View Full Version : x rays and post op visit @ 9 wks.

12-22-2010, 09:51 PM
Well, I returned to Dr. Lenke this on the 15th and he said everything is looking good. I am still having a lot of muscle aches and told him that I was having to use a vicodin daily around 4pm still. He asked where the pain was and I showed him on the xray you can see (if I attached it right :) the end of the hardware and the small curve in my lumbar area (he is hoping this will pull in or at least not change with the correction that I had). He told me to start doing measured forward and backward bends to exercise those muscles. I think that it is helping. I am sore but am feeling less localized pain in this lumbar area. Does anyone have any experience with the rest of the spine pulling in after time with the muscles strengthening?

12-22-2010, 10:40 PM
Did you have to wear a brace post-op?
At 9 weeks,how do you feel? If you could, would you be able to go back to do regular activities at this point?

12-23-2010, 08:02 AM
Pilar, no, my doc says no brace for me, he wants the muscles to get strong as soon as possible and feels that the brace delays that. He assured me that the hardware would hold until they are strong and then the fusion. I am back to full daily activities, taking care of my 1 and 6 year olds and working full time at my desk job. I am doing all of my household stuff with exception of cleaning my bathtubs (have yet to figure out how to do that with my restrictions). I get achy but the achiness is nothing compared to the pain that I had pre-op. It is a good workout/sore kind of achiness ever since I started the exercises last week. My energy level is still kinda lacking but it is getting better.

Anyone with knowledge of the lumbar curve improving over time???

12-23-2010, 09:55 AM

What levels are you fused? It looks similar to mine.

I think what you're describing is what I am experiencing, too. I am still sore in my lumbar area, especially when I use those muscles - like if I shift myself in a seat (in the car for example), it is very sore. Like you this is all below my fusion but it's the most soreness I've had.

I am hoping that curve is still improving too.

I'm glad you got a good report from Lenke :).

12-23-2010, 01:15 PM
JamieAnn, Yes, I believe that he told me T4 to L1 was my fusion. I was almost having some burning sensation in the lumbar and it felt to me that it was the end of the instrumentation maybe rubbing around (not sure how to describe). It was always by the end of the day (the longer I was upright) when the burning/pain would intensify. I do think that those exercises are helping though. So were you told it could improve yet also?

I was just wondering if anyone has had that lower curve continue to improve??

12-23-2010, 01:27 PM

Did Lenke mention what kind of T curve you had? It looks similar to my one kid who had a false double. This is a structural T curve with a largish compensatory L curve. My kid's L curve improved a lot on the table but then crept up slightly. These days, over a year out, I think it has improved just by how she stands. The hips are almost completely even whereas that was less the case earlier on. She does no PT.

She is Kid2 in this thread...her post op radiograph looks similar to yours to my eye but who knows...


Edited to add... both my kids are fused T4-L1 and I can't recall either complaining about any pain at the base of the fusion other than Kid2 who sustained a "hug" injury when she was pulled forward only several days post op by a short friend. That resolved completely after another several days. Were you pulled forward sharply at any point? The fusion has to end somewhere and this is always a concern I suppose.

12-27-2010, 08:42 AM
Pooka1, I am glad you mentioned this. I had forgotten about him talking about this. He said that the lower correction was much better in adolescents but could improve in mine as well. Something about the muscles getting stronger? I don't remember having any jolts fresh postop but I did fall at 6 wks postop on the ice. I think the postop in the hospital xrays prior to discharge looked about the same though. I think that you are right though, Kid2's look like mine, I think. just looking at that makes me think that if they would have done the surgery when I was younger, maybe better correction, but who knows, right?

12-27-2010, 09:38 AM
I don't know the answer. I think the specifics of the curve might dominate the post-op trajectory as much or more so than patient age. It's biomechanics that determine the trajectory as far as I know.

I will report back what my daughter's curve has done in June 2011. That will be 1.5 years post op. I have all her radiographs and reports and will tell you what the curve did when.

But I think you can hope for some more correction slowly over time as your body finds the new balance. The newly straightened T curve drives much of the balance-induced correction on the table... it essentially never re-develops after the T curve is corrected because it doesn't have to in order to maintain the balance. Then slowly over time your muscles and ligaments allow more correct as they loosen to accommodate the new balance that is being imposed by the straighter T curve. At least that is what I think happened with my daughter looking at the radiographs and her posture.

I can imagine where PT might accelerate this process or even achieve a better correction than with no PT but I don't know that. My daughter's posture issue is so minor that it would be hard to justify PT only for that... she is a busy girl and has much more important things. Of course that decision is entirely in my daughter's camp... whatever she wants to do. In fact even at her worst post-op balance (to my eye), it never bothered her so I doubt she will be seeking PT now.

Within the set of T curves, the false double seems to be a raw deal. My other kid had a different type of T curve and her L curve disappeared on the table, never to return. That's perfect or near perfect balance. She does not meet the definition of scoliosis (neither curve is >10*). Kid#2 has residual curves in both the fused and L portion that, though small, both meet the definition of scoliosis. She will have to rely on the balance built into the spine by the surgeon to hold stable for life. The surgeon claims her L curve will be stable.

Good luck.