
Originally Posted by
Pooka1
I think if everyone posted before and after radiographs for ALL treatments... surgical, conservative and alternative, we would cut to the chase very quickly.
Ehm, that would establish that...ehm...rods are straight. It avoids the issues of them breaking, screws popping, discs degenerating, pain and other secondary problems of surgery, quality of life...etc.
There is no global statement that will cover every patient.
Exactly. The OP exposes the widespread practice by surgeons of advising, "Surgery or nothing."
...JIS is much more amenable to bracing than is AIS.
That too is misleading and sweeping. JIS/AIS is a tenuous distinction to start. Min Mehta had great success with REALLY young kids in casts. I have heard from dozens of parents of JIS kids, braced after 10 yrs old, who progressed in brace. Dozens of kids damaged by braces before 10 yrs old. It is not only surgery that needs more scrutiny.
Fusion of T curves has been shown to stabilize the spine including the L curve for at least two decades (the length of hte study) with minimal impact in remaining discs for all patients (small study though).
Has been shown for some. For every "some", there are some others who were NOT stabilised. And what happens to the "some" after 20 yrs? We know what happened with the Harrington generation. We don't KNOW what will happen to this generation. Surgery is experimental.
"Minimal impact in remaining discs"...as you say, small study, and "minimal" might be enough to cause major pain and worse.
I'm not picking nits, but you keep making sweeping statements that are not accurate.
Other fusions, those that are largely in the lumbar or that extend below about L3 are known to be problematic.
Now that is useful information for people contemplating this type of surgery. The OP wants this type of honesty from surgeons.
Those patients often need revision as I understand this... even pedicle screw constructs are not a stable, long-term solution necessarily when they extend that far in to the lumbar.
That again is invaluable information for people contemplating surgery...and I make NO suggestions about whether choosing surgery is the best option for many people. I would imagine that for many it absolutely is the best option.
Before and after radiographs, while abundant in the surgical sections, tend to be conspicuous by their absence in the bracing/PT threads.
I could take Tamzin for an x-ray this week. That x-ray WOULD show 5 degrees lumbar, <15 degrees thoracic. I could take her for another next week and it'd show 15 lumbar, 25 thoracic. I could possibly bribe her to stand in a posture that would exacerbate her curves and show 35 degrees. I could also have me x-rayed with a completely straight spine, then a curved one. The radiographer would say I had scoliosis; so would the surgeon. I don't have scoliosis. This type of confusion about what an x-ray reliably shows needs exposed.
And furthermore, perhaps the dangerous practice of multiple x-rays by those who post them in the surgical sections is indicative of the utterly pointless proliferation of x-rays in this "watch and wait till the curves progress" culture.
Martha Hawes has done this and did improve her curve but it seems like that resulted from the change in her chest cavity shape. She was not trying to decrease her curve but was only trying to avoid respiratory symptoms.
She WAS trying to decrease her curves, but that is a pointless debate. The salutary FACT is that she reduced her curves, and they were whoppers! All those who would decry the corrective benefits of corrective breathing take note! Breathing correctively can correct scoliosis! You heard it here first! :-)
Another case is the guy who did post his before/after PT radiographs, it was obvious he just decreased the compensatory lumber through exercise and/or postural change. The structural T curve was not affected and may have gotten a bit worse.
I think you refer to the guy who posted on here some months back, did a lot of stretching stuff? No one is going to base anything for or against anything on that. Why bother mentioning it? It's a bit like clutching at straws?
The only way bracing and PT can gain a foothold is with evidence of efficacy which is hard to come by when even large curves stop progressing on their own as seen by a few cases on this group.
Bracing is losing the strangle-hold it has exerted for donkeys years. Non-invasive exercise based treatments are entirely distinct from bracing. Bracing is tied to surgery--and doesn't stop the surgeries.
It's a game of cutting loses in my opinion. People who don't have rabid curves have time to try different things. Some kids don't have that luxury.
I agree, some kids don't have the opportunity to even try non-invasive correction. The OP opened the discussion for those who do have that opportunity...and this is an important discussion.
Last edited by TAMZTOM; 12-18-2012 at 05:40 PM.
07/11: (10yrs) T40, L39, pelvic tilt, rotation T15 & L11
11/11: Chiari 1 & syrinx, T35, L27, pelvis 0
05/12: (11yrs) stopped brace, assessed T&L 25 - 30...>14lbs , >8 cm
12/12: < 25 LC & TC, >14 cms, >20 lbs, neuro symptoms abated, but are there
05/13: (12yrs) <25, >22cms height, puberty a year ago
Avoid 'faith' in 'experts'. “In consequence of this error many persons pass for normal, and indeed for highly valuable members of society, who are incurably mad...”