Other Surgeries to Fix Scoliotic Problems

[Tina_R]

My case is similar to yours - I probably had a slight case when I was younger and it went undetected. I had "low back pain" for most of my adult life - starting in my early 20s but pretty tolerable. I just dealt with it. It did get worse as I got older, but it was all muscular pain that I could handle. There was nothing noticeable about my spine being slightly crooked. At some point around my early 40s, my rib hump appeared but I didn't know what it was. I went to a local orthoped and he said that was the "classic scoliosis hump - how long have you had that?" I had noticed about 4 months prior to that appointment. He did scoliosis xrays and my curve was around 24 degrees. He said that in adults it usually doesn't change much. But mine did, - my curve was getting about 2 degrees worse per year. By age 52 I was having all sorts of issues but was still fairly active so they weren't really treating me. By age 54 I was when it got really bad and I had surgery at age 55.

By the time of my surgery, my curve was around 32 degrees - so not really all THAT bad - but it was pain the drove me to surgery. I had everything on the list: rotted discs, the one half decent disc had ruptured, stenosis, nerve impingement....

I had a great outcome, all things considered. I still have residual "pains" that we all probably have - but they are very tolerable - nothing near what they were before surgery.

My surgery was at TCSC - so I felt that I was in good hands. I am going up next week for my 4-year follow up x-rays. Hopefully I will hear that my nothing has shifted and it all still looks good!!

Kathy

Kathy, I was 10 years older than you when I had my surgery and I probably should have gotten it done sooner, by your age.
I thought they never straightened curves as small as 32 degrees but waited until they got larger. Or is pain the determining factor, maybe it's teens that wait until their curve gets larger? I forget what Linda said.

[Tina_R]

I had my lumbar MRI. They didn't inject anything into me because the radiologist said it wouldn't do any good. My hardware is keeping them from getting revealing images. The MRI was a failure.

The next thing they are going to try is a myelogram. I was told it is very expensive, so I'd better check on my insurance. Is this invasive in any way?

[jackieg412]

Yes the myelogram is invasive. They inject the dye into the epidural layer of the spinal cord. The dye follows the nerve paths that lead from the spine. They access the area very low on the spine. It is unfortunate but not horrible. If there is a trapped nerve you feel a lot of pressure on that area .But again it is doable.

[LindaRacine]

I thought they never straightened curves as small as 32 degrees but waited until they got larger. Or is pain the determining factor, maybe it's teens that wait until their curve gets larger? I forget what Linda said.

Tina...

Never isn't even close. It totally depends on the patient. For older patients who just want to reduce their pain, some may have the option of a one or two level fusion, while others have longer fusions that involve reducing the curve(s).

[Tina_R]

Yes the myelogram is invasive. They inject the dye into the epidural layer of the spinal cord. The dye follows the nerve paths that lead from the spine. They access the area very low on the spine. It is unfortunate but not horrible. If there is a trapped nerve you feel a lot of pressure on that area .But again it is doable.

About how long did yours take, Jackie? Do they allow you to drive yourself home afterwards?
Is there anything confining about it like being in a tube for an MRI? Or are you just on a table while it is done?

[Tina_R]

Tina...

Never isn't even close. It totally depends on the patient. For older patients who just want to reduce their pain, some may have the option of a one or two level fusion, while others have longer fusions that involve reducing the curve(s).

In that case I should have had my surgery two decades ago when my curve was probably in the thirties.

I just found out it's rather hard to get your password reset on this site if you've forgotten it. Unnecessarily twisty process compared to other sites.

[jackieg412]

The test is quick. You may on your stomach and the dye is injected. Then you are taken to the CT scanner. Like a big donut. That is just minutes.
I am not sure how quickly you can leave but you do have to lay on your back for awhile. I wasn't allowed to drive myself home.

[Tina_R]

The test is quick. You may on your stomach and the dye is injected. Then you are taken to the CT scanner. Like a big donut. That is just minutes.
I am not sure how quickly you can leave but you do have to lay on your back for awhile. I wasn't allowed to drive myself home.

Sounds simple and quick, I thought it would be more involved for the radiologist, that he would have to do some probing. I wonder why it is so expensive (according to the neurologist who ordered it).

Thanks, I'll have someone drive me.

[LindaRacine]

The test is quick. You may on your stomach and the dye is injected. Then you are taken to the CT scanner. Like a big donut. That is just minutes.
I am not sure how quickly you can leave but you do have to lay on your back for awhile. I wasn't allowed to drive myself home.

I don't know if it's always the same, but the two CT myelograms I had were a little more involved. After injecting the dye, they had me contort into several different poses to get good radiographs of the trouble areas.

Here's a good description of the process: https://www.hopkinsmedicine.org/heal...pies/myelogram

[titaniumed]

I had to do a double log roll while laying on the flouroscope table. This helps with the mixing process....I told them I forgot my pogo stick and they told me that would be fine. (Today's radiology joke) Iohexol was used, its iodine based.

CT machines are thinner than MRI machines, about 30" wide vs MRI machines that are about 5 feet deep. I never had any problems with either, for MRI scans, simply close your eyes....MRI machines will produce these sounds....CT machines do not make much noise....certainly not over 100 decibels. MRI can be loud.
https://www.youtube.com/watch?v=4cSV...GeneralImaging

The spinal tap can hurt a bit.....but it ends quickly. The CT process is easy....

You don't want to drive after a Spinal Tap.

I have driven after other CT scans, but not Myelograms. The way I understand it is that a myelogram requires the spinal tap, or lumbar block (same thing)

What it's like to get a Myelogram
https://www.youtube.com/watch?v=OZao...gnosticImaging

Ed

[Tina_R]

I had to do a double log roll while laying on the flouroscope table. This helps with the mixing process....I told them I forgot my pogo stick and they told me that would be fine. (Today's radiology joke) Iohexol was used, its iodine based.

CT machines are thinner than MRI machines, about 30" wide vs MRI machines that are about 5 feet deep. I never had any problems with either, for MRI scans, simply close your eyes....MRI machines will produce these sounds....CT machines do not make much noise....certainly not over 100 decibels. MRI can be loud.
https://www.youtube.com/watch?v=4cSV...GeneralImaging

The spinal tap can hurt a bit.....but it ends quickly. The CT process is easy....

You don't want to drive after a Spinal Tap.

I have driven after other CT scans, but not Myelograms. The way I understand it is that a myelogram requires the spinal tap, or lumbar block (same thing)

What it's like to get a Myelogram
https://www.youtube.com/watch?v=OZao...gnosticImaging

Ed

I've had many MRIs in my life, can't even remember what they were all for. You can close your eyes, but the knowledge that you are in a narrow tube and would have a hard time exiting on your own if you had to induces anxiety in me. I always ask for 10 mg of Diazepam to take beforehand. Some of the machines at least are open on the sides.

I am grateful toward a technician who understands the anxiety and not only talks to me continually to reassure me ("The next sequence will take 5 minutes") but listens to me as well. I know someone who had a sadistic technician who seemed to abandon him in the tube.

Funny how many different sounds the machines can produce. Some clangy like chimps banging on pipes with wrenches, others kind of squishy. I think it has varied over the years as the machines have changed.

[LindaRacine]

I've had many MRIs in my life, can't even remember what they were all for. You can close your eyes, but the knowledge that you are in a narrow tube and would have a hard time exiting on your own if you had to induces anxiety in me. I always ask for 10 mg of Diazepam to take beforehand. Some of the machines at least are open on the sides.

I am grateful toward a technician who understands the anxiety and not only talks to me continually to reassure me ("The next sequence will take 5 minutes") but listens to me as well. I know someone who had a sadistic technician who seemed to abandon him in the tube.

Funny how many different sounds the machines can produce. Some clangy like chimps banging on pipes with wrenches, others kind of squishy. I think it has varied over the years as the machines have changed.

CTs take significantly less time than MRIs. I have tremendous anxiety about going into an MRI tube, but no problem with CTs. The top of the CT tube is also considerably further away from your face than the MRI tube.

[titaniumed]

Here is a video of a true CAT scan.

Even the vet makes attempts at some humor at the end....Tomo gets a tomography!

https://www.youtube.com/watch?v=vNKq...ZooandAquarium

Search "animal CT scans" and you will see how they do other large animals.

Ed

[Tina_R]

CTs take significantly less time than MRIs. I have tremendous anxiety about going into an MRI tube, but no problem with CTs. The top of the CT tube is also considerably further away from your face than the MRI tube.

It's a big donut, so benign.

[KathyInIowa]

Kathy, I remember when you were done, but I had to go back and look at your x-rays in your first post. You had a mild S curve, but you had a decent sized spondylolisthesis (slippage) in your lower lumbar which looks quite painful....wow! I would guess that your surgeon didn't offer any alternative's for this....

I had a good spondy at mid back around T8 orT9 from a hard ski crash when I was around age 30. After a few Chiropractic adjustments and some time, it didn't show up on x-rays anymore, and was never seen again on x-ray. I have read that thoracic disc herniations usually happen from traumas. I must have really hit my ribs hard on that one. I skied on edge all the time and didn't crash much, but when I did, they were doozies and usually broke something. Either equipment or body.

Discovering your rib hump in your early 40's sure is late. (From the congenital, early onset, and idiopathic patient point of view)

Here is some material on Degenerative Scoliosis. This is a good review.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3192887/

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Kathy, I think there is a scoliosis surgical museum or Dr Moe exhibit at TCSC or somewhere in Minneapolis. Can you ask when you get there? Old scoliosis casts, Stryker frames, Metal braces, racks, screws, x-ray machinery, surgical tools, etc. That sort of thing.
I would be extremely interested in visiting...

I just discovered the Museum of Surgical Science Chicago....I didn't know this was there.
https://imss.org/plan-your-visit/#cost
https://imss.org/pain/


Glad you are doing well...

Ed

Yes, I had a very prominent slippage at it did hurt!!!!

I am in the "degenerative scoliosis" category - so I don't have any history of being treated when younger - but I just think I must have had something slightly going on as I did have unexplained low back pain most of my adult life. I didn't have a job or a lifestyle that would cause the pain so I believe it was my spine being slightly curved. When I got older and was being treated for adult onset scoliosis, they don't really take the time to figure out what was happening when I was younger. They just treated me as I was and didn't dwell on it.

I just got back yesterday from my 4-year follow up. My x-rays showed that everything is still in place and it looks like last years x-ray - so that is good news! Dr. Perra said to just keep doing whatever I'm doing to stay healthy!

1-year after my scoliosis surgery, I had surgery on both of my feet - terrible bunions on both feet. I also saw my foot surgeon yesterday this trip and he also said my x-rays looked great. It's weird to go through life hoping my joints don't start slipping out of place again! I wonder how many people ever think about their joints getting weird - sometimes that's all think about - as my hands keep getting more arthritic. Aren't genetics wonderful???

Ed - I didn't see your post until today so I didn't think to ask about that museum. I had intended to spending some time after my appointment to just enjoy a bit of the city, but it was cold, rainy, windy and very dark so I got on the road and just came home. This cold weather is hitting the Upper Midwest way too early!!

Kathy