Exercise/Running after surgery

[Sdm52980]

I am a very active person...running, weight lifting, ab exercises etc. My doctor is recommending fusing me from T3 to L3. I went and got a second opinion today. This doctor informed me that surgery would be a lifestyle change and I wouldn't be able to do that anymore. My current surgeon told me I will be able to participate in all those activities once I healed. I am just confused. Those of you who had surgery, we're you still able to resume your normal exercise routine? Thanks!
Sara

[LindaRacine]

Hi...

I would definitely avoid having surgery with the 2nd opinion. I don't think I've ever heard an experienced scoliosis specialist tell a patient that they couldn't do most activities. I think weight lifting might be a problem in the long term, as it will probably put some extra stress on the vertebrae above the below the fusion. If you're willing to take the risk of potentially needing to extend your fusion up or down, then just about any activity is fine. (Note: there's risk of degeneration even without the weight lifting, but the weight lifting probably adds at least some additional risk.)

Regards,
Linda

[Pooka1]

I agree with Linda.

And I question whether the second guy has much experience with scoliosis. He sounds clueless unless you have some other unusual condition IN ADDITION TO scoliosis.

While all orthopedic surgeons can technically operate on you, that doesn't mean you want just anyone to do so. Pick someone who specializes in scoliosis.

Good luck.

[Sdm52980]

Thanks guys! What is weird is he is supposed to be a scoliosis specialist. My present scoliosis doctor has measured my curve at 37.22 for 3 years and then just recently 40.46. The second opinion doctor came in the room today and told me my major curve was 31degrees. When I questioned this, we went out to look at the X-rays. He wasn't even measuring the same vertebrae as my other surgeon. I asked him about it and he said you just measure the vertabrae that looks the worst. I had to show him the written report so he could measure the same vertabrae as my other surgeon. I also brought some actual X-ray films with me. He said he did not have the tool to measure those. I thought that was kind of weird...considering he is a scoliosis doctor. I have films from the 90's that are not on the computer and I think doctors should always have tools to measure old films. I am going back to see my present scoliosis doctor and discuss my second opinion experience. I will definitely not be going with a doctor that tells me I will never be able to exercise again! This is just such a hard process to get a straight answer!!!!! I love my present doctor, but I have asked him over and over to measure my top curve. He says it is a compensatory curve to by large curve so doesnt make a difference. Well today, I found out it has increased. I just want all the information and feel like I am back and forth to doctors! Thanks for listening to me ramble!!!!!
Sara

[leahdragonfly]

Hi Sara,

You don't mention why you are considering surgery, but I really hope it is not just based on the measurements. The numbers you mention (30-40) are really not in the surgical range for an adult, unless you are having other issues such as pain that has been refractory to all other treatments. If you are very athletic now, I do not think you will enjoy your new, fused spine unless you are doing surgery strictly to relieve pain. If you are not having significant pain I would strongly recommend deferring surgery at this point, for as long as possible. I am curious why two surgeons recommended surgery for curves of 40 degrees or less, as it is really outside the standard of care.

[susancook]

Thanks guys! What is weird is he is supposed to be a scoliosis specialist. My present scoliosis doctor has measured my curve at 37.22 for 3 years and then just recently 40.46. The second opinion doctor came in the room today and told me my major curve was 31degrees. When I questioned this, we went out to look at the X-rays. He wasn't even measuring the same vertebrae as my other surgeon. I asked him about it and he said you just measure the vertabrae that looks the worst. I had to show him the written report so he could measure the same vertabrae as my other surgeon. I also brought some actual X-ray films with me. He said he did not have the tool to measure those. I thought that was kind of weird...considering he is a scoliosis doctor. I have films from the 90's that are not on the computer and I think doctors should always have tools to measure old films. I am going back to see my present scoliosis doctor and discuss my second opinion experience. I will definitely not be going with a doctor that tells me I will never be able to exercise again! This is just such a hard process to get a straight answer!!!!! I love my present doctor, but I have asked him over and over to measure my top curve. He says it is a compensatory curve to by large curve so doesnt make a difference. Well today, I found out it has increased. I just want all the information and feel like I am back and forth to doctors! Thanks for listening to me ramble!!!!!
Sara

Gayle brings up the same questions that I had, why are you having the surgery? Are you in a lot of pain? Have you tried physical therapy and other treatments?
Measuring the Cobb angle is not easy, and Linda can probably answer this, but I think to get any precision, the radiologist w/ his tools needs to do it.
Also, the literature [Linda, help me here also], says that change really isn't significant unless there is a 5-6* change. Dr. Hart at OHSU says 5* [for adult, degenerative at 65 years of age, that's me....it's all relative]. I was reading one of the "updates" or the literature from the Scoliosis Society, and one of the MDs said that the same woman could take an xray early in the morning and then late in the afternoon, and the afternoon xrays might be as much as 5-10* different [as we sag and settle more in the PM]. I have never heard the 10* difference mentioned any place else, but I am not a scoliosis MD. At any rate, 3* in itself maybe is a trend that needs to be watched and measured for a year or a few years or so to see if you are changing, but I'm not sure about basing surgery on 3*.

I agree that the 2nd doctor sounds like "Doctor Doom and Gloom". See the pictures and notes from the woman who skates and tap dances, I think her name is Sally. Yes, the surgery is "life changing" and you will need to learn to do things differently....just read the blogs of the very active woman and men post surgery.

Maybe get another opinion from an MD in a university setting that does adult scoliosis surgery?

I am considering surgery in the future also, so I don't envy your task of trying to sort out doctors and who to go with. Getting 2nd and 3rd opinions is a daunting task and then choosing who to go with, for such an important decision, has to be very difficult. Irina is doing that right now on the blog.

Just don't rush into surgery unless you really need to have it. I wish you the best of luck with your search.
Susan

[Jenna.KB]

Hi Sara

I do agree with the other comments but your supposed compensatory curve stuck out for me.

Just make sure your curves are checked regularly. I was told my top curve was compensatory, had a harrington rod fitted to my biggest curve at the lower part of my spine when I was 13 then at 25 my top curve was giving me considerable pain. I saw my specialist at 26 and was told my top curve was 96*, I'm now 27 and my curve is 104* (or it was in Jan this year) and I'm waiting surgery for a full fusion.

I'd just make sure they carefully monitor your compensatory curve then if you do have surgery and this begins to increase you know about it straight away

[Pooka1]

Compensatory curves are not structural and seem to exist only to try to balance the structural curve. As was the case for both my daughters, the compensatory curve decreased all by itself when the structural curves were straightened. In one case, the compensatory curve disappeared leaving a straight spine. That's because it was a normal part of the spine that was just being curved in compensation, not because of deformity or disease.

Surgeons have ways of determining if a curve is compensatory or not. That is not to say that make mistakes sometimes. It is also not to say that true compensatory curves can't still collapse under fused and unfused structural curves. But that is not usually the case. I posted a study where people at least 20 years out still have stable compensatory curves under fused curves.

It seems that if you wait too long, compensatory curves can become structuralized. But the OP doesn't seem to be even near that territory with a relative small structural curve.

This game is not for the faint-hearted.

Good luck.

[Jenna.KB]

Compensatory curves are not structural and seem to exist only to try to balance the structural curve. As was the case for both my daughters, the compensatory curve decreased all by itself when the structural curves were straightened. In one case, the compensatory curve disappeared leaving a straight spine. That's because it was a normal part of the spine that was just being curved in compensation, not because of deformity or disease.

Surgeons have ways of determining if a curve is compensatory or not. That is not to say that make mistakes sometimes. It is also not to say that true compensatory curves can't still collapse under fused and unfused structural curves. But that is not usually the case. I posted a study where people at least 20 years out still have stable compensatory curves under fused curves.

It seems that if you wait too long, compensatory curves can become structuralized. But the OP doesn't seem to be even near that territory with a relative small structural curve.

This game is not for the faint-hearted.

Good luck.

Hi

Glad to hear your daughters curves stabilised. As you say in some cases mistakes happen or the compensatory curve does increase. Mine was stabile for 12 years but now its at 104* it just makes me want to ensure that others with compensatory curves are aware the curves can increase and to have them monitored.

Hope your daughters continue to be stabilised and well generally x