Page 3 of 3 FirstFirst 123
Results 31 to 37 of 37

Thread: Increasing curve but no pain – do they do revision for this?

  1. #31
    Join Date
    May 2008
    Location
    reno,nevada
    Posts
    4,312
    Quote Originally Posted by curlygirl View Post
    I would definitely like to get a second opinion on this or maybe a third, but the options in AZ are limited.
    Irene, Dr Uribe is in Phoenix now.... I would have a talk with him....

    https://www.barrowneuro.org/person/juan-uribe-md/

    Ed
    49 yr old male, now 62, the new 63...
    Pre surgery curves T70,L70
    ALIF/PSA T2-Pelvis 01/29/08, 01/31/08 7" pelvic anchors BMP
    Dr Brett Menmuir St Marys Hospital Reno,Nevada

    Bending and twisting pics after full fusion
    http://www.scoliosis.org/forum/showt...on.&highlight=

    My x-rays
    http://www.scoliosis.org/forum/attac...2&d=1228779214

    http://www.scoliosis.org/forum/attac...3&d=1228779258

  2. #32
    Join Date
    Apr 2018
    Posts
    14

    Dr. Uribe

    Thanks! He looks good, lots of papers to his name. I still haven't gotten used to the idea of neurosurgeons doing this work but maybe I'm just old-fashioned.

  3. #33
    Join Date
    Dec 2008
    Location
    illinois
    Posts
    989
    Both orthopedic and neurosurgeons treat scoliosis. I think they are crossed trained. So either one with a good medical center is a good choice. I live near Chicago so there are many choices.
    T10-pelvis fusion 12/08
    C5,6,7 fusion 9/10
    T2--T10 fusion 2/11
    C 4-5 fusion 11/14
    Right scapulectomy 6/15
    Right pectoralis major muscle transfer to scapula
    To replace the action of Serratus Anterior muscle 3/16
    Broken neck 9/28/2018
    Emergency surgery posterior fusion C4- T3
    Repeated 11/2018 because rods pulled apart added T2 fusion
    Removal of partial right thoracic hardware 1/2020
    Removal and replacement of C4-T10 hardware with C7 and T 1
    Osteotomy

  4. #34
    Join Date
    Sep 2019
    Posts
    304
    Quote Originally Posted by LindaRacine View Post
    Nope. I think there are some instruments that might be an issue, but probably only if they're played for many hours a day, but I can't imagine that guitars would be a problem. Play on!
    I'm just wondering what instruments might be a problem if not the guitar. A guitar can be rather weighty and is held asymmetrically across the body and might apply unequal forces on each side. Sounds like the kind of thing that could either help or worsen scoliosis if exercise can do anything.

    Double bass is probably worse. Double bass players often stand with terrible posture and lean to one side. into their instrument.

  5. #35
    Join Date
    Apr 2018
    Posts
    14
    Quote Originally Posted by Tina_R View Post
    I'm just wondering what instruments might be a problem if not the guitar. A guitar can be rather weighty and is held asymmetrically across the body and might apply unequal forces on each side. Sounds like the kind of thing that could either help or worsen scoliosis if exercise can do anything.

    Double bass is probably worse. Double bass players often stand with terrible posture and lean to one side. into their instrument.


    Hi Tina - I've been wondering about this but my ortho didn't think it was a problem. I also had my husband snap random pictures of me playing so that I could show them to my PT from my phone and she thought it looked OK, too. I'm not doing rock guitar where you see people bending over their instruments. I have a 3/4 sized guitar (I'm petite so it's a better size for me) and I'm doing classical guitar, where you sit low on a stool and look up, but over to the left to see the fretboard and the music stand. In the pictures I'm sitting straight up. I also have a device called an ergoplay (common in classical guitar) that sits on the bottom of the guitar so the bulk of the weight is on the left thigh. Despite all this, in the back of my mind I still wonder if it's really, really OK. I take frequent breaks when I practice. If it turns out I have to give it up it's not the end of the world as I also play piano. This is just an interest that I developed and took on as a "plague project" during covid.

  6. #36
    Join Date
    Apr 2018
    Posts
    14

    An update on my situation

    I finally have an update after taking the time to do a couple of consults. I saw Dr. Uribe at Barrow and he said to not do anything as my muscles are used to being where they are and my body is oriented a certain way. It was disconcerting to get such radically different opinions from Dr. Stevens and Dr. Uribe as they are both highly qualified. So I decided to go for the big guns and I went virtually to Columbia Univ in NYC. Dr. Lehman there looks awesome and I saw him virtually yesterday. In order to do so I had to first see his PA, get a CT scan and an EOS (specialized x-ray) locally and upload them, along with my MRI and other films.

    Dr. Lehman is in complete agreement with Dr. Stevens and thinks that the reason Dr. Uribe said what he did is that what I need isn't really his "thing." He sees where the degeneration below my fusion is causing more deformity and he sees where my leg pain is coming from. He says it's just going to get worse unless they intervene. I'll continue to have more pain and continue to collapse inward. He wasn't selling anything or sugar coating. He was very thorough/matter of fact with me and suggested a number of options, ranging from the aggressive (3 column osteotomy that he didn't really recommend - yikes, no thanks!) to repairing the area below the fusion that's giving me pain and more deformity. He thinks he can repair that area and also give me more space between my ribs and hip - which are currently practically touching on one side - with a kickstand rod technique. He thinks he can also *maybe* tweak the bottom of my fusion a bit to give me more correction, but he wouldn't know until he gets in there and plus, he has to see me in person. I was extremely impressed with his knowledge. Also, he might not have to go in from the front as Dr. Stevens would, but he'd know after seeing me. His notes (sent in my portal) mention possible TLIF or OLIF, but right now these terms are above my grade level.

    So as much as I'd like to avoid surgery at age 67, if two good orthos say I need to do this, I have to plan for it. As far as deciding, Stevens is local so more convenient and has a good reputation. What I'm not keen on is that he operates at an ortho-specific hospital (what resources are there in case of the unexpected??) and the neuromonitoring is remote and the neurologist is watching about 4 surgeries all at once. He definitely does anterior only for a first surgery, lets you rest two days, and then does posterior work. He does have a cardiothoracic surgeon for the anterior work. I'd have to travel to NYC for Lehman, but Columbia seems to have about the best set-up in the world and you get your own neurologist, plus Lehman seems to have a few more options to offer, pending seeing me. My husband and I are fully vaxxed and have spent nothing on travel because of Covid, so we are OK with the travel and flying if it means a potentially better outcome.

    I'd love any feedback, suggestions or questions to ask. I'm supposed to see Dr. Stevens next week but if I decide to go to Lehman, wouldn't that meeting with Stevens be awkward? However, if I go with Lehman I'd need to work with Stevens for local followups and coordination. I really like him and want to maintain an excellent working relationship, whichever way I go.

    Thanks,
    Irene

    PS - screen shot of the EOS xray attached.
    Attached Images Attached Images

  7. #37
    Join Date
    May 2008
    Location
    reno,nevada
    Posts
    4,312
    Irene, How bad is the pain? Can you describe it? Describing pain needs to be exact, symptoms need to match and correlate. There has to be a relationship that the doctors can see....

    Neuropathic pain in the lumbar can produce extreme pains. For example, at times before my surgeries it felt like a horse kicked me in the hip (greater trochanter) 1" circle, and on my ankle, exactly where the tongue of a sneaker would touch, burning like a flame. Seriously, I thought I smelled smoke...Pains would come and go depending on what I would do and did this battle for around 6 years leading up to my surgeries. It helped make my decision as I waited about 33 years for my surgeries. I was a Luque candidate in 1975 and was one of those that skipped surgery in the 70's.

    I would not have had surgery "if" the pain wasn't so bad....Without surgery, I would still be doing the same things I was doing with minimal or less success. It was a downhill slide as I aged, there is no doubt about that. Degeneration ran rampant. I went downhill at the end, it was a steep drop off in the last few months and patients will know when this happens. Everything became extremely inflamed.....It's called radiculopathy. (sciatica)
    https://www.hopkinsmedicine.org/heal...and%20tingling.

    Perhaps Dr Uribe doesn't think your pain is bad enough? Or, is it the possible complications he is worried about?

    You see, we have to be aware of what can happen after our surgeries. I had a 100% guarantee that something would go wrong. The question was, what was it going to be? My pain was so bad, I had to take that chance. I waited until the end, couldn't hang in there anymore. Alternatives can only work to a point, if nerve roots are pinched or discs are herniated and protruding on the spinal cord, this is a tough battle. Stenosis or narrowing from bone spurs, bone overgrowth can only be corrected by surgery. (Bone spurs are proof that we remodel as adults).

    You can look at orthopedic complication lists and think, "Really, is THAT going to happen to me?", a small percentage, rare complications, but like Linda has stated to me many years ago that stuck, "Complications only matter, when they happen to you". There have been a few complicated cases here on this forum over the years....I lost my gall bladder, and a rare scoliosis complication. How did that happen? How can that happen? Why do these things happen? Sometimes thare are answers and sometimes the answers are not known.

    You have not mentioned ALIF. (Anterior Lumbar Interbody Fusion) I would ask about the L5-S1 level which is done by ALIF from the front before the posterior, and also ask about the Pelvic anchors. You don't see full fusions without the pelvic anchors these days....Those are the big screws that wing off at the very bottom. You can see mine in my x-rays. They are 8mm anchors which is large. .314 dia. or a tad larger than 5/16". They do ALIF for L4-L5, and L5-S1. The 2 lowest levels.

    Will they use BMP? Bone Morphogenic Protein. (Medtronics Infuse Kits) They use this product to help with the fusion process. We make our own BMP's, but some of us need more...It acts as a catalyst in growing bone. I had BMP used on all my lumbar levels. It's inserted in the spacer or cage which is installed from the front. It is FDA approved for ALIF and an on label procedure. There are "On label" and "Off label" procedures. My surgeries were on label. Infuse kits are EXPENSIVE. They also limit infection transfer from allograft's. Infection and osteoporosis would be things I would worry about. This needs to be addressed. Staph and P-Acnes. Its everywhere.....

    There are open procedures and minimally invasive procedures. They have full open, mini open, and laparoscopic procedures that are done through trochars or tubes. These minimally invasive procedures make recovery MUCH easier, I have had both full open and minimally invasive procedures done on me and there is a huge difference.

    All methods below address the front of the spine for the insertion of spacers after discectomy. The front of the spine can be reached from the front, or the side.

    ALIF is open from the front
    XLIF, LLIF, OLIF are minimally invasive from the side
    TLIF and PLIF address the front of the spine (From the back)

    Ed
    49 yr old male, now 62, the new 63...
    Pre surgery curves T70,L70
    ALIF/PSA T2-Pelvis 01/29/08, 01/31/08 7" pelvic anchors BMP
    Dr Brett Menmuir St Marys Hospital Reno,Nevada

    Bending and twisting pics after full fusion
    http://www.scoliosis.org/forum/showt...on.&highlight=

    My x-rays
    http://www.scoliosis.org/forum/attac...2&d=1228779214

    http://www.scoliosis.org/forum/attac...3&d=1228779258

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •