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is 60 degrees the new 50

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  • is 60 degrees the new 50

    Ok, I have met with three doctors about my 52 degree lumbar curve and went to the fourth doctor yesterday. The first three doctors recommended surgery, both A/P. The doctor yesterday, said that he doesn't do elective surgery until it reaches 60 degrees and his recommendation would be to follow me for two years or until it reaches 60 degrees. WHY ARE DOCTORS ALL OVER THE PAGE, IN THEIR RECOMMENDATIONS? I told him about my pain and loss of height in the last year. He said that he can't go by height, because people are taller in the morning and he didn't know when the measurements are taken (shoes, no shoes). I was getting myself ready to have the surgery, until this fourth doctor said that he wouldn't recommend it until 60 degrees and would just manage the pain for two years! Sorry, just venting!

    rich

  • #2
    Hi Rich,

    I have noticed some variation from doc to doc but I was told that generally speaking, they are looking for 60 degrees and progressing.

    Since one of my curves fit that description, there never was any question in my case.

    Sheri
    At age 56 my curves measured: 48/60/30 with lots of rotation and getting worse
    Posterior fusion T5-L4 June 30, 2009
    Excellent correction

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    • #3
      My son's doc (not a scoliosis specialist) said he wouldn't operate until 60 degrees (my son has a 50-something degree thoracic curve). But, I thought the cutoff was lower for lumbar curves.

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      • #4
        My only problem with the fourth doctor is living with the pain for two years and the way it seems to be progressing. He kept saying it would be better to have it done while your young. It just made sense for me to go along with the first 3 doctors, who recommended surgery, but now i'm not sure. Just so many possiblities can arise with waiting! I wish this was an easy decision.. I love the fact that we have a website for us to talk about stuff like this..

        rich

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        • #5
          there are plenty of nyc scoli surgeons who talk surgery over 40 degrees, & sure thing for 50 degrees...why are these other doctors changing the number upwards..??? what will they do next..move it to 70 degrees...???

          LIVE WITH THE PAIN??? is he kidding...tell HIM to live with the pain!!! easy for the doctor to say, isnt it...i cant stand doctors who talk that way...it is disgusting!

          my surgeon in nyc, an excellent one, has been talking surgery to me since 40 degrees...especially watching curves progress year after year!!!

          i would run from that 4th doctor, really fast!!

          best of luck
          jess

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          • #6
            Originally posted by rich1752 View Post
            WHY ARE DOCTORS ALL OVER THE PAGE, IN THEIR RECOMMENDATIONS?
            Because they're individuals, and because there's new research published all the time.

            There's got to be a reason you've seen so many different specialists. You may want to really figure that out. When you've found a specialist you can trust, I would advise that you go along with whatever they recommend.

            Good luck.

            Regards,
            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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            • #7
              Hi Rich,

              I agree with Linda in that not all surgeons are of the same mold. I was told by two surgeons that 50+ curve was not urgent, and if I was younger, probably could have waited a bit, but given my age they suggested to do it now rather than wait. They knew it was progressing rapidly, but my health and bones were good now, in my case, if I waited 5 or ten years, it would be a different story. There are probably many variables that surgeons go by, and also what they are comfortable with.
              Dolores A
              June 4, 2009 Anterior L3 - S1
              June 8, 2009 Posterior T4 - Pelvis
              Mark Agulnick, MD FAAOS
              NY Spine & Scoliosis Center

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              • #8
                Rich,

                I agree it seems frustrating. In my own experience, my surgeon recommended surgery for me once I had progressed to 50* in my thoracolumbar curve. He did not say that I had to have the surgery right away - in fact he told me I could wait a few years - but the fact remained that I would need it at some point in the future.

                I chose to go ahead with the surgery now for several reasons: 1)the timing was right, as I was finishing school and could put off my job search a few months to allow for recovery -- 2)Since I am still (relatively) young and flexible, my surgeon was able to do a shorter fusion than I would likely have had, had I waited several years -- 3)I have great insurance through my husband's job...only charges for the entire operation and hospital stay were my $250 hospital admission deductible -- 4)lower back pain was really starting to affect my regular & active lifestyle.

                Now, of course these are my own reasons, and yours are going to be different. I know it is hard, but it's just something that you have to take your time thinking about...I think it is important that you fully commit yourself to whatever decision you make, as your mental outlook will color the situation.

                For what it's worth, it has now been almost 6 weeks since my anterior surgery, fusing T10 - L3. Although I am not fully healed, I do not regret having the surgery so far; in fact I am glad that I did it now instead of waiting.

                Just my 2 cents!
                --Steph

                Anterior surgery 9/23/09
                Fused T10 - L3

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                • #9
                  My current surgeon told me that he would consider operating on >40, more willing to operate if it is progressing.

                  I found it very frustrating when different surgeons gave me different ranges for surgical treatment. Personally, at 53 degrees, I would 100% go for surgery, especially with pain and progression.

                  Do you have a compensatory thoracic curve rich1752?
                  45L/40T
                  Surgery 25/1/2010
                  Australia

                  Knowthyself

                  Scoliosis Corrected 25/1/2010 by Dr Angus Gray, Prince of Wales Private Hospital, Sydney. Fused T3-L4.

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                  • #10
                    My doctor and my daughter's doctor both said surgery at 45 degrees. I lost 2 inches of height before my surgery (I was 5'6" in 8th grade, 5'5" in 9th grade and 5'4" in 10th grade before my surgery). I was 5'7" after surgery. Now due to age and deterating discs, I'm back to 5'5"
                    T12- L5 fusion 1975 - Rochester, NY
                    2002 removal of bottom of rod and extra fusion
                    3/1/11 C5-C6 disc replacement
                    Daughter - T7 - L3 fusion 2004

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