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  • Spine curvature after surgery

    Hi everyone

    "Happy New Year"

    OK, can anyone share their views on curvature of the spine after surgery. I mean, is this possible and can the spine still curve after one has had rods inserted. If so, what (if any) are the contributing factors, eg., age, anterior vs posterior, risser (growth) factor, etc.

    My daughter had surgery 6 weeks ago today and I am worried this might occur?

    Rgds,
    Lisa
    Mum to Tahlia, aged 15. Fused from T2 - L3, 18/11/08.

  • #2
    Lisa, I just asked that exact question to my daughters surgeon yesterday. She is 11 and is going to have a fusion on January 26th. Her risser is 2 and with her period already starting, he decided to fuse instead of doing the growing rods. He said that the spine would settle in the months following fusion and could lose some correction but not alot. He also, said there is a chance for twisting and further curvature of the part (in her case the lower part) of the spine without instrumentation. He added that this is a small chance, but that he has had to fix these. I have a 20 year old friend that was fused at age 10 and she has lost some correction (about 7 degrees) over the last 10 years so I know that it is possible. This doesn't however, change my decision in my daughters case, because I believe it is the best treatment for her now. I have done tons of research and talked to many doctors (including Shriners) and everyone agrees that there is not a better option at this time. Hope this helps. How is your daughter six weeks post-op?? I am wondering if I can make it through the surgery. It's all I think about right now.

    Smileyskl

    Comment


    • #3
      Hi Lisa,

      My daughter had a posterior spinal fusion at the age of 13 for both Scoliosis and Kyphosis. Jamie is fused from T3-L2 and had reached skeletal maturity before surgery.

      Jamie developed what her doctor calls "junctional Kyphosis" above her fusion. Her doctor told us this does occasionally happen, but he assured us (before surgery) that he would do everything in his power to avoid it. He fused an extra vertebrae and used extra wires/hooks etc. at the top of her fusion and it still curved.


      Mary Lou
      Mom to Jamie age 21-diagnosed at age 12-spinal fusion 12/7/2004-fused from T3-L2; and Tracy age 19, mild Scoliosis-diagnosed at age 18.

      Comment


      • #4
        Originally posted by Kitty View Post
        OK, can anyone share their views on curvature of the spine after surgery. I mean, is this possible and can the spine still curve after one has had rods inserted. If so, what (if any) are the contributing factors, eg., age, anterior vs posterior, risser (growth) factor, etc. ...

        My daughter had surgery 6 weeks ago today and I am worried this might occur?
        Lisa, you know I sympathize with you for everything you and Tahlia have been through, and I think you're a great mom ... but, I think in this case you're adding stress to your life worrying over what *might* happen. There's not a thing you can do to prevent it at this point; all you can do is keep an eye out for apparent changes (outside the regular follow up visits).

        Yes, curvature can occur after fusion (in kids OR adults), but typically, it's above or below the unfused area. When this happens, the most common reason is all involved vertebra in the structural curve were not included in the fusion (it's called "decompensation"). There are certainly special cases, as Mary Lou pointed out, and from what I've read, it seems a good portion of them involve cases where kyphosis is also present.

        While smileskl was told her daughter's curve could settle and *lose* correction, I (and several other adults on here) were told just the opposite - that our curves would *continue* to correct for ±6 months post-op.

        I'm pretty sure a low Risser is the largest factor at play, but then again, a "post-menarche/Risser 2" can make for a quick jump to skeletal maturity (i.e., the risk of curve progression *should* be lowered).

        Without knowing either about smileskl's friend fused at age 10 (Risser - or whether menarche occurred pre-fusion), it's hard to compare the two scenarios. They could very well be completely different.

        Try not to worry yourself, hon.

        Regards,
        Pam
        Last edited by txmarinemom; 01-01-2009, 07:00 PM. Reason: Typo. Go figure.
        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

        Comment


        • #5
          One of the things that frustrates me about this condition is precisely that, Pam. There is nothing you can do - no exercises, no pills, no nothing. It's purely a waiting game and i hate that. And that was always clear to me and particularly so prior to surgery when we did the bracing to try and halt it and it didn't work, so i kind of felt like we were at it's mercy (or lack of). So yes, you're absolutely right and i guess we just have to see, and there's probably no point worrying or stressing about it until we have (hopefully never) that conversation with the surgeon who says it has curve, but i guess i'm sort of preparing myself for that by trying to determine the likelihood. I am certainly not stressing or anything and am happy with where things are at now and know that Tahlia is and we are focusing on the benefits that she has enjoyed since her surgery, but i will ask my surgeon about it in 2 weeks' time.

          However, Pam, i was interested to hear the comments of one of the HDA (high dependency area) doctors at the hospital when Tahlia was in the HDA who was showing me the x-rays. Tahlia was fused from T2-L3 and I noticed the rod in the top thoracic area was curved away from the direction of her natural scoliosis curve and when I asked about that, the doc said it was designed to provide further correction and straightening over time. I haven't allowed myself to get excited over this, because, like you say, this is unpredictable and I guess i'm preparing myself for anything. Is this what you mean when you say you were told that the curves would continue to correct?

          Mary Lou, my daughter sounds similiar to yours in terms of age, type of fusion and vertebrae fused. How mch further did her curve progress and what, if anything, is the surgeon recommending to address that? However, I am not sure what a "kyphosis" is? I have heard that term many times on this forum, but my surgeon has never mentioned this with regards to my daughter.

          Smiley, Tahlia is doing really well now. She has not taken pain meds for weeks and is very independent, walking and getting out occasionally too. We are on school holidays for the summer break so it is an ideal time for her to recover andnot hve to worry about school for at least another month. You will be fine. As everyone else on this forum will tell you,I'm sure, the lead-up to surgery is the worst part. I was very nervous in the weeks beforehand, but on the day of surgery i was very calm, knowing my daughter was in good, capable hands. Your daughter will be too. Please feel free to ask any questions or share anything you like on here, as there are only too many people willing to help and provide support and honestly, it was what got me through.

          CHeers,Lisa
          Mum to Tahlia, aged 15. Fused from T2 - L3, 18/11/08.

          Comment


          • #6
            Thanks Lisa,

            I really lost it tonight, it came from out of nowhere, tons of tears. I guess I have been so calm, there was bound to come a breaking point. I tell everyone how good I am doing and how I know surgery is the right thing and then it just hit me. The reality of the surgery. It's nothing anyone wants their child to go through. This is much harder than anything I have dealt with so far as a parent, though I know it could be much worse, and I thank God that it isn't. When I get on this sight, it is not for debate or anything else. I answer questions if I think I may can help. I am just a scared parent waiting on surgery for my daughter and sometimes the best thing at that moment is for someone to say that you will make it through. Just knowing others have been where I am and have made it gives me strength. I hope that your daughter or my daughter for that matter, doesn't lose correction. But one thing Pam said that is for sure - we can't live our life worrying about what "might" happen. I just try to take things one day at a time. I know with God's help my daughter and I will get through this. Thank you for the encouragement and best of luck for you and your daughter.

            Smileyskl

            Comment


            • #7
              Lisa,

              Kyphosis is a normal "front to back" curve that we all have. In my opinion, it is seen the best if you look at the spine from the side--it curves forward at the top and cuves in at the bottom (I think that's called Lordosis). Anyway, it is a normal curve. If my memory is correct, normal Kyphosis is about 40* and at the time of surgery, Jamie's was 71*.

              Jamie's junctional Kyphosis was a new curve after surgery. She curved from C6-T3 which is all above her fusion and was not part of her original Kyphosis. The first mention of junctional Kyphosis was at her six month post-op appointment. The curve progressed from 18* to 39* in a year's time. Her surgeon told us at one point that he needed to extend her fusion. At the time, Jamie and I weren't ready to hear that and I asked if we could continue to follow her closely and see if it continued to curve or not. He reluctantly agreed as long as I understood that if it continued, we would have to discuss surgery. By the time we got to her next appointment, her curve stopped progressing. It settled in at about 36*. Jamie's most recent follow-up was July 2007 and the surgeon's report states that she has a "stable junctional Kyphosis of 36*" and we were told she didn't need to be seen for two years.

              Am I sorry I didn't agree to extend her fusion? At this point, no. I knew that neither Jamie nor I were ready for more surgery at that point. Will she need more surgery in the future? Who knows. Jamie's neck curves forward, and to my trained eye, it is very noticable. To everyone else, no one even notices! If Jamie had spoke up and told her surgeon she didn't like her appearance, he probably would have considered surgery. I told Jamie that at this point I feel surgery would be more for a cosmetic reason than a medical one and I would not make that decision for her. She chose not to have more surgery.

              I understand your worries. You have to trust your doctor and yourself. You made the best decision possible for your daughter and you need to believe in that.

              Mary Lou
              Mom to Jamie age 21-diagnosed at age 12-spinal fusion 12/7/2004-fused from T3-L2; and Tracy age 19, mild Scoliosis-diagnosed at age 18.

              Comment


              • #8
                Smileyskl,

                I totally understand what you are going through! It is perfectly normal.

                You sound a lot like me. I've always told Jamie she was chosen by God to have Scoliosis. I told her He only gives stuff like this to those who can handle it, so, you can handle it, I know you can. I've always told Jamie and she's seen first hand, that her back condition is nothing compared to other children's backs.

                Hopefully this will be the hardest thing you ever have to face.

                I sent you a private message. Hang in there.

                Mary Lou
                Mom to Jamie age 21-diagnosed at age 12-spinal fusion 12/7/2004-fused from T3-L2; and Tracy age 19, mild Scoliosis-diagnosed at age 18.

                Comment


                • #9
                  Smileyskl--

                  Just want to add my support here. My 13yo son was fused 7 weeks ago and we go for the first post-op checkup on Tuesday. He seems to be doing very well so far. He went for a long walk in the woods--a hike, really--on New Year's Day and commonly walks up to 3.5 miles a day. He's been off any meds for weeks, was in school for half days the week before Christmas and will be back in school full time next week.

                  You will do fine through the upcoming surgery, although you probably won't believe it until you go through it. We will all be behind you.

                  Mary Ellen
                  Last edited by WNCmom; 01-04-2009, 05:48 PM.

                  Comment


                  • #10
                    Thanks to all

                    Thanks everyone!! I know that I will make it because I firmly believe God doesn't give us more than we can handle. However, right now, I have to remind myself of that and it helps to have encouragement from others. I appreciate your comments and support. It helps alot everytime someone says "I made it and you will too". It reminds me that there is an "After Surgery". Right now, it seems to be consuming our lives. Thanks again!!

                    Comment


                    • #11
                      Thanks to all

                      Thanks everyone!! I know that I will make it because I firmly believe God doesn't give us more than we can handle. However, right now, I have to remind myself of that and it helps to have encouragement from others. I appreciate your comments and support. It helps alot everytime someone says "I made it and you will too". It reminds me that there is an "After Surgery". Right now, it seems to be consuming our lives. Thanks again!!


                      Mary Lou, I sent you a PM


                      Mary Ellen, thats great that your son is doing so well after only 7 weeks. I hope we will be able to say the same. Thanks for the encouragemet and keep us posted.
                      Last edited by smileyskl; 01-02-2009, 03:46 PM.

                      Comment


                      • #12
                        Smileskl,
                        My son is almost 3 weeks post surgery. The anticipation is the worst and it is completely normal/understandable to be emotional.
                        I just wanted to shout out and let you know I'll be thinking of you. I was so glad to have found this forum. It has really helped me preparing for Jesse's surgery.
                        Bethany

                        Comment


                        • #13
                          Originally posted by smileyskl View Post
                          Thanks Lisa,

                          I really lost it tonight, it came from out of nowhere, tons of tears. I guess I have been so calm, there was bound to come a breaking point. I tell everyone how good I am doing and how I know surgery is the right thing and then it just hit me. The reality of the surgery. It's nothing anyone wants their child to go through. This is much harder than anything I have dealt with so far as a parent, though I know it could be much worse, and I thank God that it isn't. When I get on this sight, it is not for debate or anything else. I answer questions if I think I may can help. I am just a scared parent waiting on surgery for my daughter and sometimes the best thing at that moment is for someone to say that you will make it through. Just knowing others have been where I am and have made it gives me strength. I hope that your daughter or my daughter for that matter, doesn't lose correction. But one thing Pam said that is for sure - we can't live our life worrying about what "might" happen. I just try to take things one day at a time. I know with God's help my daughter and I will get through this. Thank you for the encouragement and best of luck for you and your daughter.

                          Smileyskl
                          HI Smiley,

                          Let me reassure you that we have ALL been there. We have ALL lost it and gotten emotional and broken down and we have ALL been terrified of the unknown. But let me also reassure you that we made it through. What you're going through is completely normal, so take a deep breath, take it one day at a time and remember you are in the company of many other mums who have been exactly where you are and gotten through it. And so will you.

                          It always warms my heart when i see so many people on this forum, complete strangers, whom I will never meet and don't even know what they look like, offering words of comfort and support and assistance. It's just lovely. I of course, am referring to people like Mary Lou, Mary Ellen and Bethany who were all there for me and who I know will be there for you.

                          So chin up hon, you've got lots of support here.

                          Take care,
                          Lisa
                          Mum to Tahlia, aged 15. Fused from T2 - L3, 18/11/08.

                          Comment


                          • #14
                            Mary Lou,
                            Thank you so much for your response. It has given me a lot to think about and I will probably refer back to your comments often, I think. I too, would not be ready for surgery a 2nd time, so if this happens to us i think I would also ask the surgeon if we could monitor closely before making a decision. It sounds like it was the right call in your case.
                            I must say it scared me a little when i read your comments, knowing this was a possibility for my daughter (oops! I hope Pam's not reading this ), but I would rather be prepared and know what the possibilities are.

                            I am guessing your daughter has her 2 year follow-up sometime this year?

                            Thanks heaps,
                            Lisa
                            Mum to Tahlia, aged 15. Fused from T2 - L3, 18/11/08.

                            Comment


                            • #15
                              Originally posted by WNCmom View Post
                              Smileyski--

                              Just want to add my support here. My 13yo son was fused 7 weeks ago and we go for the first post-op checkup on Tuesday. He seems to be doing very well so far. He went for a long walk in the woods--a hike, really--on New Year's Day and commonly walks up to 3.5 miles a day. He's been off any meds for weeks, was in school for half days the week before Christmas and will be back in school full time next week.

                              You will do fine through the upcoming surgery, although you probably won't believe it until you go through it. We will all be behind you.

                              Mary Ellen
                              Hi there Mary Ellen,
                              How wonderful it was to read that Sidney is walking so far everyday. It never ceases to amaze me how much and how quickly our kids recover and what they can do now, considering not long ago they were in a hospital bed recovering from major surgery. I encourage Tahlia to walk and she and I probably walk about 1-1 and a half kilometres a day (about 1/2 to 1 mile). I thought maybe that was pushing it, but perhaps not if Sidney is walking the distnces he is. I wasn't told much about walking after surgery, so is this something i should be encouraging. Should I be aiming for more?

                              Glad to hear Sidney's doing so well.

                              Lisa
                              Mum to Tahlia, aged 15. Fused from T2 - L3, 18/11/08.

                              Comment

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