Finally!

[Pooka1]

Sharon, I suspect the reason for not fusing skeletally mature curves below 50° is partially from the risk of decompensation (a lower degree of curvature could make it tougher to identify involved vertebra). This is just an assumption based on what I know ... and I could certainly be wrong.

Okay I never heard that mentioned. So are you saying that the curvature is "destined" to be what it is and that even trying to fuse it when its relatively small will not stop the curvature from approaching its "destined" degree?

Or am I misunderstanding that. I think Linda stated point blank that earlier shorter fusions can avoid longer later fusions. From that I take it my kids could possibly have had shorter fusions had they been fused at 40*.

Did I miss somewhere that Osumike definitely has a double major curve vs. simply a structural thoracic with a compensatory lumbar?

No I am just assuming that at this point because the surgeon reported out the lumbar degrees. I have yet to hear what the L degrees are on either of my kids because it has been determined that they are not structural I assume. So when someone comes on here saying the surgeon told them what each curve is, I assume both are structural but maybe that is a bad assumption!

Furthermore, I have gotten the distinct impression that when the curves are about the same size and especially when both are relatively large, then both are structural. Maybe that is highly inaccurate though! Also, we have now between this forum and another at least 3 cases where someone had roughly equal curves and only one was fused and the other turned out to be structural. It's a ridiculously small sample size but I have yet toi read a testimonial where the curves were both large, one was fused and the other straightened out on its own which of course is not to say it never happens.

It isn't all that unusual for compensatory curves to be misread as structural by non-specialists: My original orthopedic used to always measure my lumbar curve, too ... and it's fusion-free 30 years later because it was never actually structural.

Okay but how large was it with respect to your T curve? Was it almost as large?

[txmarinemom]

Perhaps it's as simple as it IS a major surgery, and non-surgical management is preferable vs. the risks of surgerical correction of a smaller curve that doesn't have documented progression.

Edit: I'm curious now, and (like I don't need to be doing schoolwork - LOL!) am going to do some digging ... will report back.

As far as doctors giving a lumbar measurement in cases of true double major vs. structural/compensatory combos, it doesn't sound like the doctor who took that measurement was a surgeon (Osumike stated he referred him to an orthopedic surgeon). I'd believe someone who's not a specialist would measure a compensatory curve just because I've heard it so often.

My lumbar curve was pretty close to my thoracic curve (measurement-wise) back in the early days - at least within 5 degrees or so - but no one ever measure that curve after adolescence.

[titaniumed]

Hi Mike

Welcome to the forum. 62, 50 is gettin up there. I made it to 70,70 that was fun.
Doing quite well now after surgeries.
Good luck with your decisions.


Sharon,
I failed sandbox in kindergarten.I know, it happened. I don't share that with just anybody you know. LOL

I posted a hand drawn example months ago I believe on one of Dingo's, or CD threads about how a particular curve can happen over the whole spine or over just a few vert and be the same included angle. I don't know if you saw that. Its on a Cobb measurement thread.

I can look for it if you want. Or re-draw and scan.

It throws a wrench in the gears as far as length of fusion is concerned, progression and compensation. Curve patterns are unpredictable.


Hi Pam,
Glad your back, we missed ya.

Ed

[Pooka1]

Sharon,
I failed sandbox in kindergarten.I know, it happened. I don't share that with just anybody you know. LOL

That's okay Ti Ed, I'm presently failing short-term memory class.

I posted a hand drawn example months ago I believe on one of Dingo's, or CD threads about how a particular curve can happen over the whole spine or over just a few vert and be the same included angle. I don't know if you saw that. Its on a Cobb measurement thread.

I can look for it if you want. Or re-draw and scan.

It throws a wrench in the gears as far as length of fusion is concerned, progression and compensation. Curve patterns are unpredictable.

Not sure I'm following but I would guess that T curves of a certain magnitude almost always involve X vertebrae and L curves of a certain magnitude almost always involve Y vertebrae. I'm suggesting a physical requirement/restraint on space-filling with this. Now TL curves might vary somewhat more in the number of involved vertebrae I imagine. Just guessing here.

A point in favor of this thought is the apparent prevalence of say T4-L1 fusions for T curves with an apex ~ T9. There must be some reason that particular section of 10 vertebrae is often fused and I'm guessing it is a function of the (usual) apex combined with the conventional surgical trigger angle (50*).

Of course lay people shouldn't conclude a damn thing from random testimonials so there's that.

[osumike]

Hey guys- Just an update here. I HAD an appt. With Dr. Andreshak, on Oct. 16 that I ended up cancelling. A week and a half before that, I made an appt. with another orthopedic surgeon in Toledo (Dr. Beeks). He took some more x-rays and measured it out to be 68 degree thorasic and 62 degree lumbar. The previous measurements were 62 and 50. (Why such a big difference? It was only a month between x-rays.) Anyway, he said my case would probably be best handled by someone with more experience on this. He mentioned Dr. Lenke in St Louis and Dr. Orr at the Cleveland Clinic. My appt. with Dr. Orr is on Nov. 24. I think I read Bionicwoman just had an appt. with him? Would love to know how that went. Also, on another note, was wondering if any of you had been taking pain meds alot before surgery? Ive been taking Percocet and skelaxin for a few months now. The pain on my spine and lower back and left rib cage has been terrible.

[osumike]

Sorry- I guess it was Berlinmom that had the appt. with Dr. Orr, not Bionicwoman!

[jrnyc]

Hi Osumike
so sorry you are in so much pain..sent you a private message...

best of luck
jess

[Shari]

My surgeries were at the Cleveland Clinic. My doctor was, Dr. Robert McClain. I remember seeing Lenke's name. Find the doctor you are the most at ease with, I had seen many over the years, and I knew within 5 to 10 minutes that he was the man I was trusting my life to.

It's an instant relief, and a gut feeling.

Good Luck with your search,
Shari

[Doodles]

Osumike--
Dr. Lenke was my doctor and he is very, very good. He is extremely good at the most difficult cases and does it all posterior even on mine. I was actually scheduled to have it done by a Texas doctor and decided I needed a second opinion and went to Dr. Lenke in Sept. of last year. My surgery was March 30th. This guy knows his stuff but it takes time to get to see him and get on the surgery schedule. Good luck. Janet

[BerlinMom]

Hi OSUmike, I had my appointment with Dr. Orr on Oct. 14 and I liked him. He explained just what the problems were, what needed to be done about them and how it would help. He told me percentages for improvement and odds of having to have another surgery in the future, risks, length of surgery, hospital stay and how recovery would likely move along. He didn't sugar-coat the seriousness of the surgery & recovery. I appreciated his honesty and thoroughness of information. He encouraged questions and had a good sense of humor. Like Shari said, I knew within 10 minutes that I had finally found the surgeon for me. I asked him how far out he was scheduling surgeries and he said that for big ones it's after the first of the year.

Good luck,
Peggy

[osumike]

Went to see Dr. Orr last month- He ordered more X-rays(benders), and MRI's of upper and lower back. So, I went this mornibg to have all that done and it was a disaster. They had me in the MRI tube for over an hour, and could'nt handle it anymore. The pain from just laying on that board was horrible and had to end the test. Ill stll have to go back for the lumbar MRI. So after that I went back for the Xrays and they acted like they didnt know what bending Xrays were. On top of that, since I'm 6'9", they werent sure they would even be able to do the benders. I dont know. This whole thing has just gotten to be such a pain in the ass.

[jrnyc]

can you get the xrays done at a hospital that scoli surgeons operate in? did you take a bunch of pain meds before you got in the "tube"....that helps me...

this has to be fixable..you need to be out of the pain long enuf to get the films done...pain meds for a few hours could help you handle that...& hospitals that scoli doctors use usually have xray techs that know enuf about all kinds of spine x rays..

good luck
jess

[osumike]

yeah, im making the appt's at the hospital where the surgery will be now. that will be easiest i think. and yeah, my doc gave me something to take before the next mri. Klonipen. I guess its for panic attacks. I took 2 percocets and a skelaxin before the first one, which hardly helped at all.

[sillycoffeegirl]

mri

hope you did good in your mri. i didnt take anything for mine i was fine except for almost falling asleep most of the time. lol i didnt want to fall asleep cuz i knew i would move. Then when i got done it was like a time warp so late in the day. lol I hope yours goes smoothly.

[osumike]

yeah I hope so. I think my curves are similar to yours. Did you get bending x-rays taken? If so, how did you do it? And did they give you any idea on an amount of correction? Also, just curious, where are you from and where are you going for surgery?