confused!

[muzzy80]

Hello!

I have been reading all the information about non surgical methods but I am still confused and would love for people to give me a straight answer!
I have a 70 degree thoracic curve and 60 lumbar. I went to the Schroth clinics in the UK for one of their courses. I think it has improved my posture and it is suppose to stop progression but having spoken to surgeons they say that whatever I do it will not ever stop my curve progressing. Is this true? Will I never be able to avoid surgery? Help, I need help....!
Thanks in advance

[TitaniumGrrrl]

As a post surgical patient myself, perhaps you will write off my advice. However, my understanding of genetics & anatomy (as well as my personal experience) lead me to believe that nothing can stop a curvature from progeressing if your body is programmed, so to speak, for a more severe curve. I put off my own surgery for as long as I could, choosing to pursue other, nonsurgical options (mostly therapy to strengthen muscles). My doctor supported this, but I eventually reached the point where nothing was stopping or even slowing the progression of my cuves, & I was experiencing decreased lung function on one side as a result. In my experience, surgery is sometimes unavoidable.

Don't rule out surgery as an option, & if it makes you feel better, get second or even third opinions. But chances are there may come a point where surgery is your only option to every improve your spine.

[muzzy80]

Thank you for the information. I have consulted with two surgeons who both told me to have surgery. It is such a hard decision to make especially since I am not in any significant pain. On one hand I want to wait and see if it progresses but on the other I know that it would be easier to have the surgery at a younger age ( I am 30 now). So tough.

[livingtwisted]

I am also 30 yo and have a T curve in the 60s. My ortho has told me that it is very likely that I will need surgery in my lifetime -- basically since our curves are beyond a certain degree, gravity will just continue to weigh on it and cause progression. But because it is such a risky and invasive surgery, my ortho also says there is no reason to rush into it if I'm not in pain (my pain is minimal and manageable). He wants to wait until the benefits outweigh the risks (i.e., I'm in enough pain that its worth the recovery and chance that I'll still be in pain after). So for now I'm doing everything I can to stay healthy and strong and prevent progression. I think there are some cases of even larger curves with no pain, so who knows maybe I'll be able to avoid it forever.

Sorry, I know this might just make the decision harder because your doc is telling you something different, but I wanted to give you another perspective. I guess things are trickier when the lumbar is involved so maybe that's why he is recommending surgery now. Good luck!

[TitaniumGrrrl]

I am also 30 yo and have a T curve in the 60s. My ortho has told me that it is very likely that I will need surgery in my lifetime -- basically since our curves are beyond a certain degree, gravity will just continue to weigh on it and cause progression. But because it is such a risky and invasive surgery, my ortho also says there is no reason to rush into it if I'm not in pain (my pain is minimal and manageable). He wants to wait until the benefits outweigh the risks (i.e., I'm in enough pain that its worth the recovery and chance that I'll still be in pain after). So for now I'm doing everything I can to stay healthy and strong and prevent progression. I think there are some cases of even larger curves with no pain, so who knows maybe I'll be able to avoid it forever.

Sorry, I know this might just make the decision harder because your doc is telling you something different, but I wanted to give you another perspective. I guess things are trickier when the lumbar is involved so maybe that's why he is recommending surgery now. Good luck!

I was one of those cases with no pain. Well, not *no* pain, but very little. I primarily had pain from sitting in hard-backed chairs (school was killer) or vehicles with very stiff seats, but not much pain just from, say, living & breathing. However, I had a 75 degree thoracic curve & a 47 degree lumbar curve with a 29 degree rotation (my spine looked like DNA helix), & even for as bad as all that was, I had very little pain. So little, in fact, that I was very surprised when my thoracic curve progressed from 57 degree to 75 degrees in a span of only 3 months! So while pain is a good indicator of a problem, it is not the only indicator.

[hdugger]

I think this is the difference between teen and adult patients. Exercise for teen patients in their growth spurt hasn't been shown to be effective. Even the practioners who recommend exercise don't recommend it for teens during a growth spurt. Braces are the only treatment recommended to hold a curve during those spurts.

But exercise can be effective for adults, both in halting progression and occasionally in reducing curves. How long it can hold or reduce it for is unknown - we're really in the early stages of getting good research done - but there are some promising reports for at least a short-term halt to progression.

[flerc]

Do you have a flexible spine?, saying in other words, degrees are significant lesser when you are lying down that when you are stand? Have not your vertebras a serious deformity? If that is your case, I think you have good chances. You can know it with a Rx lying down and a MR but you can have an idea measuring lying down and stand and looking your vertebras in the Rx.
Even if your spine is not flexible, you can improve it with exercises taking into account muscular chains.
If some degrees can be reduced, it would be possible to stop progression. http://ezinearticles.com/?Scoliosis-...ns?&id=5832070
I think it is like an arm wrestling between gravity force and what we can do.

[rohrer01]

muzzy80,

Unfortunately, I don't think anyone can give you a straight answer. With the size of your curves, I would suspect that most surgeons you see would recommend surgery. Every spine is different and if there were a tried and true non-surgical method, we would ALL be doing it. You need to take into consideration factors that affect your own life, health and well-being. If your curves are progressing, then you have to consider things like restrictive lung disease and stress on your heart. Your age is also a factor. Younger people heal faster than older folks. My best advice would be to talk to your health care professionals and develop a plan that works best for you as an individual. You are the only one that has to live with your decision whether or not to have the surgery. Sorry I couldn't be more help. Best wishes to you whatever you decide.

[flerc]

muzzy80,

if there were a tried and true non-surgical method, we would ALL be doing it.

Maybe that, like ANY OTHER KIND OF SOLUTION sometimes works and sometimes not.

[rohrer01]

flerc,
You are absolutely right. However, no one can give her an absolute solution as she is asking for. This is why I recommended she get together with her healthcare providers and come up with a plan that best suits her. Every spine is different, as I mentioned. If muzzy80 can find a nonsurgical method that will help her maintain her curves and her level of comfort I'm all for it. I think if one decides for surgery, they need to be mentally prepared for it, and it sounds as if muzzy80 is not ready for that leap at this time. I would never try to sway someone into surgery or out of surgery. It's a personal decision that only the one undertaking has to live with. We can give out all the advice we want with the best of intentions, but we aren't the ones living with the consequences.

[jrnyc]

hi muzzy
i believe a few people on forum have mentioned that patients without much pain do not have as good results with surgical outcomes as those with intense pain...
i do not want to quote anyone specifically, as i might get names wrong...but if you do an advanced search (on the top of this page) you might find some posts on the subject...

jess

[flerc]

roher01 I agree 100% with you. I think she need information for do the best decision and we can help her in that sense. It’s good to know about different points of view, but of course as you said, it's a personal decision, regardless what anyone, even proffessionals, can advice.

[livingtwisted]

I was one of those cases with no pain. Well, not *no* pain, but very little. I primarily had pain from sitting in hard-backed chairs (school was killer) or vehicles with very stiff seats, but not much pain just from, say, living & breathing. However, I had a 75 degree thoracic curve & a 47 degree lumbar curve with a 29 degree rotation (my spine looked like DNA helix), & even for as bad as all that was, I had very little pain. So little, in fact, that I was very surprised when my thoracic curve progressed from 57 degree to 75 degrees in a span of only 3 months! So while pain is a good indicator of a problem, it is not the only indicator.

Wow, that's quick! Sorry that happened to you, but it does just show that every case is very different. But, yes, I didn't mention that progression is another indication, along with pain. Were you in pain when it reached 75? At what age did the rapid progression happen?

[hdugger]

i believe a few people on forum have mentioned that patients without much pain do not have as good results with surgical outcomes as those with intense pain...
i do not want to quote anyone specifically, as i might get names wrong...but if you do an advanced search (on the top of this page) you might find some posts on the subject...

That's been my sense, as well. Surgery is really the only treatment if you're progressing rapidly or have pain that can't be treated using any other method (or if your curve is compromising your internal organs). And people with these problems really feel the benefits of surgery. But, if you're not progressing and not in pain, then the pain and problems that sometimes crop up after surgery can be too great a risk. You don't want to go into surgery feeling pretty good and come out feeling bad.

Balancing all that is the fact that the earlier you have surgery the better you do.

[livingtwisted]

Balancing all that is the fact that the earlier you have surgery the better you do.

True. But to make the decision even more fun... advancements in technique, instrumentation, etc are still being made and I expect will continue for some time. The methods that would be used on me today are very different than when I first became a surgical candidate.