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Old 28th January 2014, 09:17 AM
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tonibunny tonibunny is offline
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Join Date: Jan 1970
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Default Re: New to forum,daughter getting surgery

We should agree to disagree this is why I believe one shouldn't wait to have a 6 year old with a 60 degree curve treated:

- as a preadolescent with a 60+ degree thoracic curve, her lungs will have started to be affected. Even if she does not notice this yet, lung function is already going to be decreased. The aim of treatment is to prevent this deterioration in lung function, which is much more serious than it is for adolescents at this age because the lungs are still developing and there is a risk of Thoracic Insuffuciency Syndrom if the curve is not controlled. A large curve can prevent the lungs from developing properly, something that cannot later be reversed.

- we already know that her curve is progressing rapidly. It would be a mistake to wait until the curve is bigger, not only for the reasons above, but because it is far more difficult to correct a larger curve than a smaller one - especially in younger children, whose curves tend to stiffen up. Young kids with stiff, large curves often require treatments that are more invasive and are more difficult to tolerate, such as halo traction. Larger curves sometimes cause the ribcage to become very deformed, requiring a painful procedure called a Costoplasty to try to reshape them.

- this child has already been accepted for surgery by Mr Lehovsky, who is one of the most experienced surgeons in the UK. He is very well-respected. Lucy's mum could certainly seek a second opinion if she wishes, but pretty much all of the consultants would agree that a 6 year old with a progressing 60 degree curve requires treatment ASAP. This isn't a grey area or a borderline case.

There is one treatment that could be used instead of surgery, and that is serial plaster casting. However, this treatment is not usually offered for older children in the UK anymore and it is not effective for everyone anyway. The rods are seen as a much better solution as they are easier to tolerate and do not restrict the child so much, despite the need for surgery to install them.

The choice really is between having surgery now and getting a good correction, allowing Lucy to continue living her life without noticeable problems, or waiting a while until she has noticeable problems which may be irrreversible and having surgery which may not be able to correct her spine so well. I would not wait.

I myself grew up with a large curve (62/40 degrees at the age of 6 months) before growth rods were invented. I went through casting until I had fusion surgery at ten, but my curve was so stiff I underwent weeks of halo-tibial traction. My lungs were never able to develop properly and my 80 degree thoracic curve could only be reduced to 45 degrees, leaving me with a large residual deformity. Had growth rods been invented back then I could have had this treatment when I was a lot younger, and I probably could have avoided these problems.

Apologies for all these posts, Lucy's Mum, I hope you find reading both sides of this discussion to be helpful
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37 years old, diagnosed with infantile idiopathic scoliosis at 6 months old with curves of 62(T) and 40(L) degrees. Casting and Milwaukee braces until surgery at 10 - ant release/pos fusion T1-T12, halo traction. Post op cast and then TLSO. Further surgery at 18 (ant release/pos fusion extended to L3 to include lumbar curve, costoplasty) and 25 (another costoplasty). Fusion extended to L4 at 33 (XLIF with 4 pedicle screws and two short rods). Pre-op curves: 76(T) and 70(L). Post-op curves: 45(T) and 35(L). Diagnosed with Ehlers-Danlos Syndrome aged 34; scoliosis almost certainly due to this rather than being idiopathic.
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