TLSO brace vs. rods for scoliosis...

offthahook · 04-06-2006, 11:08 PM

Obviously, I have scoliosis (due to a pelvic obliquity) and it is way uncomfortable. I've seen some spine docs. who do the straightening via surgery. I am in a TSLO brace now and it makes quite a difference to be honest. I'm taller, straighter, breathing easier, not as slouched... It's not perfect by any means and not a long term solution. My Dr. even told me NOT to worry about wearing it a whole lot because our goal isn't why most people wear this brace. He just wanted to see if it made a difference. I always heard how much a TSLO brace sucked, but it seems to "work" for me. Holds my gut in really well as well and makes my legs not so uneven if you can imagine that. I can't really empty my own legbag, push uphill, do a car trasnfer, etc with it on. Well, I probably could, but it would slip and not be as effective. The brace is not wheelchair friendly, for a manual chair anyway!

I guess my question is... what would rods be like vs. this piece I'm wearing? This Dr. mentions T7 all the way down to the pelvis. The other Dr's have mentioned T5 down. Personally, I feel if my pelvis was STRAIGHT, my spine might straighten as an effect. But, man, when I sit up, my pelvis is crooked and my spineis also crooked. 45 degrees supported by XRay techs while sitting. I think I could be rodded up lower back down if that procedure would straighten my PELVIS. Would i be able to transfer and break my chair down in my car with rods? Could I empty my legbag? I hear different answers.... Like after 6 months, never, one year... So yeah, anybody got any input about what I would gain with fusion surgery? I'm about T4 complete from a GSW.

SCI-Nurse · 04-07-2006, 12:06 AM

You would need to talk with the surgeons more to find out what they are actually planning. You have very little mobility in your spine in the thoracic spine. Most of the mobility is in the cervical and lumbar spine. If you are rodded all the way from mid-thoracic to pelvis, you will have little mobility. It is likely you would not be able to bend over far enough to reach your feet. It would be even more important to have excellent hip and knee range of motion to compensate for this somewhat. There are ways to open and drain a leg bag without reaching your feet. It is more difficult to push up a ramp or hill with a TLSO unless you have a pretty good pubic "curl" added. It is a little easier to do this with the rodding as long as you have very good hip flexion range. Regardless, if your scoliosis is holding you back so much (and it is unlikely to get any better, only worse), it sounds like the surgery is what you need.

(KLD)

offthahook · 04-07-2006, 01:03 AM

Thanks for the response. My hip range is off the charts. I think that's why the pelvic obliquity exists. I have SO much range in my right hip. It's like a noodle, too. I feel I "sink down" on my right hip/pelvis/crest area (and that's what the XRays show) and that's where the unevenness starts. Then it goes up my spine as I try to compensate and overcompensate for the curvature... I think if I was perfectly AB, but had this pelvis, I would be in a bad way because of how crooked i am. Obviously, I would compensate differently. At this point, my level of injury seems to not be important. If I was S5, I still think I would be crooked in a chair. Lying down, my spine is straight (I think my pelvis is still tilted, however). I also think I have adjusted to my slouch over time and when I put on the brace !BAM! I have to get used to the tallness and difference in posture. It digs into my pec a little bit. But, my girlfriend likes the 2 handed hug since I don't have to hold on to a wheel because of the better posture with the TLSO. NIICE!

Also, I still feel like I'm torqued or twisted at the hips while in the brace. I'm definitely straighter UP, but my pelvis still feels "cocked". Left side being higher and right side lower and farther back. The brace ends above my SP incision, which is above my bellybutton-- typical placement. I wonder what surgery would do for that? Sometimes I feel like a more rigid, "less flexible" torso would be a godsend because of my sinking feeling in the chair. Then, I get scared because I know there is no looking back once the hardware is in. I wonder if I will be able to transfer, do my own BP, etc... The brace helps, but I get red spots and it really isn't doable outside the house. Just looking for others' feedback and the medical answers to my questions. Coolness.

04-06-2006, 11:08 PM	#1
offthahook Senior Member Join Date: Feb 2002 Location: Midwest Posts: 299	TLSO brace vs. rods for scoliosis... Obviously, I have scoliosis (due to a pelvic obliquity) and it is way uncomfortable. I've seen some spine docs. who do the straightening via surgery. I am in a TSLO brace now and it makes quite a difference to be honest. I'm taller, straighter, breathing easier, not as slouched... It's not perfect by any means and not a long term solution. My Dr. even told me NOT to worry about wearing it a whole lot because our goal isn't why most people wear this brace. He just wanted to see if it made a difference. I always heard how much a TSLO brace sucked, but it seems to "work" for me. Holds my gut in really well as well and makes my legs not so uneven if you can imagine that. I can't really empty my own legbag, push uphill, do a car trasnfer, etc with it on. Well, I probably could, but it would slip and not be as effective. The brace is not wheelchair friendly, for a manual chair anyway! I guess my question is... what would rods be like vs. this piece I'm wearing? This Dr. mentions T7 all the way down to the pelvis. The other Dr's have mentioned T5 down. Personally, I feel if my pelvis was STRAIGHT, my spine might straighten as an effect. But, man, when I sit up, my pelvis is crooked and my spineis also crooked. 45 degrees supported by XRay techs while sitting. I think I could be rodded up lower back down if that procedure would straighten my PELVIS. Would i be able to transfer and break my chair down in my car with rods? Could I empty my legbag? I hear different answers.... Like after 6 months, never, one year... So yeah, anybody got any input about what I would gain with fusion surgery? I'm about T4 complete from a GSW. Last edited by offthahook; 04-06-2006 at 11:10 PM.

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04-07-2006, 12:06 AM	#2
SCI-Nurse Moderator Join Date: Jul 2001 Location: USA Posts: 41,512	You would need to talk with the surgeons more to find out what they are actually planning. You have very little mobility in your spine in the thoracic spine. Most of the mobility is in the cervical and lumbar spine. If you are rodded all the way from mid-thoracic to pelvis, you will have little mobility. It is likely you would not be able to bend over far enough to reach your feet. It would be even more important to have excellent hip and knee range of motion to compensate for this somewhat. There are ways to open and drain a leg bag without reaching your feet. It is more difficult to push up a ramp or hill with a TLSO unless you have a pretty good pubic "curl" added. It is a little easier to do this with the rodding as long as you have very good hip flexion range. Regardless, if your scoliosis is holding you back so much (and it is unlikely to get any better, only worse), it sounds like the surgery is what you need. (KLD)

04-07-2006, 01:03 AM	#3
offthahook Senior Member Join Date: Feb 2002 Location: Midwest Posts: 299	Thanks for the response. My hip range is off the charts. I think that's why the pelvic obliquity exists. I have SO much range in my right hip. It's like a noodle, too. I feel I "sink down" on my right hip/pelvis/crest area (and that's what the XRays show) and that's where the unevenness starts. Then it goes up my spine as I try to compensate and overcompensate for the curvature... I think if I was perfectly AB, but had this pelvis, I would be in a bad way because of how crooked i am. Obviously, I would compensate differently. At this point, my level of injury seems to not be important. If I was S5, I still think I would be crooked in a chair. Lying down, my spine is straight (I think my pelvis is still tilted, however). I also think I have adjusted to my slouch over time and when I put on the brace !BAM! I have to get used to the tallness and difference in posture. It digs into my pec a little bit. But, my girlfriend likes the 2 handed hug since I don't have to hold on to a wheel because of the better posture with the TLSO. NIICE! Also, I still feel like I'm torqued or twisted at the hips while in the brace. I'm definitely straighter UP, but my pelvis still feels "cocked". Left side being higher and right side lower and farther back. The brace ends above my SP incision, which is above my bellybutton-- typical placement. I wonder what surgery would do for that? Sometimes I feel like a more rigid, "less flexible" torso would be a godsend because of my sinking feeling in the chair. Then, I get scared because I know there is no looking back once the hardware is in. I wonder if I will be able to transfer, do my own BP, etc... The brace helps, but I get red spots and it really isn't doable outside the house. Just looking for others' feedback and the medical answers to my questions. Coolness.