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Leg Length Discrepency and Scoliosis

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  • Leg Length Discrepency and Scoliosis

    We took our daughter (age 14) to the orthotist today to be cast for her Providence brace. She has a 30 degree thoracic curve.

    In taking her measurements, he said that it looked like one leg was shorter than the other. He was quite sure of this.

    Our daughter broke one leg when she was 9 years old, and as far as we know it healed properly. Of course, an orthopedist was overseeing her healing. Nobody ever mentioned anything to us about one leg being different from the other after that. I'm not sure if the fact that one leg was broken has anything to do with it, or not. There's an adult female cousin on my husband's side of the family that apparently had to have some sort of operation when she was 11 years old to help correct a similar problem. She was told that if it wasn't corrected she could get scoliosis.

    I was wondering if it's common to see this with scoliosis? And...does it mean anything regarding the scoliosis? When we see the doctor again in about a month I plan to mention it to him (we recently saw a specialist at Stanford Univ. Hospital, Dr. Rinsky).
    14-yr-old daughter recently DX'd with 30 degree thoracic curve. Night-time Charleston Brace started in May 2008.

  • #2
    Hi...

    My understanding is that the only way to know if one leg is longer than the other is with a special xray of both legs. Since most people with lumbar or thoracolumbar scoliosis have an uneven pelvis, it usually looks and feels as though one leg is longer than the other.

    --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
      Over time leg length discrepencies can lead to scoliosis, as well as knee, hip and ankle problems, if the difference is significant. Do a Google search and you'll find lots of info.

      There are both surgical and non-surgical methods to deal with this. Shoe lifts are often used for small differences, especially in children. Since the legs can grow at different rates, small discrepencies can change over time and therefore should be checked on a regular basis.

      Surgical intervention is usually reserved for discrepenies of greater than 2-3 cm. Legs can be either shortened or lengthen. The lengthening procedure is typically used for large discrepancies.
      Mom to Haley, 13.5 yrs old
      Diagnosed at 6 yrs old - 18T.
      Boston Brace at 9.5 yrs old - 34T/18L
      Switched to SpineCor at 10 yrs old
      Stable at ~22T OBX until 12.5 yrs old
      Adolescent growth spurt was brutal - scheduled for surgery Dec 7th.

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      • #4
        My daughter had curves of 61T and 53L prior to her fusion last August. She was fused T2-T11, leaving the lumbar curve alone since it was felt to be compensatory. Since her surgery, the lumbar curve as of Feb was only reduced to about 35 degrees---and, she has a "lean" to the left when looking at her from behind. She tends to bend her right knee when standing which then makes her "lean" go away, however, that then throws her hip out of alignment.

        She's been going to physical therapy (we saw several therapists), and all investigated to see if she had a true leg length discrepancy. She hasn't had an xray (mentioned above), but her doctor and all of the therapists don't think that it is a real leg length issue. They had her standing and laying on her back and stomach to determine whether the bones appeared longer than each other (they don't). But, she does show some signs (wearing of the foot pad) of having leg length issues.

        She is being fitted for shoe orthotics to help a collapsed foot problem (can't remember the technical name of this), and the orthotist thinks she needs a lift in one shoe. He says she has an oblique pelvis, and convinced her doctor to use the lift. The physical therapist we've been seeing thinks we should hold off on the lift (which for now we are doing), that she can be helped by exercise and the orthotics without the lift, that the collapsed foot problem is causing the pelvis turn which is then contributing to the lumbar scoliosis...I had talked to her doctor about a lift in Feb, which at the time he didn't think she should use and said it could cause more problems down the road, but apparently he spoke with the orthotist last week and agreed to the lift.

        Prior to her fusion, she wasn't noticed to have any of these issues, but, her curves were fairly well balanced so perhaps it was overlooked?? Also, we have an appointment this month at Shriner's in Philadelphia, so who knows what opinion they may add (lol, it seems everyone has a different approach, just hope that we make the right choice and further fusion isn't needed).

        Good luck to you and your daughter.

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        • #5
          short leg problem dealt with

          I'm 55 years old. Looking back, I must have had one leg longer than the other back in high school (and I don't know how many years before) because I high jumped like a left-hander instead of a right-hander because my left leg is shorter and weaker. I always thought that my right shoulder was lower because I was right handed and tended to carry heavier things in my right hand.

          When 29 years old, I began to have pains, maybe because I wasn't so active on my job and did more standing around. When I was active and not standing around, my weight shifted more often from one foot to the other whereas when less active and standing around, my weight was frequently on both feet.

          I got back into running but I my back was super stiff. I tried stretching and even hanging upside down to relieve my back stress but it didn't help. I tried wearing a shoe lift but I don't think I saw results right away.

          One day when I was using a weight machine to do some arm exercises that involved my back, I realized how much weaker the left side of my back was. It was probably around then that I looked at the rest of my left side and saw that my left thigh and calf were smaller, too.

          I began to do exercises to strengthen my left side. It took a while to do and as I did it, I noticed that I felt my leg difference more as I stood. It seemed as though I needed a shoe lift for my left side.

          I made a lift and wore it even when running. I wasn't sure how much shorter my left leg was but wearing a lift a whole inch high seemed to relieve back/hip pain. I kept exercising to be more equal and as my left side muscles gained strength, the greater muscle mass pressed on my sciatic nerve, causing great pain. I worked through it, going back to a shorter lift and increasing its height as it seemed my hips were telling me to use to make my hips level. I "maxed out" with a lift of about 3/8 inches and I guess my sciatic nerve got used to the new shifted position and the pain stopped.

          So, for about 25 years I've been putting 3/8 of an inch lift in my left shoe when I'm standing around. I don't like to always wear it and it feels funny when I go bare feet because it feels as if I'm standing on a slanted floor, but I deal with it by putting my weight on one foot or the other but not equally on both.
          There's been a couple of times when my lifts gradually shrank (the felt ones gradually wore lower and the rubber ones gradually got compressed). When I realized it, I had to build the lifts back up. Unfortunately, my sciatic nerve gradually moved to the old position and when I shifting my body back to upright made me endure another 2 weeks of pain.

          I don't have back pains any more. I'm sure that if I didn't use the shoe lifts, I'd have the same sort of back pains that my siblings have had to deal with, including they having their vertebrae fused. It helps that I'm athletic, including running. I don't use the lift when running because I'm only on one foot at a time, though I've been told that my form is inefficient and causes me to use more energy because I kind of rotate my body to the left launching off one of my feet.

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