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  #1  
Old 23rd December 2013, 02:17 PM
anutz anutz is offline
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Default Straight Spine ( Added Pics ) - Getting a Diagnosis and Assistance...

Hello...

This is my first post on here...hope this meets the required standard

I have been facing a range of issues for the past five years, i don't suffer from Scoliosis...i have had no form of operation and no fixation at any levels. I have a L5/S1 grade 1 slip which seems insignificant based on opinions i have received.

I have great difficulty with breathing and walking as well as balance...i have also had issues with symptoms of TOS which i have managed to keep under control recently. Sitting is stressful which is providing concerns for employment.

However i seem to be hitting wall after wall with regards to getting any recognition or assistance with the issues i have. None of the specialists i have seen aside from a recent visit to a Chiropractor, have performed analysis on the Saggital films.

Does anyone have any experience with Hypolordosis in the Lumbar and Hypokyphosis in the thoracic, who was able to constructively advise you?

I did not have these issues until i started a range of exercises - in hindsight the wrong ones, pelvic tucking, shoulders back, quad stretching etc...

I live in the UK

I would add an few MRI images if that would assist for people commenting

Regards
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  #2  
Old 23rd December 2013, 06:03 PM
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tonibunny tonibunny is offline
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Default Re: Straight Spine - Getting a Diagnosis and Assistance...

Hiya, welcome to SSO

I'm going to ask a few questions, hope you don't mind but it will help me to work out how best to help you

Your main problem is hypolordosis/hypokyphosis and you have the symptoms of Thoracic Outlet Syndrome, is that correct?

Have you been seen by a medically qualified spinal doctor? I'm assuming that you have had x-rays done - if so, were they taken with you standing up or lying down? Do you have copies that we could look at? It is impossible to assess spinal deformities from scans because the spine flattens out when you are lying down, so standing images are required.

In what way is sitting stressful for you? Could you describe your symptoms further please?

Respiratory problems are very unlikely to be connected to hypokyphosis/hypolordosis unless you actually have thoracic hyperlordosis. Considering you are having real trouble with breathing I think you should seek a referral to get help directly from a doctor who specialises in respiratory issues. You obviously need help here, so a respirologist would be able to get that help sorted for you. They would then be able to refer you on to a spinal specialist if they felt that your spine was the cause.

Exercises would not usually induce hypolordosis or hypokyphosis - or indeed any spinal deformity - in a healthy mature adult, so please don't blame yourself for this.

Don't worry, we'll do our best to aid you in finding help!

Welcome again,
Toni
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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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  #3  
Old 23rd December 2013, 08:54 PM
anutz anutz is offline
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Default Re: Straight Spine - Getting a Diagnosis and Assistance...

OK so here goes...

Yes main problem ( as far as i can tell ) is hypolordosis in the Lumbar/hypokyphosis or maybe even lordosis in the Thoracic - until recently i did have symptoms of TOS quite aggressively, but they have some what lessened since i stopped any form of shoulder retraction exercise, yet i cannot stop a feeling of toppling forwards or backwards, and now even my hips feel as if they will tuck at a moments notice.

I have seen 2 Neurologists, multiple sclerosis has been ruled out, and i have also seen 4 spinal surgeons. The L5/S1 spondylothesis has not been seen as significant by them. Indeed i have had lateral X-rays of the lumbar/cervial, but as of yet not the thoracic which i was hoping would have been done. I shall upload an image of the standing Lumbar X-ray i have in Neutral, Flexion and Extension.

Sitting/Bending over in general have been getting difficult, i seem to give at the hips and no where else, my Flexion X-ray shows this well i think and it has also meant from my interpretation when sitting i am having to increase hip flexion to allow me to keep forward and type etc...its very tiring. Lying on my front is difficult now as i do not seem to have any lordosis or say from the lower lumbar but a very large dip at L1/2 or T12/L1 and then a straight thoracic area up to my neck hump.

The Respiratory issue have been really draining, i shall post an MRI, i understand that i am laying down so it may not be 100% helpful but it is something else to asses. It may give some measure or indication of abnormallity. I have seen ENT specialists to help rule out other reasons for breathing disorder but there is nothing of indication. I did see a respiratory physio and was given Buteyko breathing exercises to practice, but no follow up appointment and the exercises did not provide any relief.

I recently have seen a Chiropractor who specializes in Chiropractic Bio Physics. I have not had any treatment and had X-rays done of the Lumbar and Cervical. Their comment was i had a significant flattening of the back and also a Forward Head Posture with the Lordotic curve starting to reverse. I have the offer of a treatment plan but am hesitant right away until i have gathered some more information on the possible risks of any Neck Manipulations etc. I dont have the X-rays from this visit but will try to get them.

Thanks for the Welcome and thankyou for the initial question.....

I will attach 4 MRI Images, one from 2010 and 3 from 2013, i shall also get the standing lumbar lateral X-rays ( from one of my spinal surgeon consults ) and convert them for upload

Anutz!
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  #4  
Old 23rd December 2013, 09:39 PM
anutz anutz is offline
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Default Re: Straight Spine Pics added - Getting a Diagnosis and Assistance...

OK here are some pictures...

Lumbar Neutral



Lumbar Flexion




Lumbar Extension




2013 Cervical MRI



2013 Thoracic MRI



2013 Lumbar MRI



2010 L-T MRI


Last edited by anutz; 23rd December 2013 at 10:18 PM. Reason: Added Pics
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  #5  
Old 24th December 2013, 10:48 AM
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GillyG GillyG is offline
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Default Re: Straight Spine - Getting a Diagnosis and Assistance...

Hi there Anutz and

I'm not terribly good at interpreting MRI's but you do seem to have an unnaturally straight spine and that L5/S1 spondylothesis looks very painful

I mentioned in a PM that the surgeons on our specialist list deal with the full range of spinal issues, so it might be worth trying to get a referral to one of them, or even pay to go privately for an initial assessment if at all possible. The link to the list is:

http://www.scoliosis-support.org/showthread.php?t=7250
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  #6  
Old 24th December 2013, 01:11 PM
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tonibunny tonibunny is offline
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Default Re: Straight Spine - Getting a Diagnosis and Assistance...

The MRI was done lying down though Gilly, so the natural lordosis and kyphosis is flattened out - I don't think it's possible to say whether or not someone has an unnaturally flattened lordosis or kyphosis just from an MRI image like this. I agree that it would be a good idea to seek a referral to one of the specialists on our list.
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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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  #7  
Old 24th December 2013, 01:28 PM
anutz anutz is offline
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Default Re: Straight Spine - Getting a Diagnosis and Assistance...

I am looking at arranging some more appointments in the new year and will ensure i get a full sagital X-ray of the spine in standing - i have been surprised it has not been taken already but have not felt in a position to ask for it taken when seeing consultants....
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  #8  
Old 28th December 2013, 01:20 PM
anutz anutz is offline
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Default Re: Straight Spine - Getting a Diagnosis and Assistance...

Here is an anterior X-ray i had done - one full view of the Lumbar and a few Thoracic then a crop of the lower lumbar.



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  #9  
Old 28th December 2013, 11:22 PM
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tonibunny tonibunny is offline
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Default Re: Straight Spine - Getting a Diagnosis and Assistance...

That's reassuring, you don't appear to have any lumbar scoliosis hopefully you can get the full lateral standing x-ray done soon. Please do seek a referral for your respiratory problems, won't you? hopefully there will be something that can help you with this
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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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  #10  
Old 28th December 2013, 11:43 PM
anutz anutz is offline
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Default Re: Straight Spine - Getting a Diagnosis and Assistance...

Hi

I have an appointment on the 9th to see an Ehlers-Danlos specialist as this has been something raised during previous visits to some spinal surgeons....

The combination of ED and some incorrect exercises would potentially explain where i am at - i managed really well until i began a program of stretching and foam rolling...it appears the muscles may have been helping to keep me held together. I did lots of weightlifting and never really stretched for years.

One concern i have is an increasing feeling of rotation i.e. i often feel like i am rotating and stand sometimes with a visible twist in the thoracic area....also i have seen that a common finding with Scoliosis is hypokyphosis....and many studies indicate it's a precursor...rotation continues until the spine compensates with a curve....but i don't know enough about it so will discuss these concerns in detail with the ED specialist.
The breathing compromise will also be something i discuss and then based on their advice seek further assistance

Anutz!
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  #11  
Old 29th December 2013, 12:13 AM
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tonibunny tonibunny is offline
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Default Re: Straight Spine - Getting a Diagnosis and Assistance...

Hiya,

That's good news about the EDS specialist. Having a diagnosis of (Hypermobility type) EDS doesn't generally change much but it can be useful in explaining various symptoms - including scoliosis - and in getting you access to things such as physio to help protect your joints and custom-made shoe inserts if your arches have dropped.

I have cardiovascular symptoms too so my EDS diagnosis means that I have my heart scanned every six months, and having had EDS-related Postural Orthostatic Tachycardia/Orthostatic Intolerance diagnosed means that medical staff don't panic and overtreat me if my blood pressure drops or my heartrate jumps up whist I'm in hospital.

As you've discovered, most cases of idiopathic scoliosis feature a flattening of the natural thoracic kyphosis. In fact, many people assume they have Kyphoscoliosis due to the appearance of their rib hump (and indeed, some uninformed doctors even tell their patients that they have this) when usually the opposite is true - the thoracic spine is flattened and the rib prominence is caused purely by rotation of the ribs. Your EDS specialist is likely to be a rheumatologist and may not be knowledgeable about orthopaedic conditions so don't expect them to have answers for you regarding this - your spinal consultant should definitely be able to help you though.

Spinal rotation as seen in scoliosis is always there, rather than being something that comes and goes. The easiest way to assess this is to do the Adams forward bend test (ie, simply bend forward at the waist, allow you arms to drop naturally in front of you and get someone to look at your back). Any rotation will show up as a prominence on one side of the spine. Spinal surgeons measure rotation using an instrument called a Scoliometer - this gives a measurement in degrees going up to the maximum of 30 degrees (NB this is a completely different measurement to those taken to measure spinal curves, which are called Cobb Angles). You can get an iPhone app which turns your phone into a Scoliometer and it is quite accurate in trained hands - I showed it to Mr Tucker who was impressed with it - though it is very easy for a lay person to measure inaccurately, so be careful if you try this.

Sorry if you already knew all of the above, I try to put a lot of info in my replies here as there may be other people reading who don't know this stuff
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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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  #12  
Old 29th December 2013, 01:09 PM
anutz anutz is offline
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Default Re: Straight Spine - Getting a Diagnosis and Assistance...

hi

I really appreciate the detailed responses....the more info the better

will take a look at the app...

thanks

Anutz!
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  #13  
Old 29th December 2013, 01:18 PM
anutz anutz is offline
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Default Re: Straight Spine - Getting a Diagnosis and Assistance...

OK....

so as well as the L5 spondy and issues with the shape of my back I just noticed this on the L3 vertebrae...suspecting this is due to me extending from here due to the lack of extension I can get from anywhere else....more questions for my consultants!!

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  #14  
Old 10th January 2014, 09:57 AM
anutz anutz is offline
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Default Re: Straight Spine - Getting a Diagnosis and Assistance...

Though i would add an update - i have seen an EDS specialist locally to me. He does not suspect that i have EDS, i may be "bendy" but not classified as EDS. I have an appointment on Monday to discuss all my findings so far and situation with a Spinal Surgeon.

Also i have an referral to an Respiratory consultant on the way as well

Anutz!

Last edited by anutz; 10th January 2014 at 09:58 AM. Reason: Forgot something...
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  #15  
Old 10th January 2014, 04:11 PM
KMaxwell KMaxwell is offline
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Default Re: Straight Spine - Getting a Diagnosis and Assistance...

Sounds like you have a good game plan. Good luck with your appointments.
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I was diagnosed with Scheuermann's Kyphosis at age 16. I had an 80-degree thoracolumbar kyphosis and mild scoliosis. My posterior fusion surgery was performed by Dr. Sethi in Seattle on Earth Day 2014. It reduced my kyphosis to 50 degrees and my scoliosis to about zero.
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