Page 1 of 7 123 ... LastLast
Results 1 to 15 of 102

Thread: Regarding likely outcome on pain

  1. #1
    Join Date
    Jan 2008
    Location
    NC
    Posts
    8,903

    Regarding likely outcome on pain

    (from the other thread)

    I don't know about adults nor about Anand's minimally invasive technique but I can say the literature that I was given for my kid stated the following:

    Is it common for a child to have occasional back ache months after spinal fusion?

    No, this infrequently happens.
    Then it goes on to say which pain relievers should be taken and for how long.

    I am guessing it is similar for adults but I certainly don't know that.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  2. #2
    Join Date
    Jan 2008
    Location
    NC
    Posts
    8,903
    Quote Originally Posted by hdugger View Post
    My concern/question was a little different.

    Will a patient who is now in pretty serious pain with scoliosis affecting the lumbar region (as JDM55 was, in the thread where the claim was made) have their pain completely eliminated by this or any other kind of scoliosis surgery.

    My sense is that the answer to this question, by any conservative surgeon, would be "we would certainly hope to reduce the pain, although we can't guarantee that, but it's not likely that we would completely eliminate it."
    I'd like to know the likelihood of eliminating pain completely in adult lumbar patients. It might be the majority of patients like with kids.

    If that's the case then a conservative surgeon would necessarily say that.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  3. #3
    Join Date
    Jan 2008
    Location
    NC
    Posts
    8,903
    As an additional experiment, try googling on:

    eliminate scoliosis pain

    The only things that I see come up from practioners is people associated with Spinecor and Schroth. It's not a phrase that orthopedic surgeons generally use to describe the outcome of their surgery.
    Yes I see that point but that is clearly an imperfect method to find the straight dope on this as it doesn't return the fact that most kids at least have zero pain after healing.

    So if it missed that then it might miss that most adults have zero pain after surgery (if that is the case).

    Anand is on the group now... maybe he will comment.
    Last edited by Pooka1; 12-28-2009 at 07:21 PM.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  4. #4
    Join Date
    Jan 2008
    Location
    NC
    Posts
    8,903
    Quote Originally Posted by hdugger View Post
    I think the bit you posted form the pamphlet referred to children, who are seeking surgery to stop progression but who do not have pain from their scoliosis, and it's reassuring you that the surgery will not *cause* pain. That's a reasonable assurance - I imagine that the surgery mostly does not cause pain in patients who didn't originally present with pain.
    Yes all that is true but I still want to know about the rate of pain elimination in adults.

    I'd also like to see if adults who are pain free have similar outcomes to kids who largely don't have pain.

    And by the way, my one kid with the rapid curvature rate did have pain pre-surgery that completely disappeared some months after surgery.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  5. #5
    Join Date
    Jan 2008
    Location
    NC
    Posts
    8,903
    Quote Originally Posted by hdugger View Post
    I actually meant that to indicate a kind of "snake oil salesman" kind of language. It's the thing that I find off-putting about the Spinecor and Schroth, and I find it equally off-putting in a surgeon.
    But it is clearly not strictly snake oil salesman lingo when a surgeon says it, at least w.r.t. kids and possibly w.r.t. adults.

    It either is or isn't the case that most adult lumbar patients have all their pain eliminated after the healing period. If it is the case then a surgeon pointing that out is not a snake oil salesman.

    I, too, find it off-putting when Spinecor and Schroth purveyors say it because it is brace- and PT-dependent as far as anyone knows and also they likely have no evidence to back it up like surgeons do if/when they make the statement. Surgeons saying that are just relaying the evidence.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  6. #6
    Join Date
    Apr 2009
    Posts
    1,258
    The SRS surgeon Dr. Anand, may shed some light on this for us :-)

    My two cents on this is: I've had several surgical consultations - the most recent with an SRS surgeon. I was not told that my pain would be eliminated. I was told we would hope that the pain would be reduced. No promises. My Spinecor provider made no promises either - but rather explained that many adults (in my age group) experience immediate pain relief - not all, but many. Do some people experience total elimination of pain with surgery - I believe so from what some members report in forum. Do all of them? Certainly not, again from what is reported in forum.

    Does it all boil down to a combination of treatment and patient condition? I think so, in which case - it may be best for anyone advertising to say: the treatment may reduce or eliminate pain.

    There just aren't any guarantees - with any treatment, and if someone tries to sell us one - I think we should run!

  7. #7
    Join Date
    Sep 2003
    Location
    Northern California
    Posts
    6,797
    Improvement of back pain with operative and nonoperative treatment in adults with scoliosis.

    Smith JS, Shaffrey CI, Berven S, Glassman S, Hamill C, Horton W, Ondra S, Schwab F, Shainline M, Fu KM, Bridwell K; Spinal Deformity Study Group.

    Departments of Neurosurgery and Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia 22908, USA.

    OBJECTIVE: The purpose of this study was to assess whether back pain is improved with surgical treatment compared with nonoperative management in adults with scoliosis. METHODS: This is a retrospective review of a prospective, multicentered database of adults with spinal deformity. At the time of enrollment and follow-up, patients completed standardized questionnaires, including the Oswestry Disability Index (ODI) and Scoliosis Research Society 22 questionnaire (SRS-22), and assessment of back pain using a numeric rating scale (NRS) score, with 0 and 10 corresponding to no and maximal pain, respectively. The initial plan for surgical or nonoperative treatment was made at the time of enrollment. RESULTS: Of 317 patients with back pain, 147 (46%) were managed surgically. Compared with patients managed nonoperatively, operative patients had higher baseline mean NRS scores for back pain (6.3 versus 4.8; P < 0.001), higher mean ODI scores (35 versus 26; P < 0.001), and lower mean SRS-22 scores (3.1 versus 3.4; P < 0.001). At the time of the 2-year follow-up evaluation, nonoperatively managed patients did not have significant change in the NRS score for back pain (P = 0.9), ODI (P = 0.7), or SRS-22 (P = 0.9). In contrast, at the 2-year follow-up evaluation, surgically treated patients had significant improvement in the mean NRS score for back pain (6.3 to 2.6; P < 0.001), ODI score (35 to 20; P < 0.001), and SRS-22 score (3.1 to 3.8; P < 0.001). Compared with nonoperatively treated patients, at the time of the 2-year follow-up evaluation, operatively treated patients had a lower NRS score for back pain (P < 0.001) and ODI (P = 0.001), and higher SRS-22 (P < 0.001). CONCLUSIONS: Despite having started with significantly greater back pain and disability and worse health status, surgically treated patients had significantly less back pain and disability and improved health status compared with nonoperatively treated patients at the time of the 2-year follow-up evaluation. Compared with nonoperative treatment, surgery can offer significant improvement of back pain for adults with scoliosis.

  8. #8
    Join Date
    Apr 2009
    Posts
    1,258
    I would have some questions about that study - what are the results 20 years down the road, etc, etc.

  9. #9
    Join Date
    Sep 2003
    Location
    Northern California
    Posts
    6,797
    Quote Originally Posted by mamamax View Post
    I would have some questions about that study - what are the results 20 years down the road, etc, etc.
    I agree. At least you know that the 20-year follow up is coming. I'd like to see even a 5 or 10 year follow up to Schroth, Clear, or any of the other alternative methods.

    --Linda

  10. #10
    Join Date
    Jan 2008
    Location
    NC
    Posts
    8,903
    I will settle for no less than a 90 year follow up out of Schroth.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  11. #11
    Join Date
    Apr 2009
    Posts
    1,258
    Quote Originally Posted by LindaRacine View Post
    I agree. At least you know that the 20-year follow up is coming. I'd like to see even a 5 or 10 year follow up to Schroth, Clear, or any of the other alternative methods.

    --Linda
    Agreed - I would like a lot more long term studies than we are provided with. Schroth should have more than we see. I wonder if they exist but have not yet been translated? So far, Spinecor only has one 5 year follow up with adults I believe. And by the time we have a long term surgical follow up - techniques will have changed. In the non surgical world - Martha's 15 year study looks great - but how on earth do we duplicate it? Complicated :-)

  12. #12
    Join Date
    Jan 2008
    Location
    NC
    Posts
    8,903
    Quote Originally Posted by mamamax View Post
    So far, Spinecor only has one 5 year follow up with adults I believe.
    If you find that can you please post it?

    'kay thanks.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  13. #13
    Join Date
    Jan 2008
    Location
    NC
    Posts
    8,903
    Quote Originally Posted by hdugger View Post
    Thanks, Linda. That answered my question. So, taken as a whole, the surgical patients saw their pain reduced (roughly in half), but not eliminated. That's in line with what I'd expect, based on listening to adults after surgery on this forum.
    Those are means. There could be plenty of patients who had their pain eliminated.

    Again, if I went into a surgeon and he had a brochure stressing "eliminate pain," I would walk out of the office.
    I doubt any surgeon stresses "eliminating pain" unless they have evidence for that. Anand didn't stress it. He mentioned it because surgery can eliminate pain. I think surgeons will give evidence for rates of reduction and elimination among their patients.

    I have no argument that surgery can straighten a spine and reduce pain. Eliminating pain, though, in people who already have significant pain, would be an unusual outcome
    Not sure we know that. And what of people with "some" pain? Maybe most of that is entirely eliminated.

    Who knows.
    Last edited by Pooka1; 12-29-2009 at 01:19 PM.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  14. #14
    Join Date
    Apr 2009
    Posts
    1,258
    Quote Originally Posted by Pooka1 View Post
    If you find that can you please post it?

    'kay thanks.

    My mistake! Sorry - There is only a retrospective study (oral presentation) with 23 adults: http://www.scoliosisjournal.com/content/2/S1/S23

    But at least we know there is one coming

  15. #15
    Join Date
    Sep 2003
    Location
    Northern California
    Posts
    6,797
    Quote Originally Posted by mamamax View Post
    So far, Spinecor only has one 5 year follow up with adults I believe.
    I'd like to see that if it exists.

    Quote Originally Posted by mamamax View Post
    In the non surgical world - Martha's 15 year study looks great
    Martha Hawe's does not have a 15-year study. She has an anecdotal case, which has never been reported in a peer reviewed journal.

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •