A recent Schroth study

[Pooka1]

I did not realize you had no choice. Do you live in the U.S.? If you do, what happens to parents who can't afford the surgery when their kids need it that badly, is it considered an emergency situation that gets paid for by the government? If you live in Canada or wherever else there is free health care, I guess I have my answer.

I live in NC. No rational parent when faced with a medical consensus denies their child care. There are some objectively irrational parents who think they have a choice but they don't.

There are very, very few areas of medical consensus in scoliosis. None in adult as far as I can see other than perhaps deformity causing radiculopathy. But there is a notable consensus in large, progressing T curves in AIS. You treat surgically with the gold standard of fusion which has a 40 year track record. Or stapling. Or more recently, you treat with tethering although the jury is still out, especially on the long term of secondary curves.

Shriner's Hospitals and Medicaid are presumably available for families who need those resources although Shriner's uses LITERAL blood money from their circuses with elephants, large cats, etc. They are disgusting, despicable people.

[Tina_R]

I live in NC. No rational parent when faced with a medical consensus denies their child care. There are some objectively irrational parents who think they have a choice but they don't.

There are very, very few areas of medical consensus in scoliosis. None in adult as far as I can see other than perhaps deformity causing radiculopathy. But there is a notable consensus in large, progressing T curves in AIS. You treat surgically with the gold standard of fusion which has a 40 year track record. Or stapling. Or more recently, you treat with tethering although the jury is still out, especially on the long term of secondary curves.

Shriner's Hospitals and Medicaid are presumably available for families who need those resources although Shriner's uses LITERAL blood money from their circuses with elephants, large cats, etc. They are disgusting, despicable people.

No rational parent would deny their children medical care except for the cost. My surgery and hospital stay cost $150K before insurance kicked in. Is it any less expensive for children? Not every family has insurance and many can't afford this amount of money. Since poor people can get emergency room treatment for free I assume that if the scoliosis surgery is a true emergency, it's covered.

i didn't know anything about Shriners and how they funded all that free medical care.

[Tina_R]

Nope. As far as I know, only Joe, myself, and the person who posts, are able to remove previous posts. I definitely didn't do that, and I can't imagine Joe would, as he never gets involved without consulting me first.

To see all of your posts, click on your name in one of your current posts, then select View Forum Posts. It looks like you have 313 total posts.

I agree that some reputable spine centers have begun offering Schroth treatment. We can't know why, but I'd bet it's because there has been some patient demand for it. I actually think this is a good thing. If these reputable centers see patients getting some benefit from the program, they'll continue and it will benefit the patient community. It will also hopefully moderate the pricing. If it turns out that that they don't see any benefit, they'll drop the program. Let's wait and see.

--Linda

I was looking in the wrong place, I was looking at my profile, where only my posts from the last few days show up. My posts are all here, thanks.

It seems backwards to offer Schroth and then see if there are any good results; where was all the testing with good results that you presume should have preceded their offering it? But sure, let's see what happens, if any benefits come out of this.

A rheumatologist offered me a referral to a chiropractor for all my medical troubles. Why not, I'll try anything. Acupuncture might be next.

[LindaRacine]

It seems backwards to offer Schroth and then see if there are any good results; where was all the testing with good results that you presume should have preceded their offering it? But sure, let's see what happens, if any benefits come out of this.

Who's going to do the testing? In terms of Schroth, there is some evidence that it helps, at least on a temporary basis. The thing we don't know is what happens to these patients over the remainder of their lives. That's true of all treatments. How do we ever know if something works unless someone tries and evaluates it over time?

For what it's worth, scoliosis is rarely, if ever, an emergency.

[Tina_R]

Who's going to do the testing? In terms of Schroth, there is some evidence that it helps, at least on a temporary basis. The thing we don't know is what happens to these patients over the remainder of their lives. That's true of all treatments. How do we ever know if something works unless someone tries and evaluates it over time?

I assumed treatments go through the same approval process as new drugs do, tested before being offered to the general public. Pooka1 talks of studies not showing any benefit for Schroth, so studies exist. I assumed studies and tests are synonymous.

With scoliosis there needs to be more follow-up on patients over the course of a lifetime. This can't be that hard to do these days with computers. Even if you lose track of some people who never see a doctor again, others will reappear in a medical database if they need more spine treatment later. Why not link all the databases just for study purposes? Be interesting to know how juveniles treated with spinal fusion fare over the course of their lives.

For what it's worth, scoliosis is rarely, if ever, an emergency.

Except for patients whose deformity is so severe they are slowly losing the ability to breathe?

[Pooka1]

Be interesting to know how juveniles treated with spinal fusion fare over the course of their lives.

juveniles are a very small population. Maybe you mean adolescents? If so, we have decades of data on fusion. T fusions that stay above about T12 or L1 and that drive enough straightness in compensatory L curves are pretty stable. All other configurations - the bets are off. Luckily the most common curves are T curves last I checked. Small mercies.

[Tina_R]

juveniles are a very small population. Maybe you mean adolescents? If so, we have decades of data on fusion. T fusions that stay above about T12 or L1 and that drive enough straightness in compensatory L curves are pretty stable. All other configurations - the bets are off. Luckily the most common curves are T curves last I checked. Small mercies.

I just meant young people rather than middle-aged people. I see that juvenile scoliosis is a different thing from adolescent scoliosis, often goes in tandem with other medical problems, and needs immediate attention. As for adolescent onset scoliosis I've wondered if it's better to get fused early or try to avoid fusion for as long as possible but face more risks with surgery as middle age approaches. I know it's different in every case.

What do you mean, the bets are off? Kids who have lumbar fusions do not have stable curves? Will they eventually start curving again outside of the fused area?

And what about adjacent segment disease? Will many people who had fusion early in life suffer from that later on? Seems like there's lots of time for it to develop in a young person.

[Pooka1]

What do you mean, the bets are off? Kids who have lumbar fusions do not have stable curves? Will they eventually start curving again outside of the fused area?

I mean I have only heard reference to the one case type (T curve fused above a certain point with a straight enough lumbar) as being able to be stable for life. More case types could easily have been mentioned in the same breath if they were in the same category. I think it is also the case that those same T curves fused with a Harrington rod can also be stable. So it is the curve location and not the instrumentation. In re, say, lumbar curves, I think I saw a recent reference to linkage to cervical issues.

And what about adjacent segment disease? Will many people who had fusion early in life suffer from that later on? Seems like there's lots of time for it to develop in a young person.

Yes but it doesn't seem to be the case in T fusions that stay above about T12 or L1 where the lumbar is driven straight enough per Boachie.

It seems to me that the adults who have AIS (as opposed to degenerative which is almost exclusively lumbar I think) who need treatment as adults had sub-surgical or stable curves when they were younger. It took a while to progress to surgical territory. My twins reached that territory in no time flat with one having the highest progression rate compared to other cases mentioned here. That curve was going to cripple or kill her if it wasn't treated. She never would have gone to high school or college or Europe or done several zoo internships where she routinely lifted 50 - 75 pound bales of hay and such. She would be in a bed or dead.

That is why I had no choice.

[LindaRacine]

I assumed treatments go through the same approval process as new drugs do, tested before being offered to the general public. Pooka1 talks of studies not showing any benefit for Schroth, so studies exist. I assumed studies and tests are synonymous.

With scoliosis there needs to be more follow-up on patients over the course of a lifetime. This can't be that hard to do these days with computers. Even if you lose track of some people who never see a doctor again, others will reappear in a medical database if they need more spine treatment later. Why not link all the databases just for study purposes? Be interesting to know how juveniles treated with spinal fusion fare over the course of their lives.



Except for patients whose deformity is so severe they are slowly losing the ability to breathe?

Yes, this would still not be an emergency