http://drlloydhey.blogspot.com/2011/...in-review.html
From Dr. Hey...
I have often wondered why the older patients here seem to need longer fusions based on the testimonials. Most AIS curves are thoracic only yet the majority of adult testimonials seem to be about double major curves. Something isn't matching up. Maybe the double majors just progress more than T curves in adulthood. I have read that lumbar curves and certain TL curves tend to progress in adulthood but I don't know that it is more than T curves. I can't prove any of that statistically, it just seems so based on reading this forum. Here is an explanation for that if it is true. And it seems some with only originally a structural thoracic curve have such changes in the lumbar that they develop a structural curve there also if they don't get the T curve stabilized.
While I think screening of kids is questionable until they can demonstrate an effective conservative treatment, screening of adults with known scoliosis certainly is not.
From Dr. Hey...
This also illustrates importance of screening for, and following scoliosis in younger people, especially during the adolescent and young adult years. If this woman would have had her scoliosis fixed years ago before the lowest levels of her spine became degenerative, we could have more likely fixed it with a shorter fusion, preserving the bottom 2-3 discs. As people get into their late 30's and 40's, often those lowest discs have degenerated so much that they must be included in the fusion -- not the end of the world, but it sure is nice to have "a stitch in time that saves nine!" - or that saves some mobile disc spaces.
While I think screening of kids is questionable until they can demonstrate an effective conservative treatment, screening of adults with known scoliosis certainly is not.
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