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Thread: Scoliosis-Pain increasing

  1. #1
    Senior Member Niese's Avatar
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    Scoliosis-Pain increasing

    I am 27 months post since my injury. About a year ago I went and saw a Scoliosis Dr that said I had a mild case of scoliosis. As the months have gone on it seems like I have gotten worse. In January I went to see my Orthotis for my leg braces and he raised concern about my scoliosis. I had an appointment with my rehab Dr recently and asked her about it. She didn't even look at me. But she did refer me to the Scoliosis Dr. Here is where the bigger problem comes in. I can't even get in to see him until Sept.. If it didn't feel like I was getting worse day by day it wouldn't be a big deal. But everday seems to be getting worse. It's to the point that sitting in my wheelchair is painful. Should I talk to my Orthotis and see if I can just pay for the brace to be made or do I take the chance and wait for my scoliosis Dr? Any input would be wonderful
    Thanks,
    Niese

    For those of you that have noticed this is a repeated post. I can't find the original post and that's why I re-posted it.

  2. #2
    Niese, be patient. Your previous duplicate post, and replies, will be transferred to this forum very soon by Jeff (from the Conversion forum, which is now not available to members).

    (KLD)

  3. #3
    Niese,

    In answer to your question, it is unfortunate that you won't get to see your orthopedic surgeon until September. You should not be getting a brace until you see your orthopedic surgeon for the following reasons. It is not clear that a brace is what you need. It is expensive and often is not effective in preventing change of curvature or eliminating discomfort from the scoliosis. If you are uncomfortable in a chair, what is most likely to help is having your seat adjusted so that your hip is at the correct angle and having some kind of support for your thorax.

    It is important that you yourself understand how scoliosis is measured and the decision-making process that an orthopedic surgeon goes through. Scoliosis is measured in degrees of curvature. It is called Cobb's method and the following image is from a web site that discusses scoliosis (http://www.rad.washington.edu/mskbook/scoliosis.html)


    Braces do not reverse curves and, in most cases, particularly if the cause of the scoliosis is orthopedic (i.e. due to a bony deformity), will not prevent progression of the curve. In some people, it may slow down progression of the curve. I suspect that if you are showing rapid progression to a curve to exceeds 30 degrees, you should be able to get an appointment much more quickly than 2 months from now. You need to find out what the change of your curvature was before and now.

    The options available for treatment of scoliosis are relatively limited. The first is of course the brace. The second is placement of rods or other types of prostheses to prevent the curvature. The third, if you have one or two vertebrae that are responsible for the curvature, is to cut the vertebrae or build them up in some way as to reduce the curvature. Relatively few orthopedic doctors do the latter but, in my opinion, is probably the best way to treat rapidly progressive and severe scoliosis.

    I assume that you are in a wheelchair and that you are not spending a lot of time on your feet or engaged in athletics. One of the reasons that scoliosis develops is because your spine has to curve in order to keep your balance. So, for example, if one vertebral body has been compressed and is tilted, the spinal column above those segments curves over to the other side to maintain balance. Hence, all scolioses tend to be S-shaped. When you are sitting in a wheelchair, however, changing the seat so that your pelvis is tilted to compensate... this may eliminate the progression of the curvature.

    If your doctors do decide to use a brace, please understand that the brace should be designed and made by somebody with experience in designing braces for people with spinal cord injury. If you have loss of sensation in parts of the body where the brace must push against, you want to make sure that the brace does not put undue pressure on the skin.

    Wise.
    Last edited by Wise Young; 07-04-2005 at 08:50 PM.

  4. #4
    The third, if you have one or two vertebrae that are responsible for the curvature, is to cut the vertebrae or build them up in some way as to reduce the curvature. Relatively few orthopedic doctors do the latter but, in my opinion, is probably the best way to treat rapidly progressive and severe scoliosis.
    Are you referring to Dr. Betz's procedure?

  5. #5
    Senior Member Niese's Avatar
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    Wise,
    In that article it talked about using electrical stimulation? What exactly would they do and how does that work? Also if braces don't help with the curvature of the spine or help with the pain what do they help with? I know when doing the xrays for scoliosis they want one with weight bearing. How does that work if you are in a wheelchair? When the time comes would it be a good idea for me to use my braces and the walker to stand and get the weight bearing xray or not?
    Thanks,
    Niese
    Last edited by Niese; 07-05-2005 at 11:35 AM.

  6. #6
    Senior Member alan's Avatar
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    My curve not only is like Dr. Young's picture, but my spine (and thus my torso) is torqued to the right, so my right side is forward of my left side. I'm sure that doesn't help my back pains any - it certainly screws up my sitting balance,
    Alan

    Proofread carefully to see if you any words out.

  7. #7
    Dr. Betz is one of the orthopedic surgeons who do these types of procedures. There are others. Wise.

  8. #8
    Niese, electrical stimulation has not yet (to my knowledge) been shown to prevent or reverse the curvature due to an orthopedic deformity. Internal fixation is effective in preventing progression of the curve and even reverse the curve to some degree but has limited ability to straighten out the spine. External braces can reduce the progression of the curve also but they must be carefully designed, particularly for people with spinal cord injury and loss of sensation. For people in wheelchairs, seating and postural support often provides a better solution.

    X-rays of the spine while standing (weight-bearing) is useful to evaluate people who spend time standing because it shows the positioning of the vertebrae and the curvature in the standing position. In people who spend a lot of time in wheelchairs, it is useful to get the x-rays when in a wheelchair, particularly with and without correction.

    Did you find out what your curvature is? You should find out because it will allow you to judge whether there is progression and how rapid the progression has been.

    Wise.

  9. #9
    Senior Member alan's Avatar
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    The last scoliosis x-ray I had was taken in June, but was done with my aide holding my shoulders up so they'd be level. That's not how I sit, and nobody's going to hold my shoulders even during all the time I'm sitting. I don't think that x-ray served any purpose (and they had to shoot it three times.) I felt straighter because I was being held up, and the x-ray didn't show as much of a curve as it would have without me being held up, IMO.
    Alan

    Proofread carefully to see if you any words out.

  10. #10
    Senior Member Niese's Avatar
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    Wise,
    I haven't found out what the curvature is yet. Initially my appointment w/ the scoliosis Dr. was in Sept.. I called my Dr. up yesterday and talked to her about it and she told me that she would try to call the Dr. to change it. They called me today and changed my appointment to the first of August. I wish it was sooner but I'm not going to complain. I have another question. When I say that I'm hurting it's not so much my back but my ribs on the right side. The distance between my ribs & hip are ok on the left side but not on the right. I get out of my chair and lay on the bed and I eventually stop hurting but my ribs and my hip are still close. Yesterday I got down and layed on my floor for awhile and I stopped hurting. I felt to see the distance between my ribs & hip and it was actually the same on both sides. Why would laying on the floor make such a distance? Would it be a good idea for me to do this as often as possible?

    Thanks,
    Niese

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