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  • #16
    Linda,


    Thank-you so much !!! Although the information is quite sobering - quite depressing actually. I think I'll go shopping - that always cheers me up.






    Celia

    Canadian eh
    Daughter, Deirdre born Oct 2000. Diagnosed with 60 degree curve at the age of 19 months. Serial casting by Dr. Hedden at Sick Kid's Hospital. Currently being treated by Dr. Rivard and Dr. Coillard in Montreal with the Spinecor brace and curve is holding at "2" degrees. Next appointment 2008

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    • #17
      Thank you Linda, for the information, both on the lower back supportingbraces and the study.
      Sorry for my slow reply.

      Those back supporting braces might be helping though it seemed quite bulky. I recently saw a newspaper ad on a lower back brace with traction function. It was developed in South Korea. The price was fairly expensive which gave me second thoughts on purchase.

      I will ask my doctor about pain management for scoliosis, but I doubt that there is any specific one for scoliosis in area.


      As to the study, I did not know how I should react to it...

      I wish a totally new fusion method will be developed soon so that more patients become eligible for surgery.

      As my curve worsens, I am shrinking (I already lost about 2 inches since I was 15) and my rib hump is growing and there's less and less clothes that I can wear. I try to remain cheerful and optimistic, but sometimes I get so depressed that nothing can be done to stop my curve progression.

      If there is anyone out there who have big progressive curves but is not eligible for fusion? What does your doctor say to you?

      ********

      By the way, I found the following 2 studies on unfused scoliosis
      patients. It might to be of interest to others though I thought the
      follow-up years are too short.

      http://www.ncbi.nlm.nih.gov/entrez/q...t_uids=3192566

      J Bone Joint Surg Br. 1988 Nov;70(5):712-6.

      Long-term follow-up of fused and unfused idiopathic scoliosis

      Edgar MA, Mehta MH.
      Institute of Orthopaedics, Royal National Orthopaedic Hospital, Stanmore, Middlesex, England.

      We reviewed 77 unfused and 91 fused patients with idiopathic scoliosis who first attended between 1949 and 1965. Both groups were re-examined at least 10 years after reaching skeletal maturity, with attention to progression of the Cobb angle, increased in vertebral rotation, back pain and psychosocial problems. We found that spinal fusion protects the scoliotic spine from further deterioration during adult life except for those with severe curves and marked rotation. Fusion also significantly reduced the incidence of severe pain and allowed patients to carry out heavy physical work, but did not confer complete immunity from backache. Surgery improved the appearance, but patients were not always completely satisfied with the cosmetic result.

      PMID: 3192566 [PubMed - indexed for MEDLINE]


      http://www.ncbi.nlm.nih.gov/entrez/q...t_uids=2956582
      Orthopedics. 1987 Jun;10(6):931-9.

      ******

      The natural history of unfused scoliosis.

      Edgar MA.

      Seventy-eight unfused patients with idiopathic scoliosis were followed from skeletal maturity over a mean period of 17 years (range 10 to 27 years) with a mean age at follow up of 33.7 years. The following aspects were investigated: curve deterioration, back pain incidence, and
      psychosocial details. There was considerable variation in the
      progression rate of similar deformities but on average significant
      deterioration occurred when the Cobb angle was over 55 degrees with a maximum deterioration approaching 1.5 degrees per year in the thoracic curves between 90 degrees and 100 degrees mature Cobb angle.
      Thoracolumbar and lumbar curves were slightly more benign with a maximum progression rate of about 1 degree when the mature angle was 80 degrees to 90 degrees. The thoracic component of double curves progressed least.
      Rotation increased in proportion to the Cobb angle progression except in some lumbar curves where lateral subluxation occurred with a disproportionate amount of rotation. The incidence of back pain inrelation to pain in the general population and in fused patients remains uncertain. Eighty-two percent of patients had married and 87% had job satisfaction; 10% received treatment for depression.

      PMID: 2956582 [PubMed - indexed for MEDLINE] totally new fusion method totally new fusion methos

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      • #18
        Hi Katy...

        Here's a more recent study:

        AMA. 2003 Feb 5;289(5):559-67. Related Articles, Links

        Comment in:

        * J Fam Pract. 2003 Jun;52(6):451-2.
        * JAMA. 2003 Feb 5;289(5):608-9.
        * JAMA. 2003 May 28;289(20):2644; author reply 2644-5.


        Health and function of patients with untreated idiopathic scoliosis: a 50-year natural history study.

        Weinstein SL, Dolan LA, Spratt KF, Peterson KK, Spoonamore MJ, Ponseti IV.

        Department of Orthopaedic Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA. stuart-weinstein@uiowa.edu

        CONTEXT: Previous long-term studies of idiopathic scoliosis have included patients with other etiologies, leading to the erroneous conclusion that all types of idiopathic scoliosis inevitably end in disability. Late-onset idiopathic scoliosis (LIS) is a distinct entity with a unique natural history. OBJECTIVE: To present the outcomes related to health and function in untreated patients with LIS. DESIGN, SETTING, AND PATIENTS: Prospective natural history study performed at a midwestern university with outpatient evaluation of patients who presented between 1932 and 1948. At 50-year follow-up, which began in 1992, 117 untreated patients were compared with 62 age- and sex-matched volunteers. The patients' mean age was 66 years (range, 54-80 years). MAIN OUTCOME MEASURES: Mortality, back pain, pulmonary symptoms, general function, depression, and body image. RESULTS: The estimated probability of survival was approximately 0.55 (95% confidence interval [CI], 0.47-0.63) compared with 0.57 expected for the general population. There was no significant difference in the demographic characteristics of the 2 groups. Twenty-two (22%) of 98 patients complained of shortness of breath during everyday activities compared with 8 (15%) of 53 controls. An increased risk of shortness of breath was also associated with the combination of a Cobb angle greater than 80 degrees and a thoracic apex (adjusted odds ratio, 9.75; 95% CI, 1.15-82.98). Sixty-six (61%) of 109 patients reported chronic back pain compared with 22 (35%) of 62 controls (P =.003). However, of those with pain, 48 (68%) of 71 patients and 12 (71%) of 17 controls reported only little or moderate back pain. CONCLUSIONS: Untreated adults with LIS are productive and functional at a high level at 50-year follow-up. Untreated LIS causes little physical impairment other than back pain and cosmetic concerns.

        --Linda
        Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
        ---------------------------------------------------------------------------------------------------------------------------------------------------
        Surgery 2/10/93 A/P fusion T4-L3
        Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

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