydon 14, VACTERL, GERD, DGE, VEPTR #137, thoracic insufficiency, rib anomalies, congenital scoliosis, missing coccyx, fatty filum/TC, anal stenosis, horseshoe kidney, dbl ureter in left kidney, ureterocele, kidney reflux, neurogenic bladder, bilateral hip dysplasia, right leg/foot dyplasia, tibial torsion, clubfoot with 8 toes, pes cavus, single umblilical artery, etc. http://carmellb-ivil.tripod.com/myfamily/

  5. #5
    Join Date
    Nov 2005
    Posts
    404
    Hi,

    Following on from Carmell's excellent post above, I thought I'd mention that the Milwaukee brace does allow the ribcage to expand. It's a more noticeable brace than TLSOs or bodycasts but it might well be a good option for now.

    I had infantile scoliosis too, and wore bodycasts and Milwaukees throughout my childhood until I had my thoracic spine fused aged 10. My thoracic curve (just under 70 degrees) was really stiff too and couldn't be corrected in braces or casts, but they did prevent it from getting much worse and allowed me to grow to a decent height before I had my first fusion (which was T1-T12). These days there are so many more options and had I been a child today, I would be having growth rods instead BTW I met Miss Mehta every now and then as she was based at my hospital and worked with my own surgeon - that lady is a heroine.

    Milwaukees aren't as bad as they look, and if you grow up wearing them from toddlerhood they are a lot easier to tolerate than if you're suddenly faced with wearing one as an older child. Hugs to Jack and good luck with whatever treatment you decide upon!

  6. #6
    Join Date
    Jun 2007
    Posts
    16
    That's why this method of casting - with the rib cage exposed - is so important, I believe. It does allow for so much more room.

    And, his was not always rigid - it was more flexible on diagnosis - it's just that as he's getting older, we're told it's more rigid.

    tonibunny - that is awesome. We had the distinct honor of having Miss Mehta diagnose and apply the first cast for Jackson.

    I think at this point we are really leaning toward his doc's recommendation of Providence because it does allow some out of brace time, which I DO think is important to avoid muscle atrophy and deterioration of the ribcage - definitely a huge consideration. Now, we just need to leap across the hurdle of finding someone reliable to do it, then a doctor who will follow his progress (or hopefully NON-progress, is more apt).
    Action Jackson - no brace is going to slow me down!
    Diagnosed with a 70 degree thoracic curve 6/6/07
    MRI on 6/14/07 - comes back clean on 6/15/07
    Brace arrived on 6/20/07
    1st Cast applied by Dr. Mehta 8/1/07 at 70
    Yielded no results, back up to 70 out of cast.
    2nd Cast improved down to 40s, 3rd got us into the 30s, as did cast #4.
    At 20 months, in cast 5, correction isn't being achieved.

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