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Thread: "Over-corrected" in Surgery?

  1. #1
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    Jan 2008
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    Question "Over-corrected" in Surgery?

    I am about 7 weeks post 1st time surgery (Dr Vaccaro, Rothman Institute in Phila) and so far recovery is going very well. HOWEVER, now one leg is almost an inch 'shorter' than the other. Vaccaro said he 'over-corrected' (his words!); before surgery right hip and shoulder was high, now right hip and shoulder are lower. In other words, with feet flat on the ground I tilt to the right! Nice straight back, no hump, 2 inches taller, no pain when walking, but now I have to have a lift on my right shoe!

    My curve was huge (double-curve 60/80 degress, with kyphosis) and very painful. It was progressing quickly after menopause, and I am SOOO grateful to be free of that back pain. At first this seemed like a minor issue compared to what I was suffering before, but I am starting to wonder...
    Has anyone else had this happen? Should I watch out for complications with this assymetry?

    I'm still wearing a brace, and taking it easy. But as I feel stronger and better I'm walking more and the imbalance becomes more noticeable. I live in Florida and traveled to Philly after trying for a year to get it done locally. So going back to Vaccaro is not an easy thing. Anyway, I don't really feel 'wronged'... Doc said it was one the most complex scoli surgeries he'd ever done. And I sure don't want to go back and do it over! I will start physical therapy once brace comes off in a month and expect to address this problem with therapists.

    I would appreciate hearing feedback, or if you've had any other post-surgery issues like this.
    Mild scoliosis diagnosed at 12, wore brace for a year then ignored till after menopause when it started to progress. Lost 5 inches in height. Pre-surgery double curve measured @60/80 degrees. Surgery May 14 & 15, 2008 in Philly, Rothman Inst; Instrumentation & spine fused T1 to L4 with screws into hips. Wore brace for 3 months. Good recovery; totally off pain meds after one year. Now 3 inches taller with no hump, but I lean to side in thoracic & wear 3/4 in. lift on right shoe. No regrets!

  2. #2
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    Jun 2008
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    I am new to this forum and you are the first person who I have seen who went to dr. vaccaro and he is who I am contemplating having surgery with. he told me my scoli was complicated but i would be crazy if i came out with one leg shorter. i have had 2 hip replacements and they were perfect so that would make me mental. what did you think of him beside the uneven leg?
    avis

  3. #3
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    Based on my surgery, I think you are in good hands with Vaccaro.
    I didn't have any experience with surgeons before this. I went thru hell trying to find and pick one. I went to Rothman / Jefferson because my brother had two spine surgeries with Vaccaro (not for scoliosis) and he highly reccomended him. After getting the run-around from several FL surgeons (and their office staffs) I decided to travel to Philly for the operations & recovery. I've had no issues with infections, nerve pain, my sutures healed beautifully and quickly (much prasied by all nurses and docs who saw me) I'm standing straight, (at least front to back!) and less than 2 months out I'm doing really well. To my thinking, I have to credit Vaccaro. You have to be quick and prepared when you see him, he's fast!... but I like him. He seems intensely interested in what he does and in your spine, and he has a very good support staff.
    Yes, I have this uneven leg thing now, and I'm still trying to assess the impact of that. I don't know how much it's a result of the severity of my deformity (a sharp S-curve). For now it seems a minor inconvenience. Friends are amazed at how much straighter and younger I look now.
    At some point we have to trust the surgeon, even tho the decision is scary. Just by being on this forum you're doing your homework. Good luck with your surgery!
    Mild scoliosis diagnosed at 12, wore brace for a year then ignored till after menopause when it started to progress. Lost 5 inches in height. Pre-surgery double curve measured @60/80 degrees. Surgery May 14 & 15, 2008 in Philly, Rothman Inst; Instrumentation & spine fused T1 to L4 with screws into hips. Wore brace for 3 months. Good recovery; totally off pain meds after one year. Now 3 inches taller with no hump, but I lean to side in thoracic & wear 3/4 in. lift on right shoe. No regrets!

  4. #4
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    Jun 2008
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    Does he plan to do anything to correct it or will it "self-correct?" I would be afraid that down the road it would cause hip or knee or even back problems? You are right about him being fast. He was unbelievable when I saw him and I really liked him as well. He told me I had a 57 degree curve and my scoli xray series says it is 45 degrees. Somehow I believe him. Good luck in your continued recovery.
    avis

  5. #5
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    yeah, that's my concern... that the imbalance will cause problems with neck/back/ whatever! I'm hoping physical therapy in a month or so will help and give me some guidance. I also will see a specialist for shoe lift and advice.
    I would not want to go back to surgery to correct it and sure hope it doesn't lead to that. The difference in height is less than an inch... so it amazes me how much difference that little bit makes.
    Mild scoliosis diagnosed at 12, wore brace for a year then ignored till after menopause when it started to progress. Lost 5 inches in height. Pre-surgery double curve measured @60/80 degrees. Surgery May 14 & 15, 2008 in Philly, Rothman Inst; Instrumentation & spine fused T1 to L4 with screws into hips. Wore brace for 3 months. Good recovery; totally off pain meds after one year. Now 3 inches taller with no hump, but I lean to side in thoracic & wear 3/4 in. lift on right shoe. No regrets!

  6. #6
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    NJ
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    Sometimes the correction/spine "settle" with a slight loss of correction during the healing period. If your spine is so much straighter and your leg is indeed really shorter by measurement than it is not the fault of the spine surgery.

    I felt really bizarre during the healing period. I felt really tilted, twisted and unbalanced until my body got used to the rearrangement. I compared it to an amputee who felt the extremity was still there after it was removed. I call it "phantom back".

    According to a colleague of mine who has seen Dr. Vaccaro's work in the OR, she would highly recommend him any time.
    Last edited by Karen Ocker; 07-06-2008 at 03:31 PM.
    Original scoliosis surgery 1956 T-4 to L-2 ~100 degree thoracic (triple)curves at age 14. NO hardware-lost correction.
    Anterior/posterior revision T-4 to Sacrum in 2002, age 60, by Dr. Boachie-Adjei @Hospital for Special Surgery, NY = 50% correction

  7. #7
    Join Date
    Jan 2007
    Location
    Canada
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    101
    I titled to the right by 15 degrees after my first surgery. At first I thought possibly one leg was shorter than the other but the problem was the angle at L4. It was so stiff my surgeon couldn't straighten it during the first surgery. I thought over time it might correct itself but it didn't. I started to have pain in my left hip and right shoulder from walking crooked. 6 months later I had an osteotomy just above L4 and now I am as straight as can be. No more pain when walking! I don't think I could have lived with it the way it was and I am glad I went back in.
    Good luck.
    CarolS
    68 degree right lumbar scoliosis, mild kyphosis at L1-2
    Anterior/Posterior Correction, T8 to Sacrum, Sept 20th, 2007
    Osteotomy March 20,2008
    Thrilled with results!

  8. #8
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    Jan 2008
    Location
    St Pete Florida
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    Update to 'over-correction' issue:
    I just saw an orthotics specialist, who said my hips were basically even and level, and legs the same length. My 'leaning to the right' sensation is coming just from the throracic. We discussed how wearing a lift in my shoe might create MORE problems! It's very complex...
    So now I'm trying NO shoe lift, seeing if my body and senses will adjust, and I'll gradually get rid of this feeling of leaning to the right. I can see in a mirror that my upper body is canted to the right. When I walk I feel a little like a peg-leg sailor, which I can't explain if my lower body is basically symetrical.

    I have not yet seen a physical therapist about this (still wearing brace), though early on they had noticed it and thought a shoe lift might help. I can't imagine with all the instrumentation in there that anything could move, but maybe my body has to learn a new way of holding itself. Would appreciate hearing from others who have had similar post-surgery 'settling' issues. Thanks!
    Mild scoliosis diagnosed at 12, wore brace for a year then ignored till after menopause when it started to progress. Lost 5 inches in height. Pre-surgery double curve measured @60/80 degrees. Surgery May 14 & 15, 2008 in Philly, Rothman Inst; Instrumentation & spine fused T1 to L4 with screws into hips. Wore brace for 3 months. Good recovery; totally off pain meds after one year. Now 3 inches taller with no hump, but I lean to side in thoracic & wear 3/4 in. lift on right shoe. No regrets!

  9. #9
    Join Date
    Jan 2008
    Location
    Utah
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    I am almost three months post surgery, looking a wee bit crooked, leaning to the right. My P.T. is helping me adjust to my new back by correcting my posture. I also thought I was somewhat overcorrected. However, the clinical coordinator for Dr. Boachie said that MANY patients think one leg becomes shorter or they weren't properly corrected. It take several months for your posture improve that condition.
    65* curve at age 55
    T4 - L3 Fusions on May 20, 2008 by Dr. Boachie, NYC
    Curve corrected to 26*
    Blog specifically about my recovery =
    http://gingerinrecovery.blogspot.com

  10. #10
    Join Date
    Oct 2007
    Location
    Indiana
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    That is something I worked on with my physical therapist when I first went at about 6 months post-op... I was tilted just a little. He suggested I look in the mirror (he actually said after my shower, before I got dressed -- so my clothes weren't hiding anything) so I could feel what was straight--hips, back, and if my shoulders looked even or not. We are so used to being a little out of whack and compensating for our curves (or with some, a lot out of whack) and our muscles want to continue to do what they've been doing. When I first straightened using the mirror to go by, it felt wrong or off from what seemed straight to me. Don't expect it to fix itself on its own-- it won't always happen. You need to work at it a little too.
    66 and still heartbroken...
    2007 52 w/ severe lumbar stenosis & L2L3 lateral listhesis (side shift)
    5/4/07 posterior spinal fusion T2-L4 w/ laminectomies and osteotomies @L2L3, L3L4
    Dr. Kim Hammerberg, Rush Univ. Medical Center in Chicago

    Corrected to 15
    2014 DXd w/CMT (type 2)

    Click to view my pics: pics of scoli x-rays digital x-rays, and pics of me

  11. #11
    Join Date
    Aug 2006
    Location
    Lawrence, Kansas/ Overland Park, KS
    Posts
    195
    I had surgery about 7 weeks ago, and if you look at my before/after pics in my signature you can see that I also lean the other direction now. My doctor told me that it was because my lower compensary curve was not fused and that it would self correct over time as my muscles readjust. hopefully that's true, and i won't be a side-ways wonder forever!
    aBbiE
    22 yr old F,KU college student
    Kyphoscoliosis...
    Scoliosis (25T, 23L) diagnosed @ 14 yrs old; curves June 08 were 45T, 32L with 18 degree rotation
    Kyphosis of 65 degrees...
    I am missing a lumbar vertebrae

    Surgery 6/30/2008 with Dr. Lawrence Lenke
    Fused T2-L2


    before/after pics
    all smiles!

  12. #12
    Join Date
    Apr 2007
    Location
    Seattle, WA
    Posts
    385

    posture

    My son has tilted since his surgery and it does worry me a lot. He holds himself with his right shoulder higher than his left and he bends his left knee, thereby leaning a little to his left side. He has been in physical therapy for it since late March and it is only helping a little. It does really help with his flexibility and strength though so we plug along at it twice a week for the most part.

    He has finally started to become a little more self-aware of how he holds himself. He will now go and look at himself in the bathroom mirror and try to even out his shoulders if I ask him to do so. He has a checkup with the surgeon this Thursday (it's been 13 months since his surgery) and I wonder, as always, what, if anything the surgeon will say can be done about this posture issue. Alexander is doing great other than his posture though and I would hate (really!) for another surgery to be mentioned as a way to fix it.

    If anyone has any comments about this or suggestions about fixing this problem, thank you in advance.
    Laurie

    Mother of Alexander & Zachary:
    Alex is 16 years old and in the 11th grade. He has congenital scoliosis due to a hemivertebrae at T10. Wore a TLSO brace for 3 1/2 years. Pre-op curves were T45 & L65; curves post-op are approx. T31 & L34. Had a posterior spinal fusion from T8 to L3 on 7/12/07 at age 12. Doing great now in so many ways, but still working on improving posture.
    Zach is 13 years old and very energetic.

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