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      06-19-2007, 03:12 PM   #1
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Surgery or No Surgery?

I just came back from my spine doctor and I have a big decision to make...

I have some good sized scoliosis, which will get worse year by year. To the point where my back will be at a 80 degree angle in 30 years (I'm 26 currently.) The doctor recommends surgery, but it is no joke. Requires a 1 week hospital stay, 3 surgeons, and probably 6mo-1yr recovery. I also trade in getting a straight spine, for limited mobility, as I will have permanent screws and rods in my back.

The negatives if I do not do this surgery are each year it will get worse, to the point I will be tilted in walking and have constant pain. This is probably a stretch, but has anyone had any surgery or issues with scoliosis in general?

I wonder if I can still drive within 6 weeks after surgery - I can plan a ED before it and have 6 weeks to recover until redelivery...
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      06-19-2007, 03:31 PM   #2
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Get other surgeons' opinions first; pay for them out of pocket if you must.

Search for other forums online, for patients who have had similar surgeries.

Also, don't plan ED until after you're fully recovered. You never know if you may have to go back into the hospital a month or 2 after the first surgery, for some additional corrective surgery; it's unlikely, but possible. The surgeon may have to adjust something if it's not perfect.
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      06-19-2007, 04:17 PM   #3
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I'm would be very cautious about a spine surgery since it may affect so many nerves. Consult with as many experienced physicians as you can before you make the decision. Are there any other options?(something like special exercises, etc.)
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      06-19-2007, 04:19 PM   #4
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Nothing besides surgery will correct it, nothing besides surgery can guarantee it will not progress. I could possibly wear a brace, but that does not guarantee that it will not become worse and I would have to wear it 23 hours/day.

Definitely will seek other opinions.
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      06-19-2007, 04:29 PM   #5
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This guy:

http://www.osclajolla.com/index.cfm?...&doctor=VanDam

Did this over 19 years ago at Walter Reed.

If I ever need any more work I will definitely seek his advice.

If you have doubts go see him. He'll give you the straight story.

You will need a lot more than 6 weeks to recover.
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      06-19-2007, 04:35 PM   #6
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You had it done? Can you expand on that if you wouldn't mind?
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      06-19-2007, 04:40 PM   #7
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I had a friend with scoliosis, she's a black belt in the martial arts I was involved in. I didn't find out till later about it and when I asked her "does it hurt?" she replied, "all the time, but I'm used to it now so it doesn't distract me." The thing about that young lady is she was one of THE best students there and she performed the rolls (even dive rolls) real well for someone with a condition like that, so it surprised me to find out. I don't recall her saying anything about seeking surgery for it in her case though.

Best of luck with your decision, it's not an easy thing to decide but perhaps the long-term benefits will be worth it.
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      06-19-2007, 04:51 PM   #8
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So honestly, I wouldn't take advice from people on a public forum.

You're not going to get the best advice other then "go do it" or "no that sounds risky".


Here's what you need to do:

1. Develop an understanding of what kind of scoliosis you have - is it lumbar or thoracic? What is the sequela of never getting it fixed or only using conservative therapies? What will your symptoms progress to if untreated?

2. Decide how long you can seek 2nd opinions or more renown surgeons. If you can live 2 years without much debilitation, use that 2 year span to find the person that you want to do the surgery.

3. Understand risks versus benefits, and understand how many times this surgery may need to be "modified".

4. Get a percentage of the following:

a. Complications
b. Percentage of people requiring revisions
c. Percentage of people without symptoms after 1st surgery
d. Life limitations with the surgery

5. Discuss with your family members and physicians, not strangers on a message board that may or may not know much about anything at all.

6. Get another opinion after you have done all of the above. You should be seeing a Neurosurgeon about this, not an Orthopaedist.

7. Investigate why this was not caught earlier - Your old pediatrician, physicians, or even schools if they did mandatory screening - Being 26 and first finding out that you have a rapidly progressing scoliosis is quite unusual, and potentially a source of litigation for your surgery costs not covered by insurance, as well as pain and suffering.

8. PM me if you are willing to venture to the east coast, I can set you up with the top people here in the North East

Good Luck
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      06-19-2007, 04:59 PM   #9
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I would definitely recommend doing everything in your power to avoid surgery. Spine surgery is always painful and results are not guranteed. That being said, if you you are scoliotic, I am not sure how many options you have. How many levels would they have to fuse and what degree scoliosis do you have now? If you decide to go through with it, make sure the surgeon uses neuromonitoring consisting of SSEPs, TcMEPs, and EMG. Best of luck with your decision, and I cannot imagine you will be driving a car 6 weeks after that procedure.
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      06-19-2007, 05:06 PM   #10
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Quote:
Originally Posted by slubu View Post
I just came back from my spine doctor and I have a big decision to make...

I have some good sized scoliosis, which will get worse year by year. To the point where my back will be at a 80 degree angle in 30 years (I'm 26 currently.) The doctor recommends surgery, but it is no joke. Requires a 1 week hospital stay, 3 surgeons, and probably 6mo-1yr recovery. I also trade in getting a straight spine, for limited mobility, as I will have permanent screws and rods in my back.

The negatives if I do not do this surgery are each year it will get worse, to the point I will be tilted in walking and have constant pain. This is probably a stretch, but has anyone had any surgery or issues with scoliosis in general?

I wonder if I can still drive within 6 weeks after surgery - I can plan a ED before it and have 6 weeks to recover until redelivery...

Scoliosis is a very common spinal deformity that is quite prevalent and usually of no consequence for the majority of people who have it. For those with functional impairment or significant curve progression, surgery may be indicated.

As others have suggested, the best advice will be from qualified physicians, not from members on this board. Not even qualified physicians can make a simple determination unless they have evaluated your medical history, performed a physical exam, and reviewed ancillary findings.

FYI, your health plan and IPA are mandated to provide you with the option of a second opinion should you request it. This is usually done via your primary care physician who submits the request through your IPA's HMO Utilization Management Department. PPO plans are less of a hassle.

Three sources of misinformation: The news media, family and friends. Listen to the latter two and ignore them all.
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      06-19-2007, 05:07 PM   #11
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how did you get a spine injury in the first place? imho if its not hurting and your conscious about ur posture and spinal positioning, you shouldn't get surgery...

i have a messed up serratus which is the muscle that holds your traps shoulder blade towards the center of your back... its a winging shoulder as some people might know it as... and it may because i damaged the nerve and since then have learned some bad techniques for everyday living such as lifting things, grabbing things, etc. i have no pain yet the winging does affect many things in my life... because it was an injury from so long ago, the nerve may have slightly repaired itself and therefore probably just has scar tissue and crap around the nerve preventing a more efficient firing of the nerve.

i guess in summation because i have no pain, i am doing PT instead of surgery for the time being.

--i didn't really understand your post either... i mean is it because the muscles arent stabilizing your back? because of back weakness or nerves not firing? or what?
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      06-19-2007, 05:12 PM   #12
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I appreciate all the information. I would never base my decision on what somebody tells me on a public forum. But sometimes hearing different people's viewpoints, risk tolerances, etc. help put things in perspective and shed light in a means not previously considered.

In response to some questions:

I have what's called a "major three curve" or something. The thoracic is minor, the lumbar is what is problematic. It is at 53 degrees right now. It was about 45 degrees in 2000. Obviously it is getting worse.
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      06-19-2007, 05:13 PM   #13
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My best friend had scoliosis and wore a brace for a couple of years (15yo to 17yo) and he kept getting worse.
He had surgery when he was almost 18 and since then, I would say, he does what 99.99% of us do on a daily basis. He's back is stiff of course, but it doesn't bother him at all.
He's now 35 with 2 kids.
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      06-19-2007, 05:14 PM   #14
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Quote:
Originally Posted by just4kickz View Post
how did you get a spine injury in the first place? imho if its not hurting and your conscious about ur posture and spinal positioning, you shouldn't get surgery...

i have a messed up serratus which is the muscle that holds your traps shoulder blade towards the center of your back... its a winging shoulder as some people might know it as... and it may because i damaged the nerve and since then have learned some bad techniques for everyday living such as lifting things, grabbing things, etc. i have no pain yet the winging does affect many things in my life... because it was an injury from so long ago, the nerve may have slightly repaired itself and therefore probably just has scar tissue and crap around the nerve preventing a more efficient firing of the nerve.

i guess in summation because i have no pain, i am doing PT instead of surgery for the time being.

--i didn't really understand your post either... i mean is it because the muscles arent stabilizing your back? because of back weakness or nerves not firing? or what?

It's just genetic, something that went undetected. I knew I had it in 2000, but they did not recommend surgery, just physical therapy to assist in the pain.

As for having pain, I have it all the time, minor, exacerbated by such things as walking or standing for a long duration, etc. Playing physical sports like basketball pretty much immobilize me for a day or two afterwards.
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      06-19-2007, 05:18 PM   #15
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Random question but does anyone know if you get taller? 53 degrees is quite substantial, and when it gets straightened, I wonder what happens. I know I was supposed to be about 2-3" taller w/out scoliosis.
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      06-19-2007, 05:22 PM   #16
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Quote:
Originally Posted by slubu View Post
It's just genetic, something that went undetected. I knew I had it in 2000, but they did not recommend surgery, just physical therapy to assist in the pain.

As for having pain, I have it all the time, minor, exacerbated by such things as walking or standing for a long duration, etc. Playing physical sports like basketball pretty much immobilize me for a day or two afterwards.
yeah i guess since PT didn't work as well as you had hoped... surgery is the way to go...
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      06-19-2007, 05:23 PM   #17
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Quote:
Originally Posted by slubu View Post
You had it done? Can you expand on that if you wouldn't mind?
I was in the Army, and mine was for an injury and not scoliosis so I had no choice.

I really don't want to elaborate too much as this is a major decision and I don't want to sway you one way or another.

Please try to see Dr Van Dam. He has been doing spines a very long time and will tell it to you straight. The good and the bad.

And get this book:

http://www.amazon.com/Mayo-Clinic-Ch.../dp/1893005275
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      06-19-2007, 06:15 PM   #18
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Good luck in what ever you do.
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      06-19-2007, 10:13 PM   #19
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my mommy has scoliosis.. and she's afraid to get surgery.. but we keep telling her to get it checked out.. if she sits for a while her lower back starts to ache and it lasts for days...

so i think its better to get it fixed and let it heal then suffer for the rest of ur life. also... doctors these days are pretty good. my brother just came out of surgery Sunday and the surgery only took 3 hours for a pretty banged up knee.. anyway good luck =]
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      06-20-2007, 12:43 PM   #20
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Usually the surgeon fuses you in the neutral position that you're in now, that is, they don't straighten you before fusing. It's to prevent progression of the scoliosis, not to fix it.

But that's a good question for your surgeons.

I generally agree about the neurosurgeon post - neurosurgeon > orthopedic for spine surgery, but there are tremendous exceptions. Some awesome orthopedic spine surgeons out there, as well as some crappy neurosurgeons.

Defininately, definately shop around. Take your time and do your research.
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      06-20-2007, 01:59 PM   #21
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Hey!

I found out that I had scoliosis at the age of 16, I am now 20. I went to two or three specialists. I don't remember what degree mine was at the moment I have the X-ray at home, I'm assuming it was between 20-30 degrees in the lumbar section.

They said that because it was congenital scoliosis that I wouldn't need surgery and because I was already 16 that it probably wouldn't progress too much more.

It's now a few years later and I have problems sleeping. Any wrong positioning will lead to a day full of low back / hip pain. My knees and ankles hurt me regularly too.

I decided to go to a chiropractor because I was concerned on how this would effect me later on when i wanted to get pregnant (carrying all that extra weight will be more difficult for us than it is for normal people). This time around the X-rays show that the degree is a little tiny bit higher.

I've been doing intensive therapy to try to stabilize it as much as possible and have better posture, and it's been working for me. The pain is minimal and the lumbar support option that is in the premium package is wonderful!

This is just my experience; I don't know what you should do. Hopefully you will be alright after the first surgery and you won't have to ever go back. I've heard of rods breaking, doctors keep changing the metal they are made from and they have all either bended or broke at one time or another.

I joined this board: http://www.scoliosis.org/forum/index.php

Maybe you should to.

Quick question: Does having scoliosis make us "disabled"? Is it something that I have to mention when applying for a job? Can I get handicap parking pass? It would be nice to be able to park anywhere I want to.

I wanted to ask my chiropractor that but I didn't know if it was a stupid question and I didn't want to seem selfish.
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      06-21-2007, 01:04 AM   #22
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Quote:
Originally Posted by ksfrogman View Post
Scoliosis is a very common spinal deformity that is quite prevalent and usually of no consequence for the majority of people who have it. For those with functional impairment or significant curve progression, surgery may be indicated.

As others have suggested, the best advice will be from qualified physicians, not from members on this board. Not even qualified physicians can make a simple determination unless they have evaluated your medical history, performed a physical exam, and reviewed ancillary findings.

FYI, your health plan and IPA are mandated to provide you with the option of a second opinion should you request it. This is usually done via your primary care physician who submits the request through your IPA's HMO Utilization Management Department. PPO plans are less of a hassle.

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you mean hvla cant fix this?

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