DD recently diagnosed -- any suggestions?

[LindaRacine]

I think they did wake her up but I don't have the notes. Are there other ways to check?

It's typically either in the notes, or on the anesthesia record.

[LindaRacine]

I thought the way they tell if it is structural is how much it bends out, no? Did your surgeon do bending films?

That's pretty much it.

https://pubs.rsna.org/doi/10.1148/rg.307105061

"Because of vertebral morphologic changes (eg, wedging and rotation), a structural curve is not correctable with ipsilateral bending. By contrast, no vertebral morphologic changes take place in a nonstructural curve, which is a mild compensatory curve enabling sagittal and coronal truncal balance; therefore, it is correctable with ipsilateral bending. A nonstructural curve does not usually progress. However, a nonstructural curve may progress to a structural curve if ligament shortening results from growth retardation on the concave side of curvature (8)."

[Concerneddad]

I thought the way they tell if it is structural is how much it bends out, no? Did your surgeon do bending films?

Nope, never a bending x-ray. His view is that unless you are at the point where surgery is on the table, better not to subject them to the extra radiation.

[titaniumed]

Nope, no such law (then or now). The only reason they'd wake a patient up for permission is if they either didn't know they'd stage the surgery, or they forgot to get permission prior to anesthesia.

It probably was because I did not sign an advanced directive or medical power of attorney at the hospital. It's also stated in my hospital reports. I know, this isn't the norm....and was surprised when he woke me up. They obviously had permission for the first surgery.

I wanted myself or my surgeon calling ALL the medical decisions, not my family, friends, heirs, state, lawyer, legal document or a court. I guess I could get into it but it would be a really long post.

Funny since a lot of people would think that a family member would be the right thing to do, but I can give an example where it isn't.... especially in end of life decisions.

I had 100% trust in my surgeon.

Ed

[titaniumed]

But because the top curve is now about 25% bigger, much more displaced, and a bunch more rotated, the doc thinks that it's probably a primary thoracolumbar curve, with a mostly compensatory lumbar curve at the bottom. In the unlikely event that she did need to be fused in the next few years, he thinks that they would just need to do the top one. The only problem there is that even the top curve is low enough that they'd probably need to go to L2, which is when the bad stuff starts to happen. (If it came to that, we'd probably see if there was an alternative that would spare that level like an anterior approach or a hybrid.)

My curves were pretty much matched over the years. That why I asked. 50/50, 60/60, 70/70. Within about 3 degrees....

My lumbar curve ended up getting extremely stiff and I had to do a lot of stretching over the years. I had a professional $1800 stretching chair that my Chiro bought for me, and an arch table. I was told it could be fused "as is" by my surgeon.

It was similar to this model...
https://www.4mdmedical.com/sp1000-stretch-partner.html

http://www.inversion-table-therapy.c...Bench/2327/1/1

The arch table looks simple but is very effective and you have to be very careful how much time you spend laying on this. The weight of your legs pulls hard on your lower spine depending on your exact position laying on the arch. Just 5 minutes and you will really notice it.

She has a lot of years ahead of her....I started Chiropractic at age 28, that when my scoliosis pain became focused, if that's the right word.

It's hard to say what will happen technology wise in 25-30 years. It keeps improving.

Ed

[titaniumed]

Nope, never a bending x-ray. His view is that unless you are at the point where surgery is on the table, better not to subject them to the extra radiation.

My benders were done by my surgeon leading into surgery. I don't know how much I bent out, don't think it was all that great....

I have shot a lot of x-rays over the years....Hard to say, maybe 75. Also a few CT's and Flouroscopy before and during surgery. I have a few x-rays from a few days after surgery from strange angles I guess looking at the lumbar implants. They would always do the diagnostics during the grave shift and I liked those since I got out of the room and would go on a hallway trip. Lots of sliding across big tables on big x-ray machines. Laying down of course.

Cancer is a whole different program. Usually it takes time, some of it acts fast, some of it acts slow. Like Prostate cancer in men.....After age 50 in men, I have seen some large numbers. I have a friend who has had lymphoma for about 50 years. He told me that he set the record....He is 83 now.

Ed

[Concerneddad]

Last update ever, at least barring something very unforeseen -- just in time for a spiffy new board!

Annual check last week. Same 40T/32L as the year before. Risser 5. He said that she doesn't need to come back annually any more. Any progression now will be very slow -- too slow to measure except in 5-10 year timespans. He said at this point, she can either not do anything and just come back to him (he follows his patients as adults if they want) or another doc if the curves become symptomatic years down the line, or if she wants to be more proactive, it's fine to check every 5-10 years. But it will be up to her, since she'll be an adult.

So that's the end of it as far as I'm concerned. Hope everyone is well!

[Pooka1]

Last update ever, at least barring something very unforeseen -- just in time for a spiffy new board!

Annual check last week. Same 40T/32L as the year before. Risser 5. He said that she doesn't need to come back annually any more. Any progression now will be very slow -- too slow to measure except in 5-10 year timespans. He said at this point, she can either not do anything and just come back to him (he follows his patients as adults if they want) or another doc if the curves become symptomatic years down the line, or if she wants to be more proactive, it's fine to check every 5-10 years. But it will be up to her, since she'll be an adult.

So that's the end of it as far as I'm concerned. Hope everyone is well!

Very good news. I admire how you managed her case.

We had people on here with even 50* T curves that didn't progress for decades.