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  • sagital imbalance?

    Have not posted in a while (always look in though to see how everyone is doing), all is fine except my posture, it seems to me that my hips are pushing forward when I stand, making my belly look pregnant, I'm about 5'51/2" tall and weigh about 132lbs. I look like a skinny (old) preganant woman. Also my neck with I am experiencing pain is also jutting forward. I tried to understand what sagital imbalance is from the posts on this forum and on line.
    I have an appointment with a recommended physical therapist on Tuesday coming, this therapist I'm told is all about posture. When I see him I will ask his opinion also. So I guess my question is, could my changing posture have anything to do with sagittal imbalance? thanks, hope everyone is doing well!
    Dolores A
    June 4, 2009 Anterior L3 - S1
    June 8, 2009 Posterior T4 - Pelvis
    Mark Agulnick, MD FAAOS
    NY Spine & Scoliosis Center

  • #2
    Sagittal imbalance

    Hi -- I had surgery last December, and also notice, now, that my head juts forward. It was probably that way before but I am very conscious of it now. I try to consciously push my head back, but it seems very unnatural. When I sleep on my back, I sleep without a pillow, thinking that might help, but really don't know. If you find your therapist helpful with the posture issue, I would appreciate his information, as I am in the NYC area (I assume you are also). Thanks very much.

    Comment


    • #3
      Hi Susan, thanks for your input, I will post after my appt. with therapist what comes of the consult, not sure yet if I should notify my surgeon of what is happening. What levels are you fused?
      Dolores A
      June 4, 2009 Anterior L3 - S1
      June 8, 2009 Posterior T4 - Pelvis
      Mark Agulnick, MD FAAOS
      NY Spine & Scoliosis Center

      Comment


      • #4
        Sagittal imbalance

        Hi Dolores -- I am fused from T3 down to the sacrum, with pelvic anchors. Had a really severe curve (double major, both over 90 degrees) but never had any pain or problems associated with the curves, just I was getting shorter and the curves were increasing; so I was corrected to approximately 60/50 degrees, so still crooked but much better than before. I next see my surgeon (Dr. Boachie) in November, but when I asked previously about the posture issue, he said just to make an effort to hold my head high, but nothing about seeing a therapist. I will ask him next visit, but in meantime, if I could find a posture therapist, I think that would be of tremendous help. So if you find yours to be helpful, I would appreciate your input about him. Thanks so much! Hope your visit goes well.

        Comment


        • #5
          I am fused from T4 to sacrum and had my surgery by Dr. Lenke about 10 weeks ago. I have had a very good recovery so far. I saw him in St. Louis on Sept. 19 and told him that my neck was jutting forward somewhat and that I couldn't tilt my head back at all to put drops in my eyes. (I have to lie down in bed now to do this.) He looked at my before and after surgery x-rays and said that my neck looked the same. It is not. I also can't tilt my head back to drink the last part of water, etc. in a glass. All of this is small stuff since I am now free of lumbar pain and have a straight spine but it does bother me somewhat as he did not seem to have an answer for it or a remedy.
          Jane

          Comment


          • #6
            Sagittal imbalance simply means that your spine is not balanced in the front/back plane. THIS article explains it in fairly simple language.
            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


            • #7
              Sagittal imbalance was one of the problems I was most concerned about, that and infection. Dolores, do you know if you had osteotomies? I had some but never found out how many and have a decent curve in my lower back, similar to what I had as a teenager. So far no problems. How does your lower back look - is there plenty of lordosis? I might be on the wrong track but think s.i. has to do with your lordosis? Someone more knowledgeable maybe able to correct me on that.

              Hoping the therapist can help you Dolores. Please let us know.
              Surgery March 3, 2009 at almost 58, now 63.
              Dr. Askin, Brisbane, Australia
              T4-Pelvis, Posterior only
              Osteotomies and Laminectomies
              Was 68 degrees, now 22 and pain free

              Comment


              • #8
                Jane,

                My neck was pretty stiff at first, but it has gotten much better as the months have gone by. I used to be unable to tolerate a pillow, for instance. But now I can use one if I want. I think you will see an improvement in your range of motion over time, as long as you're not fused too high up.

                Evelyn
                age 48
                80* thoracolumbar; 40* thoracic
                Reduced to ~16* thoracolumbar; ~0* thoracic
                Surgery 3/14/12 with Dr. Lenke in St. Louis, T4 to S1 with pelvic fixation
                Broken rods 12/1/19; scheduled for revision fusion L1-L3-4 with Dr. Lenke 2/4/2020
                Not "confused" anymore, but don't know how to change my username.

                Comment


                • #9
                  Which way does a positiv or neg saggital or coronal imbalance lean?

                  Thanks Linda for the great resources.

                  Which way does a positive sagiital imbalance and a negative saggital imbalance lean? Same question for coronal imbalance?

                  Does zero sagittal and coronal imbalance means "normal or non-scoliotic" [I would assume since the word IMBALANCE is used]?

                  Thanks
                  Susan
                  Adult Onset Degen Scoliosis @65, 25* T & 36* L w/ 11.2 cm coronal balance; T kyphosis 90*; Sev disc degen T & L stenosis

                  2013: T3- S1 Fusion w/ ALIF L4-S1/XLIF L2-4, PSF T4-S1 2 surgeries
                  2014: Hernia @ ALIF repaired; Emergency screw removal SCI T4,5 sec to PJK
                  2015: Rev Broken Bil T & L rods and no fusion: 2 revision surgeries; hardware P. Acnes infection
                  2016: Ant/Lat Lumbar diskectomy w/ 4 cages + BMP + harvested bone
                  2018: Removal L4,5 screw
                  2021: Removal T1 screw & rod

                  Comment


                  • #10
                    Originally posted by susancook View Post
                    Thanks Linda for the great resources.

                    Which way does a positive sagiital imbalance and a negative saggital imbalance lean? Same question for coronal imbalance?

                    Does zero sagittal and coronal imbalance means "normal or non-scoliotic" [I would assume since the word IMBALANCE is used]?

                    Thanks
                    Susan
                    Positive sagittal balance is leaning forward. There's no difference in the designation for coronal balance; it can be either right or left. Zero coronal and sagittal balance is the norm.
                    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


                    • #11
                      Originally posted by LindaRacine View Post
                      Positive sagittal balance is leaning forward. There's no difference in the designation for coronal balance; it can be either right or left. Zero coronal and sagittal balance is the norm.
                      Thanks, Linda! You are such a wealth of knowledge! I am still learning the scoliosis language. Susan
                      Adult Onset Degen Scoliosis @65, 25* T & 36* L w/ 11.2 cm coronal balance; T kyphosis 90*; Sev disc degen T & L stenosis

                      2013: T3- S1 Fusion w/ ALIF L4-S1/XLIF L2-4, PSF T4-S1 2 surgeries
                      2014: Hernia @ ALIF repaired; Emergency screw removal SCI T4,5 sec to PJK
                      2015: Rev Broken Bil T & L rods and no fusion: 2 revision surgeries; hardware P. Acnes infection
                      2016: Ant/Lat Lumbar diskectomy w/ 4 cages + BMP + harvested bone
                      2018: Removal L4,5 screw
                      2021: Removal T1 screw & rod

                      Comment


                      • #12
                        I'm sorry you're having problem Dolores. Have you had this issue since your surgery or is it new? Are you having any pain with this problem? ((Hugs))
                        __________________________________________
                        Debbe - 50 yrs old

                        Milwalkee Brace 1976 - 79
                        Told by Dr. my curve would never progress

                        Surgery 10/15/08 in NYC by Dr. Michael Neuwirth
                        Pre-Surgury Thorasic: 66 degrees
                        Pre-Surgery Lumbar: 66 degrees

                        Post-Surgery Thorasic: 34 degrees
                        Post-Surgery Lumbar: 22 degrees

                        Comment


                        • #13
                          Please help

                          Hi to all,
                          I have read the article on sagital imbalance--I feel I may have a problem with it. I have a 16 level spine fusion,done in last year and a half. and 3 level cervical.All summer I have had a harder time walking and have found myself leaning rt and shiffting my hips out and locking my knees. It is tiring to say the least. I fell several times now, and I am back at Pt. The Pt has found right leg shorter and is working on muscles to help that. Thus I am falling right. I do not see the Dr until Dec. I am beginning to think it is a balance issue,and I tried to explain to Pt. I know the people here understand much more about this then even he does. We do deal with things like this all of the time. My question is should I bring this to Dr before Dec, as I will lose my insurance in Feb. Very scary!Please let me know what you think.
                          T10-pelvis fusion 12/08
                          C5,6,7 fusion 9/10
                          T2--T10 fusion 2/11
                          C 4-5 fusion 11/14
                          Right scapulectomy 6/15
                          Right pectoralis major muscle transfer to scapula
                          To replace the action of Serratus Anterior muscle 3/16
                          Broken neck 9/28/2018
                          Emergency surgery posterior fusion C4- T3
                          Repeated 11/2018 because rods pulled apart added T2 fusion
                          Removal of partial right thoracic hardware 1/2020
                          Removal and replacement of C4-T10 hardware with C7 and T 1
                          Osteotomy

                          Comment


                          • #14
                            hi jackie
                            i absolutely think you should get in to see your doctor
                            before December...why wait...???? will your insurance
                            cover it...? if so, again...why wait...??
                            what if you need tx...and it cannot be completed by
                            February...? why not get a jump on it now...

                            hope you feel better....
                            jess

                            Comment


                            • #15
                              I agree with Jess. It may not be what you're thinking, but it may. Ring today for an appt and get the ball rolling. The urgency is mainly because of your insurance situation. Good luck!
                              Surgery March 3, 2009 at almost 58, now 63.
                              Dr. Askin, Brisbane, Australia
                              T4-Pelvis, Posterior only
                              Osteotomies and Laminectomies
                              Was 68 degrees, now 22 and pain free

                              Comment

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