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Simon
2nd February 2008, 06:58 PM
http://i254.photobucket.com/albums/hh99/sibow123/myback004.jpg


http://i254.photobucket.com/albums/hh99/sibow123/myback002.jpg

http://i254.photobucket.com/albums/hh99/sibow123/myback001.jpg

Just a couple of photos for you to look at

Simon

Johanlundborg
2nd February 2008, 08:49 PM
Hi Simon !

Thanks for sharing !!
Have you got a date for surgery ?
Or do you still hesitate ?

Simon
2nd February 2008, 09:09 PM
Its going to be march mate as mr williamson s if off till the end of feb Am on the urgent list i have been told am still a bit hesitant about having it done but i know deep down am being silly and i need to take everybodys and the surgeons advice and get it sorted ............
Thanks mate

P.s
Does anyone know seeing the pics roughly what disk would be fused i dont know anything about the spine all s i know is it thoracic curve

Phoenix
2nd February 2008, 09:42 PM
Thanks for sharing your pics Simon. I'm still learning about all the vertebrae but I'm sure someone'll be along with an answer.

mark
3rd February 2008, 02:28 PM
Hello Simon

Thanks for putting up the pictures, i know how hard it is to share these kind of things with people.

I hope the meeting with the surgeon goes ok and try not worry.

We are here to help and support you through it all

By the way i will also put them in the gallery if you dont mind

mark

Kentish
3rd February 2008, 02:30 PM
Thanx for adding your pics Simon.

I dont have any of mine as I banned all sideways pics of me before I had my fusion.

As for which vertebrae you're gonna have fused, I would guess at something like T5 - T10. Dont take my word for it though as I'm not even 100% sure which of mine are fused. I had a birth defect in my T10 so I think I'm fused from T8 - T12 and it looks from your pics that your hump is a bit higher than what mine was.

Phoenix
3rd February 2008, 08:28 PM
Kentish
(Sorry for hijacking the thread, Simon) I just noticed you were diagnosed at 19. Wouldn't you have finished your growth spurt by then? Or had you seen signs early teens? I remember you mentioning your family thought it was postural - your back sounds like my sons (he has cong KS)- I did tell him to sit up straight a couple of times, it was like a typical teenage slouch. I don't do that any more! It's just that, you'd have thought you'd have 'escaped' if you hadn't shown sighns by adulthood - I suppose it's because of the congenital element, the spine is flawed so eventually pressure will make it move?

sara1
3rd February 2008, 09:20 PM
Hi simon,

Thanks for sharing photos, and all the best for you and your up and coming surgery.

sara
x

GillyG
3rd February 2008, 10:09 PM
Originally posted by Phoenix@Feb 3 2008, 08:28 PM
Kentish
(Sorry for hijacking the thread, Simon) I just noticed you were diagnosed at 19. Wouldn't you have finished your growth spurt by then? Or had you seen signs early teens? I remember you mentioning your family thought it was postural - your back sounds like my sons (he has cong KS)- I did tell him to sit up straight a couple of times, it was like a typical teenage slouch. I don't do that any more! It's just that, you'd have thought you'd have 'escaped' if you hadn't shown sighns by adulthood - I suppose it's because of the congenital element, the spine is flawed so eventually pressure will make it move?
Phoenix, many of us were told our curves wouldn't progress as we had finished growing, but sadly that all too often isn't the case, even with idiopathic scoliosis. I didn't seek further help until I was really struggling with the pain as I didn't think anything could be done, so I just ignored it! Luckily, my GP referred me to a fantastic spinal surgeon who was happy to perform my surgery despite me being 49 at the time!

Kentish
3rd February 2008, 11:21 PM
Originally posted by Phoenix@Feb 3 2008, 08:28 PM
Kentish
(Sorry for hijacking the thread, Simon) I just noticed you were diagnosed at 19. Wouldn't you have finished your growth spurt by then? Or had you seen signs early teens? I remember you mentioning your family thought it was postural - your back sounds like my sons (he has cong KS)- I did tell him to sit up straight a couple of times, it was like a typical teenage slouch. I don't do that any more! It's just that, you'd have thought you'd have 'escaped' if you hadn't shown sighns by adulthood - I suppose it's because of the congenital element, the spine is flawed so eventually pressure will make it move?
Yes I'd finished my growth spurt by then but I was suffering a lot of pain and there were signs that my spine was collapsing so had to have the surgery or risk being in a wheel chair. But my specialist told me that I was a rarity as most people with my type of defect either need surgery very early in their teens or live the rest of their lives with no problem.

Thats what I meant when i said your son wasnt necessarily going to need surgery as if he gets to his late teens, doesnt have any pain and his spine becomes stable, it might not be needed :-)

Simon
17th February 2008, 05:17 PM
Hi guys i posted a question above asking if anyone would know what vertbreirs would be fused or you think would be fused

Phoenix
17th February 2008, 05:25 PM
Sorry Simon, I'm still new to the anatomy of the spine - your curve certainly looks upper thoracic but I can't be sure. Whay don't you ring the consultant's secretary and have them look at your notes and let you know? I only learned where my son's curve was after our appointment when I rang the hospital about something else. I guess he must have told us but my head must have blanked it out. Amazed Jean's advice about taking a pad and pen into the consultant meetings is spot on - I'll certainly do that for our next visit.

Why not ring up and see what they can tell you?

titch
17th February 2008, 05:43 PM
It's very difficult to know, as at least some of it depends on how much anchoring is needed for the rods to hold steady. You're not overweight or musclebound, so that goes in your favour for a shorter fusion. At least some of it will depend on whether they need to do any osteotomies, as it may need to be a little longer if they do.

All of that said, while your pic doesn't include your lordosis, I certainly don't think you're looking at a low lumbar fusion. I'd expect it to start high, T1 or T2, but would doubt it'll come lower than L2 unless there is lordosis correction needed as well. That's still pretty vague though, as it could certainly be shorter than that, too.

Simon
17th February 2008, 06:20 PM
Thanks titch and everyone else

Can someone tell me what lordosis is and also what are osteotomies i aint got a clue

jfkimberly
17th February 2008, 06:49 PM
Lordosis is the opposite of kyphosis (curving forward, such as your upper back). Lordosis is where your spine bends backwards. Everybody (should) have some natural curve in their lumbar spine, but in cases where a patient has pronounced kyphosis, their lordosis also often becomes pronounced to compensate for the forward bend of the thoracic spine. It's the body's way of keeping itself balanced.

Osteotomy literally means cutting of bone. But in our case, it generally refers to surgically altering some of the ribs to reduce the appearance of the rib hump.

GillyG
17th February 2008, 08:05 PM
I think the osteotomy procedure Titch was referring to would be where they cut a wedge of bone from one or more of your vertebrae so that they can change the alignment of your spine. I was a possible candidate for this in my lumbar spine to correct the loss of lordosis caused by my scoliosis. In the end, my surgeon decided not to do it as in my case he thought it could possibly cause more problems than it would cure.

jfkimberly
17th February 2008, 08:31 PM
Oh, thanks for the clarification Gilly!

titch
18th February 2008, 04:11 PM
If you have a look in my gallery there is an xray I've marked up that shows you the result of the very large osteotomy that I had to correct a kyphosis at the back of my waist.

In your case you wouldn't have a huge osteotomy like that Simon, but sometimes they do 3-5 (occcasionally more) small ones to gently correct a thoracic kyphosis. That kind of osteotomy provides in the region of 5-7 degrees of correction each, whereas the type they did on me provides something like 30-40 degrees of correction in one go. That's alright in your lordosis, as it can be quite sharp without looking or feeling odd - and also you're going with the natural direction of the spine. Trying to get correction at a single level like that doesn't really work for the upper back though, as it can leave you with a strange profile, and make it difficult to instrument or ensure fusion. The upper back generally responds better to the smaller osteotomies as they allow a much more natural curve to the kyphosis. I think generally speaking that osteotomies are more likely to be used in a kyphosis with a sharper apex than yours has, but in the end it'll be up to the surgeon, and it may be that a couple of osteotomies would allow a shorter fusion by virtue of making more correction over a shorter length.

Simon
18th February 2008, 04:50 PM
Thanks for the info titch

I aint got a clue what they will be doing to me alls i know is that am having a postierier spinal fusion

he has not said anythink about osteotomy

It it the norm to do this in this kind of surgery and would you know if the fusion would be high up as you have said T1 and isnt that the start of my neck

titch
18th February 2008, 06:19 PM
T1 is the top thoracic vertebra, which would mean that you'd have the disc between that and the start of your neck free. Quite a few people here, including tonibunny & jonny, are fused from T1 :-)

It's entirely possible you'd have something like T2/3 to T10/12, without any osteotomies - basically, there's no way to know as it will depend on the doctor's preference, and his assessment of your curve, the state of your bones, any disc degeneration and so on. Even so, I'd expect it to be most or all of your thoracic vertebrae, and to start pretty high - that's based on the fusion levels that seem to be "normal" for kyphosis among people I've known over the years on the forums. The osteotomies are really hard to know - they're certainly done often enough to class as normal in fusion for kyphosis, but so much depends on how the curve behaves, which again puts it very much in the ballpark of the surgeon.

Osteotomies aren't actually as scary as they may sound - part of the process of making posterior fusion at a level involves roughing up the back of the vertebra, because without that damage, there won't be a healing process to happen, if you see what I mean. So they have to mess around with it anyway, the only difference is that they cut a little more away. (Hopefully I'm not just making it sound even worse!) I guess there's a few alternatives - 1) they're not necessary in your case 2) he hasn't decided 3) they don't alter the risk in your case, just make for more confusing explanations :P

Simon
18th February 2008, 06:28 PM
Thanks titch you should become a kphosis/scoliosis lecture you would be great at it

Sarah
10th March 2008, 10:46 PM
Hi. Are you having rods or just correction and fusion without metalwork? Am completely out of loop with the surgeries. :)

Simon
11th March 2008, 01:41 AM
Am having rods and screws and correction

mark
24th March 2008, 09:39 PM
And by this time tomorrow you should be all screwed and corrected up mate :-D and SSO will be celebrating another successful visit to the operating theatre :niceone: