Pro- and Contra-Surgery Debate Article

[ARN010]

http://www.pubmedcentral.nih.gov/art...medid=18826571

[Karen Ocker]

Interesting but small study

Fifty year follow up of 117 patients with untreated AIS----

This is a very small study-117

Scoliosis was actually killing me at age 59 with 30/80/40 deg curves by increasing shortness of breath--which is very scary.

[Pooka1]

I don't know how these articles questioning the need for surgery get published. Maybe these journals aren't peer-reviewed?

[rtremb]

ARN010

Thank you for the link to the article.

Ruth

[Susie*Bee]

Thanks, ARN010, for sharing the article. I thought it was interesting.

[Writer]

I think the article is not only very interesting, it is a landmark publication. It acknowledges publicly, in a broad-based surgery journal, the legitimacy of non-surgical treatment for scoliosis and the hitherto suppressed controversy about choice between surgery and alternatives.

If it stimulates more such debates and more research on surgery and the alternatives, so much the better. All the information and data pro and con for each side needs to come out in the open so that medical practitioners and their patients can make informed choices based on all available evidence.

Patient Safety in Surgery is *of course* a peer-reviewed journal. Anyone can verify this by a quick look at the masthead. There are almost 50 names on it, 34 of them on the editorial board.

http://www.pssjournal.com/edboard/

The function of an editorial board is to critique submissions and ensure that they meet the standards of the journal.

[Karen Ocker]

Alternatives???

How most of us would prefer alternatives to painful surgery but the facts are that many of us had such severe, malignant -in my case- curves that absolutely no alternatives have been shown to permanently arrest or stop them. We are not against alternatives it's just that, if you really search the forum archives, you will hear many members who have tried,various alternatives, at great expense, without success . We try to learn from other member experiences.
When I was a teen I was told the curves would not progress after skeletal maturity. Yet, even my fused, no hardware, spine weakened(no osteoporosis) to the point where it progressed by age 59. I lost lung tissue and respiratory capacity--this is very scary. Though Harrington rods came later, some had problems with
a lack of lordotic curve causing wear and tear on the lumbar joints. Also, Harrington rods have an upper and lower hook. So the spine can still curve and collapse in between. Alternatives will not stop that. PT can minimize some symptoms.

We are constantly looking for better ways to help ourselves. Persons without scoliosis do not experience this urgency. Periodically, a newer member will find publications which are outdated-though interesting but not really state-of-the art. Even presently practicing GPs have this old knowledge. One told me the "scoliosis surgery is not done over the age of 19". Sadly, when we point this out it is taken as a criticism.
Yes, exercises and bracing can help some curves-small ones-but a search of the forum archives will show many members who have used these alternatives faithfully and more--and still end up with serious curves requiring surgery.

Lastly, I was called to anesthetize a 72 year old patient with untreated scoliosis for a colonoscopy. She was literally dying from it(scoliosis) because her lungs were so compressed that she had a tracheotomy and needed a ventilator.
It made me grateful that I had a revision at age 60.

[ARN010]

I Agree Surgery May be Only Option

I definitely agree, so far, I am thrilled with the result for my sweet daughter (now with a zero curve from a 49 degree curve). I am hopeful that we have headed off a lot of the potential side effects of a progressing curve (including the self esteem "hit" she could take given that she was developing a noticeable hump at age 10 and, of course, pulmonary and/or cardiac problems, and the onset of pain). Anyhow, I liked the summary of pro and con in that article it seemed to give a quick review of the main arguments I had been hearing folks talk about. I received multiple claims on this forum and in the real world some of which were outrageous including, "what a bad mom I was to consider surgery for my child" and that "with proper yoga, PT, growing rods, etc. I would have a better outcome". Anyhow, I feel I made the right choice and I consulted more than one international authority on the subject which gave me confidence. I also liked the fact that the Harrington rods are tried, tested for many decades despite newer approaches/technologies that have yet to be proven. I guess time will tell but there was no time, with her progressing 3.2 degrees per month at the onset of her peak growth velocity, to hesitate in the decision-making. She's doing great today and I am so grateful. Take care!

[CHRIS WBS]

Thanks for sharing the article. The bottom line is that every surgical procedure carries risks whether it is spinal fusion, knee replacement or heart by-pass; and as such there will be pro and contra studies reported. As an older adult who recently had corrective surgery for untreated AIS, my only regret is that I was not treated sooner. My surgeon even commented that he wished he could have treated me when I was younger. I am already benefiting from this surgery and have decided to live in the present and not worry about what may happen years from now.

Chris