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Is surgery ALWAYS inevitable?

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  • Is surgery ALWAYS inevitable?

    I am a 46 yo female having posted previously needing info.

    Thanks Linda!! for the wonderful info..I'm going to follow up with a consult with Dr. Bradford at UCSF if I can get an appt. .. all the docs mentioned take my insurance!!, and have ordered Elise Browne's yoga for Scoliosis CD.

    I have a 66 deg T curve with a 55 deg compensatory curve with no real pain,just tiredness and occasional pinching sensation at my bend wondering..

    *Is surgery always inevitable with large curves such as mine? anyone ever heard of a person living 'til old with scoliosis untreated by surgical means?..will there always be lung/heart issues??
    *The pinching type sensation at my bend is a wierd feeling..due to the twisting at that point??anyone else experience this type feeling?
    *Is the 55 deg compensatory curve a L curve??my report does not say
    *Will I easily be able to tell if my lungs or heart is being affected by the scoliosis??
    Thanks all I have been happy to find this site!

  • #2
    Hi Kimbo...

    Dr. Bradford is semi-retired, so I'd recommend that you make an appointment with one of the other three doctors.

    To answer some of your questions:

    *Your compensatory curve could be almost anywhere. Without seeing your x-rays, no one can tell you where it is.

    *I know of several people with curves similar to yours who are still living. If you're average, you can expect a 1-2 degree curvature increase per year. So, 20 years from now, your thoracic curve might be 86 to 106 degrees. At that point, you definitely could have significant pulmonary function loss. The problem with waiting to see if that happens is that you might find that you're no longer a surgical candidate because of your pulmonary status. My recommendation is to find a doctor you can trust, and then go along with whatever they recommend.

    Whether or not you can know if your heart/lungs are becoming affected is something I don't know. I've known people with smallish curves who claim that they are always short of breath, and people with very large curves who say that they haven't noticed anything. Since there are a lot of other things that can affect pulmonary function, I don't think there's any real way of estimating who will have a big problem and who won't. The Weinstein study of 2002 (Health and Function of Patients with Untreated Idiopathic Scoliosis: A 50-Year Natural History Study) addresses the issue of pulmonary function. Here are the important points:

    *All 4 patients with chronic obstructive pulmonary disease had large curvatures involving the thoracic spine (one 82° double major curve and 3 thoracic curves averaging 101°).

    *Twenty-two (22%) of 98 patients reported shortness of breath during everyday activities compared with 8 (15%) of 53 controls.

    *Thirty-five (39%) of 89 patients and 15 (31%) of 48 controls had shortness of breath while walking 1 city block. Smoking status was not related to shortness of breath in either the patient or control group.

    *Although there were no significant differences in reported shortness of breath with activities between groups, there was a relationship between shortness of breath and the size and location of the curve (unadjusted odds ratio [OR], 2.13; 95% CI, 0.72-6.28). For patients with relatively small curves (<80° with thoracic involvement or <50° lumbar), those with a thoracic apex were at no greater risk for shortness of breath with activities than those with a single lumbar curve (adjusted OR, 0.43; 95% CI, 0.08-2.44). However, patients with the combination of a large (>80°) curve and a thoracic apex had significantly greater odds of shortness of breath than did those with large (>50°) lumbar curves (adjusted OR, 9.75; 95% CI, 1.15-82.98).

    Hope that helps.

    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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    • #3
      Linda,

      What are the names of the other three doctors in San Francisco? Would you recommend any of them over the others? Thank you.

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      • #4
        Serena Hu, Sigurd Berven and Vedat Deviren. I would let any of them operate on me if necessary.

        --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

        Comment


        • #5
          Hi Kimbo,

          We have just been having this discussion about living to older years without surgery in the "Psychological Effects" section of this forum. At least two of us (age 56 and 47) have weighed in with not opting for surgery and feeling pretty good.

          Again, it would be great to hear from older folks who have managed their scoliosis without surgery.

          Octavia

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