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Thread: Why brace instead of surgery?

  1. #1
    Join Date
    Aug 2004
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    South Dakota
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    Question Why brace instead of surgery?

    Hello,
    I've just been "listening in" on a lot of these threads, wondering if I may some day find myself in a different category. My 11 y.o. daughter started wearing a brace in early August. We were told she has an upper curve of 40 degrees, and I don't even remember the lower one. (Only saw the doc once so far and I didn't realize how frequently those figures would be referred to. Will have to check next mo. when we see him again.
    What it seems like I keep reading is that many have worn a brace for years and then end up having surgery anyhow; sometimes wearing a brace again after surgery?? It just has me wondering......... why do they put so many folks thru the discomfort of wearing a brace for years and then do surgery? The brace doesn't correct the curve, just slows or stops it. Right. Surgery actually corrects it. And it sounds as tho there are not really any long term ill effects. So why don't they just do surgery right off the bat? Anybody know?
    Donna
    Mom to two sets of kids: 1 biological set, grown & married - 1 adopted set, 6 & 11
    Donna
    Mom to 2 biological kids, grown & Married and 2 adopted kids, 6 & 11

  2. #2
    Join Date
    Sep 2003
    Location
    Austin, TX
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    61
    Donna,

    If the curve is discovered in time, bracing adolescents is effective at preventing the progression of scoliosis in the majority of cases. Most people who wore a brace as adolescents will never need surgery.

    While surgery does correct the curve, at least partially, it certainly does have risks and should therefore not be performed unless bracing hasn't worked.

    Also, the braces some people wear after surgery are only worn for a short time, while healing. Most patients do not need a postoperative brace.

    Dave

  3. #3
    Join Date
    Sep 2003
    Location
    Northern California
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    Hi Donna...

    There are several reasons to put a kid into a brace. First, bracing actually works well enough to keep most kids from ever having to have surgery. The object is to keep the curves from increasing until the child is skeletally mature.

    Also, even if a child does need surgery, it's best, if possible, to wait until the child is skeletally mature. My understanding is that there are two reasons for that. First, the child is allowed to grow to their full potential. Secondly, if a child does have to have their spine fused before they are fully grown, both the front and the back of the spine have to be fused (two surgeries), or the child will end up with something called crankshaft phenomenon.

    Anyway, if the child isn't braced during growth, when surgery is finally performed, it would probably be on much larger curves than it would be if the child was braced. (I think that it's dangerous to fully reduce really large curves, but I could be wrong about that.)

    As far as kids having to wear a brace after surgery, that can be for two entirely different reasons: 1) to keep the kid's torso from moving while fusion starts, and 2) if not all of a kid's curves are fused.

    In case you're interested, here's a link to a chart showing the risk of progression in kids:

    http://www.vh.org/pediatric/provider...abilities.html

    Regards,
    Linda

  4. #4
    Join Date
    Aug 2004
    Location
    South Dakota
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    Dave & Linda.......... Thanks so much for your helpful input. I guess I forgot to state in my question, "Why when the curve is so great already do they wait for surgery?" I had understood that it can often eliminate the need for surgery if caught early enough. Your answers are helpful. I guess I know there are always risks with surgery, but after reading so many positive comments about straighter backs after surgery, it's easy for me to look at the huge curve on my daughter's back and wish she didn't have to live with it the rest of her life. It shows my ignorance about the procedure. Hadn't really sunk in that the spine is fused and so growing discontinues. That makes sense to me then. I certainly don't relish the idea of putting her through surgery either, as I"m sure no one does. She's already had enough strikes against her in life - I'm just bein' a Mom - wanting things to be as good as possible for her.
    To me, her curve looks much worse now than it did in June when we first saw the Dr. I don't know if it's just because I'm looking at it all the time now and so I'm seeing what I never saw before, or if it's just progressing very rapidly. Do you think I should try for an earlier appointment? We go in again on 10/7. Or is there not much point?
    Donna
    Mom to 2 biological kids, grown & Married and 2 adopted kids, 6 & 11

  5. #5
    Join Date
    Sep 2003
    Location
    Northern California
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    Hi Donna...

    As far as I know, it wouldn't hurt to move her appointment up. If your doctor is as busy as the doctors around here, however, it's unlikely you'll get an earlier appointment.

    By the way, Dave won't mention it himself, but he's written a great book "Scoliosis Surgery The Definitive Patient Reference." I'd urge you to read that book so that you know what to expect. You can buy it on the NSF website, or directly from Dave at http://www.curvedspine.com.

    Regards,
    Linda

  6. #6
    Join Date
    Aug 2004
    Location
    South Dakota
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    Thanks much, Linda
    We haven't been told she need surgery, only that if the brace doesn't do the job, she may. I'll look into the book.
    I imagine you're right, and I probably won't be able to get an earlier appt. The doc only comes to our town once a month -- but it never hurts to try. Will also check out the link you mentioned. HAven't don't that yet.
    Donna
    Mom to 2 biological kids, grown & Married and 2 adopted kids, 6 & 11

  7. #7
    Join Date
    Sep 2004
    Posts
    5
    hi Donna,

    My daughter was diagnosed with sciliosis at 15 she is now 24 the doctor told her to wear the brace, so she wore for 2 days and then sad i rather be dead then wear this again.

    A few month later she had the operation on her spine wich had 45% curve. Now years later she is developing pain in the place where they put the rod. I am sad and dissapointed in the hole idea of surgery. Maybe if I insisted for her to wear the brace constantly or keep an eye on her 24 seven that would of worked.
    One day she came home carying the brace in her hand. I knew them that was the end of the brace.
    good luck to you.

  8. #8
    Join Date
    Aug 2004
    Location
    South Dakota
    Posts
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    Belss you, Stella
    It's so easy to look back and say "I should've..." I've done that with my little son. He had major surgery on his skull at 6 mos. old and then had to wear a little helmet 24/7 for several mos. afterward. He so often wanted it off and seemed so hot and miserable in it that I'd take it off and give him breaks (lots of them!). Now he has quite a "dip" and and bump on top of his head..................and I do the same thing you're doing.
    Fortunately my daughter has a wonderful additude most of the time and is really cooperating.
    I do hope your daughter can get some help with the pain she's experiencing.
    Donna
    Donna
    Mom to 2 biological kids, grown & Married and 2 adopted kids, 6 & 11

  9. #9
    Join Date
    Sep 2004
    Location
    London, England
    Posts
    11
    Hey there!
    I was braced 3 years prior to my operation. I was told this was to slow down the curve, but sadly they didnt work and i had the operation 2 months ago. I have now been braced again after the operation. The reason they dont operate straight away is because normally many patients grow out of scoliosis or the curve doesnt get to servere to be operated on.

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