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Surgeox

[The case here](http://journal.medizzy.com/scoliosis-surgery-before-and-after/)


JavaShipped

How do they correct this? The article explains the case and the outcome, but not the procedure. Do that separate the muscles from the spine and reposition it and then somehow reconnect the muscles fibers? Why didn't they address the lower spinal deformity? Apologies, I'm curious but very ill informed! Studying for my post grad entry to medicine in the UK.


Scrub-in

As far as the procedure, we dissect down through the skin and muscle down to the bone. Next we remove the posterior [ligamentum flavum](https://en.m.wikipedia.org/wiki/Ligamenta_flava) and some of the spinous processes to create flexibility and make room for the hardware. Once the bone is prepared, and any osteotomies are performed if needed, we insert [pedicle screws](https://www.google.com/amp/s/www.spineuniverse.com/amp/5361). Once the screws are in, two parallel rods are installed along the channels created by the screw heads. We bend and manipulate the rod to bring the spine to the desired position. We then irrigate, do some additional decorticating of some surrounding bone to promote bone healing, then drop in some bone graft and close.


WikiTextBot

**Ligamenta flava** The ligamenta flava (singular, ligamentum flavum, Latin for yellow ligament) are a series of ligaments that connect the ventral parts of the laminae of adjacent vertebrae. Each ligamentum flavum connects two adjacent vertrebrae, beginning with the junction of the axis and third cervical vertebra, continuing down to the junction of the fifth lumbar vertebra and the sacrum. They are best seen from the interior of the vertebral canal; when looked at from the outer surface they appear short, being overlapped by the lamina of the vertebral arch. Each ligament consists of two lateral portions which commence one on either side of the roots of the articular processes, and extend backward to the point where the laminae meet to form the spinous process; the posterior margins of the two portions are in contact and to a certain extent united, slight intervals being left for the passage of small vessels. *** ^[ [^PM](https://www.reddit.com/message/compose?to=kittens_from_space) ^| [^Exclude ^me](https://reddit.com/message/compose?to=WikiTextBot&message=Excludeme&subject=Excludeme) ^| [^Exclude ^from ^subreddit](https://np.reddit.com/r/medizzy/about/banned) ^| [^FAQ ^/ ^Information](https://np.reddit.com/r/WikiTextBot/wiki/index) ^| [^Source](https://github.com/kittenswolf/WikiTextBot) ^] ^Downvote ^to ^remove ^| ^v0.28


Venvel

Good Bot.


JaeHoon_Cho

>bend and manipulate I was lucky to have the opportunity to shadow an orthopedic surgeon whose specialty was in backs, and Jesus Christ did it open up my eyes to how brutal the procedure could be. In order to manipulate the spine in place, they had to throw their entire weight behind the instruments. Crazy how much the body can withstand.


steammodels

Brilliant explanation. Thanks


IdeletedTheTiramisu

It's just absolutely amazing what clever surgeon's and their teams can do! Really am in awe, hats off you you all.


[deleted]

How long does it take the musculature to recover and adapt?


Scrub-in

That is a good question to which I do not know the answer at the moment. I’ll have to ask one of my docs. I’ll let ya know!


[deleted]

It seems like quite a lot of structural cutting to what keeps you upright?


Scrub-in

[If you look at the muscle anatomy ](https://teachmeanatomy.info/back/muscles/intrinsic/) You see that most of the muscle attaches to the lateral aspect of the spine itself. When we do our approach we come right down the center at the spinous processes (the ridge you can feel down the center of your back) so we do as little cutting as possible to the muscles themselves. When we close the incision, we use [heavy suture](https://en.m.wikipedia.org/wiki/Surgical_suture) to bring the layers back together so they heal.


[deleted]

That’s so cool, thank you!


makebelieveworld

Is this only done on really bad cases of scoliosis? My mom has it and her back is always hurting and she has a visible curvature but she only seems to do physical therapy. Is surgery an option for her? What is the recovery like?


Scrub-in

I have seen curves as small as 15 degrees all the way up to 100+ degrees, so we do a wide variety. For [pediatric idiopathic scoliosis ](http://www.childrenshospital.org/conditions-and-treatments/conditions/i/idiopathic-scoliosis) there are options from bracing to surgery. There are a few treatment options for [adult scoliosis](https://health.clevelandclinic.org/5-surprising-facts-about-adult-scoliosis-2/) as well.


makebelieveworld

Cool thanks for the info! Super informative.


Alpha_Wolfgang

i got 51' s curve and ALMOST had this surgery, but i turned 18 a month later and they said they wouldnt do it for me. life has been very painful.


makebelieveworld

Maybe you can find a different doctor that would do it. I hope you don't live your life in pain. My mom finds the physical therapy very helpful.


oneofa_twin

Awesome. But my one question is how do the ribs respond to such a drastic shift? Are the ribs formed normally and the scoliosis shifts the ribs such that this procedure bring the ribs back to a normal position? Or, are the ribs contorted after the surgery?


Venvel

I can't even imagine what it must be like seeing and doing this in person. Incredible. How long does this surgery usually take?


Scrub-in

It depends on a few factors such as how many levels, the size of the curve, etc. For an idiopathic curve say T4-T12, probably about 2 ½ hours skin incision to skin closure. The harder cases are the double and triple curve neuromuscular cases where we are fusing T2 to the pelvis; they can take 10-12 hours.


WavesOfJoy

Yep, I was one of the latter cases. Three curves, T2-L4 fusion, and massive bloodloss. My surgery took over 12 hours to complete and I was also only 13 years old when it happened. I was 5'8" before the correction and I'm now 6'2".


Venvel

Whoa, that's intense.


Scrub-in

I feel for the surgeons, they don’t get breaks like I do.


Huge-Yakmen

Think of braces for your teeth, but in your spine


Schootingstarr

I remembered seeing a gif about it on Reddit once but can't find it. Here's a YouTube video tho https://youtu.be/Yzx-3xjzrFc (It's a cgi animation, so fairly tame compared to the OP)


kiki-cakes

https://www.reddit.com/r/educationalgifs/comments/bvblny/how_scoliosis_curvature_of_the_spine_surgery_is/?utm_source=share&utm_medium=ios_app its long but very informative!


Laurenamy_p

I can half help with your question about why didn’t they address the lower spinal deformity. I have this surgery around 7 years ago, and in my case because of the degree of my curves and the fact I wanted a career in dance, I was told by my surgeon that they would fuse just the top deformity, and hope that the lower deformity will then be pulled into place too. Apologies if it’s not very clear, I can’t really remember the full terms & im still struggling from my NYE night out 😭


ibuildcommunities

Holy mother of god. That is some major surgery. So cool how far we have done with these kinds of procedures. How do they manage not to damage the spinal cord? I assume robotics?


[deleted]

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crestonfunk

Neurologist too. I had my L4, L5 and S1 fused. It stopped the numbness with a little remaining nerve damage but none of that moves anymore, of course. You get mentally ready for it. You know you’re not gonna bend but the weird thing is that you can’t twist. I can’t see my balls except for in the mirror. My wife shaves down there for me now.


Chantelle_Marie28

Would you recommend fusing? I had my L4,L5 shaved downed but it hasn't worked its started to move again, I am desperate for them to take it out and fuse the discs but they won't do it. The pain in my legs is horrendous and I'm on so many meds, I'm more than happy to lose some of my movement if it means I can get off the meds.


crestonfunk

I am NOT a doctor. But I’d say that if the nerve is pinched really badly you may get permanent nerve damage. I got some of that. I have weird burning and numbness in my foot because I waited too long. But maybe you’re not a good candidate for surgery? What’s your age and General health?


Chantelle_Marie28

29 and general health is good, I was a carer and loved my job but unfortunately one of the residents collapsed and took me with her. When they did the surgery my nerves were deeply embedded and they needed to pull them out. This caused my legs to go numb and I loved it. But the feeling came with evenegence. My spine is a bit of an odd case instead of being numb the nerve damaged has caused me to be hypersensitive, when they test my reflexes my leg go off into another planet and they pain is horrible. I've gone from someone who was independent and went off camping and hiking to someone who lives back with their parents on 2 types of morphine and a shit ton of other painkillers, I think the plan in the end is to fuse it but right now they want to continue with epidurals, the only trouble with that is I'm on the NHS and my last epidural was August 2018. I should be looking after my parents now not them still looking after me. I'm so sorry I didn't realise how much I needed to rant, I'm just so pissed off.


crestonfunk

Oh shit the NHS. Why do they not give regular epidurals. This is not the first time I’ve heard this. My friend in Scotland needs fusion in his cervical spine but NHS has refused to attempt epidurals. Here in the US, I have Blue Shield. They wouldn’t approve my fusion until I had a couple of epidurals.


hipstershatehipsters

I’m in almost the exact same situation. My problem started at around 22 and I turned 30 this year. I’ve been told by 2 surgeons now that fusion is my only option, but I’m still putting it off. Combo of insurance not covering it yet and just the general fear of it not doing anything to really help. Being stuck at home after living a fairly active lifestyle is truly the worst though. I’ve found working out to be very good for me, but the soreness can sometimes be too much. I really have to watch what I do. I hope you find some relief, as I wouldn’t wish chronic pain on anyone. It’s hard to even get across to someone what it’s like.


Chantelle_Marie28

I feel your pain, I was the same age when it happened. It was so frustrating when I told people I had a bad back as some would tell me I was too young to have back issues. I usually just showed them the scar on my back, and that would keep them quiet. I did try doing some gentle yoga in hope it would help but I had to stop as it sends shooting pains down my legs and then my feet get really bad pins and needles. I really hope you get the help and support you need.


hipstershatehipsters

Thanks for that. It’s tough to convey to people and a wholly frustrating experience to miss out on so much. I felt myself in that rant though so I wanted to show some support. You’ll be in my thoughts.


lovekittytherapy

Same here, I'm sorry for what you're having to go through. 😥


naruflo

Fusions result in more fusions down the line secondary to adjacent segment degeneration, so I understand why your doctors are putting it off. I am sorry you are going through all of this.


HeathenHumanist

This exactly. Orthos want to put off fusion since it almost guarantees degeneration in the adjacent discus. In a 60-year-old, you could expect them to need 1 maybe 2 more adjacent disc fusions throughout the rest of their life, but in a 20s patient? I'd guess several more surgeries. But of course having 10 years of relief between surgeries may absolutely be worth it, rather than living with the pain (and potential permanent nerve damage) for the next 40 years till they're in their 60s.


Diplodocus114

I had cortisone epidurals for severe sciatica. They can only do a limited number before the scar tissue from the injections makes things worse. Back in 2004 the maximum was 6 - every 6 months. I had 5.


lovekittytherapy

I'm so so sorry.. I'm just reading in passing, and felt the need to say something. I'm just so damned sorry for your situation and pain. I'm 28 have Fibromyalgia and chronic pain since I was 11. I have some spinal stenosis that's starting and it and the endo are genetic in the family. I've worked since I was 16 in various jobs, but my favorite is the animal medical field, but it can be hell on a body that's not right. Over the years my pain and symptoms have worsened leading to more meds and even more symptoms develop as the years go on. I just feel so much sympathy when I see someone else suffering like this.. I wasn't diagnosed until I was 21.. before then everyone just assumed I was lazy. You know, they say you're too young to feel anything like that yet.. but bless my doctor who listened to me and took me seriously. I was basically bed ridden before seeing him and him starting me on the meds I'm on. If not for him, I would've been dead long ago. I couldn't stand it. But when I filled out the, why are you wanting to be seen, forms at first, I put that I fantasized about getting epidurals constantly. I used to wish I could just reach in my body and grasp my lower spine to stabilize it, like maybe it could help. And I'm having to live in a family compound kind of situation. Three family members that are older and need help themselves, and me not being able to be on my own, so I get that too. Anyway.. sorry lol I know what you mean by needing to vent. I just wanted to say I'm sorry for what you're going through, and I hope that you can get the help needed to give you a better quality of life.


Chantelle_Marie28

Thank you, for your reply I'm so sorry to hear what you are going through, I will definitely put some of those suggestions to use. In a non horrible way I'm happy that there are some other people out there who have been or are going through the same thing as I don't feel so isolated. It makes feel stronger and that I can cope with this and gives me hope that I can get my pain stable without the use of so many painkillers/nerve blockers.


lovekittytherapy

Lol you're welcome, and I completely get it. It can be extremely isolating. Joining groups of Fibro sufferers on FB kind of helped me feel a bit less isolated. If you want, you can message me any time on here. :)


DobieLover4ever

I am so sorry you are suffering. ❤️


crewchief535

My wife has severe stenosis in her neck and several ruptured and degenerating disks in her thoracic and lumbar spine. Her neurosurgeon has recommended that she stay off from doing the surgery for as long as possible due to how young she is. Fusions aren't a one and done operation, you typically have to go back in and refuse the adjacent vertebra due to them taking on the added stress. But that all depends on how active you are. My wife's aunt has had to go back in twice since getting her fusion done some 25 years ago.


Ange-Vengeur

This is my pat advice to anyone questioning their medical choices. Don't get advice here. Get a second opinion, preferably from a large city specialty clinic (like CINN in Chicago where you also have experts at Northwestern for referral) or a well respected teaching hospital. Small town hospitals simply do not attract the best and brightest most of the time. A major exception to that is in Green Bay, where athletes and people from all over the world come to see the best ortho (knee/ankle) specialty surgeon in the country. Do your homework. You only live once, and you should aim for the best care you can get. You're worth it!


Alman0429

Isn’t this neurosurgery? Neurologist don’t operate


crestonfunk

I had a neurologist on my spinal fusion who apparently used wires hooked up to some lantern battery or cell phone charger or Nintendo Switch or something to make sure I would have feeling in my legs so the surgeon didn’t close with fucked up shit happening. Also had a vascular surgeon because they had to go through the front for the L5/S1 job and they had to take my guts out and lay them on the table and he needed to be there in case the sliced one of my main blood delivery tubes. I asked them to take a phone pic of this shit going down but they refused because lawyers which sucks because you don’t get to do that every day. Edit: yeah you’re right. Neurosurgeon. Mofo was out of network too. Wasn’t aware of any of this until after.


thenineteenthhole

A neurophysiologist performed intraoperative neuromonitoring during your spinal surgery. Most likely somatosensory evoked potentials (SSEP), spontaneous & triggered electromyography (EMG), neuromuscular junction testing (Train of four), and electroencephalography (EEG). The “wires” aka electrodes send and record signals from your central/peripheral nervous system and are actively monitored at each step of the surgery. Think of the board game of operation...dumbed down, the neurophysiologist’s machine starts to beep, boop, and buzz if the surgeon gets near your spinal cord/nerve roots.


Cthulu2013

Neuro will be the sending physician who's working the case


[deleted]

Does the internal brace stay there for life? And how much does this hurt to recover from? I can't even look at the picture without being scared


HBsuth

Scoliosis surgery is major, major surgery. My daughter had this done back in April, and she is still recovering from it. You get the surgery if you are in enough pain that you are willing to endure the recovery. She had a major spinal deformity, along with arthritic degeneration in her tailbone. She was in a lot of pain all the time. She is very comfortable now, and says it was totally worth it. But May, June, and July were all hard.


Megwen

I'm glad your daughter is feeling better now. I bet the surgery was scary for you. My old step-brother had it done because it was life-threatening. They originally thought it was a 90 degree angle, but it turns out it was twisting around in a loop basically and started touching itself. Like, vertebra that weren't supposed to touch were touching. He could have easily died during surgery.


HBsuth

I looked at surgeries like this before my daughter went in. Your brother is incredibly brave! Was he in traction a long time before they could operate, or was that not the approach?


Megwen

I don't remember; we were both in middle school, and I haven't seen him in years.


[deleted]

Fuck dude, I’m getting that shit soon. The doc said the recovery wasn’t too bad, but now I’m hearing all kinds of conflicting reports. Kinda sorta freaking myself out now lmao. But if she’s not in pain anymore, it’s probably worth the three months recovery.


falloutjosie

I had the surgery back in october of last year and was back to normal within a few weeks (keep in mind I was 18 at the time) with no PT afterwards (definitely should have done it but honestly didn’t really need it). Don’t be scared - you’re gonna feel nervous but the doctors (or at least mine) are specialists in scoliosis and do this stuff all the time. The pain is gonna suck for a few weeks but it gets less and less intense. I had to miss my first semester of college to have this done and I’m so glad I did. I feel incredible now and I’m back at school. Yes it’s scary because they’re literally opening up your back and rearranging it essentially, but you’ll be dead asleep during it and when you wake up you’ll be on so many drugs you won’t even remember it. Have someone write down or tape things you say after you wake up for something to look forward to :)


[deleted]

Hahaha oh lord. When I got some bits in my shoulder replaced, I said some really not nice stuff to my nurses. I don’t remember it a bit. Like not mean, but drugged out flirty and too forward. That’s reassuring though, I’ve been kinda freaked out about it for awhile. Going in next week to put the surgery date in stone.


falloutjosie

Oh no haha. Don’t worry about it, you likely have a great team of doctors who will take great care of you. Another note - I had a pretty big portion of my back affected that had to be fixed. I can’t remember where exactly but i have a scar from almost the top of my shoulder blades to my waist. My parents were shocked how quickly I recovered 😅


[deleted]

Oh shit. That’s a big scar. Like damn that’s big lmao. The part they’re gonna fix isn’t horribly big luckily, but it’s enough to be pretty damn painful and really impact my ability to do much physical stuff. I own an ornamental iron and access control company, so physical work is the name of the game for about 70% of it. Luckily my fabricators do the heavy lifting and stuff for me.


falloutjosie

Yeah it is haha. Good thing it doesn’t bother me! You’re gonna have a weight restriction that goes up every post-op check-in.


SmokeyUnicycle

> said some really not nice stuff to my nurses. I don’t remember it a bit. Like not mean, but drugged out flirty and too forward. How... how did you find out about it?


[deleted]

My good ol’ mother. She likes to remind me of it lmao


[deleted]

A lot of people do end up getting their hardware removed somewhere down the line. Sometimes it just gets uncomfortable or the screws loosen up, or press on the skin in weird ways. Hardware removal isn’t uncommon, but I’m a peds nurse so some of our patients get theirs’ removed at adult hospitals later after they’ve aged out of the system. As far as recovery, our pathway goes like this: first night, you get the good meds. PCA with morphine, IV Valium with if needed. Catheter for peeing, IV fluids. We turn every 2 hours to prevent pressure sores, the patient mainly sleeps. The day after surgery, the catheter comes out, the PCA button is taken away, the patient eats and is put on oral pain killers (we usually start with norco), then physical therapy gets the patient out of bed. Walk the halls at least 3 times that day, work with PT twice. The second post op day, more pain meds, more PT, and sometimes if all goes well, we send them home. Yep, we send kids home two days after this enormous surgery. Most people stay a third night, but very rarely do they stay past that. Home with PT set up, pain med prescription, and off they go. It’s incredibly painful, but some handle it better than others. The worst is people who refuse to get out of bed and follow the program. They’re in a lot more pain- the reason we have it set up the way we do is based on evidence and experience in how to deal with pain and help them get back to normal as quickly as possible.


Scrub-in

Yep, the hardware is in for life as long as no infection develops and it doesn’t fail. I have scrubbed hundreds of these cases and seen some hardware failures, some infections, but the vast majority were routine. As for recovery, I’m not sure. We have the good drugs available, but I imagine it is painful. Docs usually recommend 6 months heal time before heavy exercise and 12 months before contact sports.


boisdeb

You can do contact sports one year after? I'm happy it recovers to that point but also surprised.


Scrub-in

After a year, that area of the spine has fused into one solid bone mass with cobalt chrome reinforcements, it’s going to be strong!


nullsignature

I bet it's boss for squatting and deadlifting; no chance of rounding or hyperextending your back!


wolfgirlnaya

100% chance of your mom freaking out when you tell her you'd been deadlifting, though. *eyeroll* I do get plenty of compliments on my posture any time it comes up. It's fun to see how they react when I say "thanks! My spine is fused so I couldn't slouch if I tried!"


wolfgirlnaya

The internal braces are called Harrington Rods. They're intended to be permanent, but they may be removed/replaced if complications arise, including if the patient is a child at the time of fusion and outgrows the implants. I have my T4-L5 fused. Honestly, I don't remember any pain, but my memory of the time is completely fucked thanks to a lovely combo of massive depression and so many painkillers. I'm a rare case in that I've had no issues with recovery or function. It helps that I was incredibly fit and flexible when I got it done. Recovery-wise, I was in hospital for a week, bedridden for a month, and on restrictions for a year. It took a lot of getting used to. I have to be picky about cars now, because headrests tend to put way too much strain on my neck. I'll also be giving birth soon, and it's completely up in the air whether or not I'd be able to get an epidural if I wanted or needed one. Apart from that, I'm effectively free to do whatever I feel up to doing. And minus the massive pregnant belly, I can still touch my toes.


Soakd

yep. its in there for life. stiff as a board.


K_Pumpkin

I had a bone graft in my pointer finger. Had a bone tumor, and it made my finger keep breaking so had to be fixed. I asked what kind of sedation I was getting and if I could stay awake. He said, “I always put people fully asleep for this. I could do a full block but the bone drill is really loud and it can be unsettling.” Needless to say I took the offer and got knocked out.


JusCallMeEli

I had a surgeon tell me that orthopedic surgery is just carpentry, but with bones instead of wood.


ibuildcommunities

Wow, thanks for explaining!!


jrd08003

There are a couple robotic systems able to provide mechanical guidance to surgeons while Placing pedicure screws, I’m a rep for one of them.


genusbender

There’s a neurophysiologist involved too. I’m the US it’s usually a third party rep that hooks up some pretty cool stuff to make sure the lo surgeon and team don’t mess up anything neuro wise. It’s a very long surgery. P


RaiynMann

There actually are several Robotic systems out that that assist in this type of surgery for pedicle screw placement. The correction is still done through manual means, but the surgery time is being cut down as well as more accurate screw placement. To answer the other questions, Doctors will do CT scans either prior to or day of the surgery and use a fluroscopy device(or the Robotic or navigation system) during the surgery to ensure accurate placement. I can go into much more detail if interested. It's an amazing field, with some ground breaking advancements in navigated and Robotic surgeries. If your interested in more research you can look at Globus Medical ExcelsiusGPS system or the Medrontic Stealth/Mazor X system. Edit: also orthopedic surgery is also scarily similar to carpentry, it's all the same tools (hammers, chisels and screws)


smallbutfierce

Thanks for the OT shoutout!


Ange-Vengeur

I think you left out Respiratory Therapy, but that's okay because they're usually out on a smoke break anyway. (joking, though a surprising number of them do smoke)


I_like_squirtles

My sister had this done when we were teenagers. A few years later she was hit by a drunk driver and had to have metal rods in both femurs. Strongest girl I know and she is half robot now. I can’t imagine having either one of those done.


JaFFsTer

Ortho surgeons are basically carpenters that the state lets work on people. The most low tech solution is usually the answer


RNGeebs

I did a spinal surgery workshop where they basically just show us how it’s done, they take these bone clippers and clip the spinal processes right off (kinda brutal). Then they drill holes right through the (pedicles or laminae, forget exactly which) then just use a big torque wrench to screw in some heavy duty screws at the right angle so it doesn’t breach through the bone. After that they clip in some special nut/connecting pieces to the top of the screws which they can insert rods into. It’s super satisfying because when you secure the connecting pieces onto the screws there’s a big clicking sound of them being locked into place. The rods and screws basically replace the articulating processes of the spinal column and they can be adjusted


ibuildcommunities

Appreciate the explanation!


Marha01

Why do they clip spinal processes off?


Scrub-in

We also use the spinal processes as bone graft at the end of the surgery. Part of my job is to chop up the bone into smaller pieces that we spread along the entire construct to facilitate bone fusion.


RNGeebs

That’s where they drill the screws into the spine, the connections from the spinal processes to the vertebral body


not_mantiteo

I had a friend in high school that got this done. The x rays afterwards are insane. Huge spikes lol


[deleted]

That’s gonna be me in a month or two. I’m fucking dreading it.


makebelieveworld

Dont worry, you will be fine. And when it is over you will be taller. And when you are an old person you will not be hunched over like the rest of us.


[deleted]

I’m mostly worried about if my employees can handle everything while I’m down. They’re great at the metal fabrication part, but I normally handle all of the electronics and access control stuff. But holy shit, the thought of getting around pain free is exciting. Extra heights wouldn’t be too bad either lmao.


-Samg381-

It'll go great. Start training your amanuensis now, lol. Also teamviewer is your friend.


[deleted]

Lmao that’s a good idea. Ive actually never thought about FaceTiming my guys when they’re out in the field. Shit, now I’m not worried near as much. Thanks!


chordae

No, just don’t put the screws into the spinal canal.


tired_and_hungry2

They now use intraoperative 3D guidance for drilling the screws. It helps the surgeon pick the right angle (it’s a pretty tight fit). But 5-10 years ago it was all by feel and x ray.. lots of x-rays


oblik

Probably a very good jig that lines the drill up with the "definitely safe to drill" part of the spine


mattyairways

This was posted a while ago. Stoked I was able to find it. https://www.reddit.com/r/educationalgifs/comments/bvblny/how_scoliosis_curvature_of_the_spine_surgery_is/?utm_source=share&utm_medium=ios_app&utm_name=iossmf


507mark

Friend of mine had same procedure 2 months ago, gained 2" height.


Wookiees_n_cream

This is probably a really stupid question... But... Can they bend after this surgery? How's their mobility? I know absolutely nothing about this.


[deleted]

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[deleted]

So the metal braces are permanent?


[deleted]

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maulidon

Childish question here, but is the brace visible under the skin? Like the way ribs or knuckles press up from underneath the skin?


Scrub-in

Good question! The answer is: it depends. On most idiopathic scoliosis patients the muscles on the back are healthy and thick and cover the hardware well. Some neuromuscular patients, who have other underlying conditions such as cerebral palsy tend to be less healthy and since they are not very active, don’t have a thick layer of muscle to cover the hardware. This makes them more likely to develop infections and skin breakdown even under the best of post op care.


[deleted]

Occasionally, especially when the surgery is done at a young age, they go back in 7-10 years later to remove some of all of the hardware. This can be due to it pinching muscles/nerves as the patient grows. I had this surgery when I was 13 and they left extra room at the top of the metal rod to accommodate growth in my neck/upper spine, but I ended up not growing as much as predicted. The rods occasionally pinch the nerves in my neck and shoulders and I was given the option to have surgery to shorten or remove part of them, but I opted to put up with the discomfort to avoid another surgery (especially since the first had a ton of complications)


DaFuuuc

I know this sounds stupid, but were you always 6’5 and the curvature in your spine made you 6’1? Or does the brace literally stretch you taller?


opage24

You can't bend you back that we'll, so you have to bend from the hips.


maebird-

My friend had this surgery! She can’t twist suuuper well or do a lot of exercises in our gym class. Push ups, curl ups, and a lot of stretches are out of the question for her. But she can twist side to side more than she thought she’d be able to. The only things she has trouble with were the things above, bending down to pick up something, and walking down stairs in the early months. Of course, that’s from my outside perspective so she may say differently.


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undercoverballer

Ummm I hope you got an opinion from an MD and not just a chiropractor?


Scrub-in

Seconded! Please get a second opinion from an orthopedic surgeon, chiropractic adjustment is not a substitute for proper orthopedic care. Even if you don’t need surgery, physical therapy and bracing will be much more effective long term than chiro. I don’t mean to be pushy, but I have had multiple patients who were misled by chiropractors and ended up coming to our ortho docs much later than they should have, leading to more extensive surgery.


SalsaRice

My SO had this. They can bend over, but it's best not to over do it. I believe there's an increased risk for back pain. They only do the surgery for very bad scoliosis cases. Most people with mild scoliosis do not get surgery.


wolfgirlnaya

I've had my spine fused for 12 years now. Got 4" taller and went from putting my knees up behind my shoulders to being able to juuuust touch my toes. The fused section doesn't bend, but the unfused vertebrae help compensate for that. Gotta be careful, though, because you can definitely put too much strain on one or two vertebrae and end up stiff and sore.


507mark

Titanium rods do bend but not as much as a normal spine.


tileyourbathroom

Eww girl you got dirty bones


domeoldboys

Thats burnt flesh on the bones, they pretty much cauterise as they cut to prevent excessive bleeding and they fill the entire OR with the strange smell of burnt flesh.


[deleted]

I think that might be my least favorite smell ever


Furlange

My Patients during a c-section: “omg is something burning in here??” Me: “please don’t think about it too much..”


hotmarhotmar

Or getting a root canal and the drill starts going and you can smell the burning of teeth, gets me every time.


KetchupIsABeverage

It all depends on which mammal you’re roasting


makebelieveworld

Strange or delicious?


domeoldboys

Strange, just strange


e-wrecked

I thought they looked like barbeque ribs.


[deleted]

Well in a sense......


Inappropriatenurse

r/forbiddensnacks


Foxy-Sloth

Yo i am dying!!


IM_SAD_PM_TITS

Yo.... please don't


Andromeda853

I was literally like “tf those bones needed a bath”


RandomChickenWing

Just straightened my back looking at this


henkie316

Yeah and it feels really good to do


Lumasarecute

This look so painful! Can the body actually reject the surgery?


dottiemommy

Recovery from this surgery is extremely painful and takes a long time.


DanSkaFloof

Normally it takes 8-10 days and it isn't as painful as you might think. I had this done to me, and it wasn't that painful lol (I later had an infection and the second surgery, despite being minor, was more painful than the first one).


Gwenny99

8-10 days??? Took me months to recover, 4 days in the hospital and almost 2 months out of school. I have almost my entire spine fused (more than the photo)


YunasNirvana

Same! I was out of the hospital after a week but I couldn’t even go back to school until 3 months later... The recovery process was rough for me. It has been 10 years now and I can honestly barely remember it but I know that I spent most days sleeping with Valium in my system. At one point I got some kind of stomach bug and couldn’t keep anything down, which is really fun when you are stuck in bed and can’t even roll over on your own... Thanks, mom, for helping me clean vomit off of myself more than once. I was also severely malnourished because I didn’t feel hungry most days and legitimately slept for days straight to get through the pain and when I had to learn how to walk again I went through a dizzy spell where my body essentially went through a panic attack. I would stand up and suddenly see all black and then while spots in my vision and then lose all control of my body and black out. Super fun for someone who just had major back surgery 😅 I didn’t shower for months either. Man, what a recovery lol


dottiemommy

Did you have a long fusion like the one in the photo? For a long fusion like that, it's 8-10 days in the hospital but then months of physical therapy, possibly wearing a brace, and pain after that.


falloutjosie

I had it done from around my shoulder blades to the middle of my waist with a curve of almost 50 degrees and recovered within about two or three weeks. No PT or brace. The pain was unbelievable but I was on so many drugs I can’t even remember it. I was in the hospital for 5 days. Walking was a bit hard but they got me walking the day after surgery and as much as I protested I’m glad they made me. My doctor told me walking is the best thing you can be doing - walk all the time. That was essentially my PT. A year after and I’m feeling fantastic.


dottiemommy

I wish my outcome was as positive as yours. Unfortunately, while my fusion was very helpful in ways, I still deal with chronic pain and physical limitations. My SI joints are in bad shape now.


falloutjosie

Shit dude I’m sorry


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dottiemommy

Since when? I'm not prescribed antibiotics before dental surgery and I had this surgery twice: 8 and 27 years ago. Plus other spinal surgeries.


agjjnf222

According to the AHA guidelines, those with artificial heart valves, a history of infective endocarditis, certain congenital heart conditions, heart transplant are definite in need of prophylactic antibiotics before dental procedures due to the risk of transient bacteremia from gingival bleeding. From the American college of orthopedic, it looks like there has been some controversy about this topic but it is not recommended or needed.


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Imydie

How much pain did u have before the surgery Was it a choice or did u HAVE to have the surgery If u didn’t get it done what would’ve happened What were the degrees of ur curvature How long was the surgery Was the procedure free , if it wasn’t what was the cost How long were u in the hospital for What was the pain like after the surgery(recovery Did u have any complications Is it painful When u sneeze or cough How has ur life been after all these years


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Gwenny99

I am not the only one who has hit their head getting in the car!


SuperClicheUsername

1. I had what I would've called a lot of pain before the surgery. Consistently 4-5/10 and up to maybe 7. After surgery it got more painful (I'm 1.5 yrs post op.). Consistently 6-7 and spikes to 8 or 9. 2. "Choice" in that I could get it performed immediately or slowly have my lungs crushed for the rest of my life. After 40-50 degrees it progresses throughout your life even after you stop growing. 3. 67.3 degrees iirc 4. 8 hours maybe? It took the whole day is my understanding. 5. Nope, I don't know for sure I would have to ask my parents. We had good insurance though. 6. In hospital for about a week. 7. Only complication was UTI because of the catheter that is needed because of pain meds. 8. Don't think I've ever noticed any. Maybe a bit when I'm laying down. 9.Ehhhh. The chronic pain is pretty bad and I can't walk around for more than a few hours. Never been able to get prescription pain meds after the surgery unfortunately. Limited to ibuprofen when the pain is bad.


Alpha_Wolfgang

makes me kinda glad i didnt get the surgery. knowing my luck i would be in worse pain afterward. sorry man, i hope they can do something. its also absurd that you, we, cant get any real painkillers for this.


Gwenny99

Someone else that had this done chiming in here: 1. No pain before surgery was done 2. I was 14 at the time, kind of had a choice I guess, but if I didn't get it done, it would have twisted my entire upper body and I would have severe pain now. 3. over 50 Degree curve 4. Surgery was about 8 hours 5. Definitely not free and idk the cost but I am guessing over 50K (US) 6. I was in the hospital for 4 days 7. Pain was awful. I didn't eat well for weeks, very uncomfortable to lay down or sit up straight. I play the violin, and it took a while for me to adjust to the new posture 8. No complications Edit: Forgot to mention that the dissolvable stitches took forever to go away and were stabbing me from the inside for about a year, also my muscles were very sore for a while since they have to cut them to get to the spine 9. It does hurt when I have a big sneeze since I can't bend my spine, but normally, no it does not 10. Life has been fine, not to the point to have children yet, but that will be interesting....Great posture for violin playing though! I do get massages frequently since, like I said, my muscles can get knotted up or overall painful (but maybe that is normal for anyone) My back does get sore when walking around all day, for instance at an amusement park, but overall it is pretty good. Occasional sciatic nerve pinches that can last for weeks.


puzzlebuns

Is it just the hardware that’s fused, or is there bone to bone fusion too, like during spinal fusion for disc hernias? What’s it like not having a flexible backbone?


beaslebitten

Is the coffee-grounds effect on the spine just from cauterizing the... muscle?


Scrub-in

Yes, muscle and accessory vessels.


Veritius340

Forbidden ribs


SweetboyRomero

One thing I love about reddit - you can almost guarantee someone has already commented the first thing you thought of.


IdeletedTheTiramisu

Yep, definitely giving bbq vibes


DarkyHelmety

r/forbiddensnacks


hhyyk

How do they do to not make this person bleed ?


riotgirlckb

Cauterize the site


Scrub-in

We do get quite a bit of bleeding even using cautery. People sometimes forget that bones bleed, a lot. I would say the most blood loss occurs when we are cannulating the spine pedicles just before we insert the screw. Additionally if we have to do [Ponte Osteotomies ](https://www2.aofoundation.org/wps/portal/!ut/p/a0/04_Sj9CPykssy0xPLMnMz0vMAfGjzOKN_A0M3D2DDbz9_UMMDRyDXQ3dw9wMDAx8jfULsh0VAdAsNSU!/?bone=Spine&segment=DeformityScoliosis&soloState=lyteframe&contentUrl=srg/popup/additional_material/55/X140-OsteotomiesForLargeCurves.jsp) we can lose quite a bit to bone bleeding.


Poppintags6969

So like are our spines always that dirty?


sumire_aiita

gotta drink water cuz that goes down your spine, when ya don’t drink water your insides can’t get washed trust me, i saw this in a dream once


Maximussav

Yennefer?


sharkcurtain

Those do be some BIG retractors


TableyTable

my mans went from ? to !


diphteria

Giant paperclip


d4rkfibr

Hey to all you med guys, quick question. I have some scoliosis, it's hasemt be rated to be really bad but it's still noticeable. Im a 39 year old dude. My wonderful parents never had it corrected for me as a kid. Is there anything i can do about it now or is it too late? I am in a some discomfort from it and it looks crappy. I've heard you end up with more problems but wanted to know of it's even a option or would i be ruining my life by doing the surgery so late. Thanks.


Gwenny99

I believe adults can still get it done, just takes longer to recover. I would definitely suggest getting an ortho surgeon to look into it. If you are anywhere near Johns Hopkins, Dr. Sponseller did my surgery and is an excellent doctor. I don't know if he only does pediatric though, but I am sure they could recommend someone.


Shep_Meister

Thanks I hate Scoliosis surgery


[deleted]

Can someone explain why the bones are so brown? And the surgery looks amazing, it's awesome how far we have come!!


[deleted]

From cauterizing to stop the bleeding


Cantaimforshit

Everytime I watch one of those surgeries I'm just waiting for something to fracture or get tugged on a little too hard


HappyPancakeOfDeath

Jesus Christ. I have a really bad scoliosis and when I see pictures like that, I just can't believe that the wrist of us scoliosis patients is looking like this and that you actually need this incredibly big surgery to fix it. Holy shit.


Lostinonederland

My mum has just undergone a second surgery within her back to stabilise lumbar scoliosis and bulging discs that were compressing her spinal cord. I've just found out that I have thoracic scoliosis but not severe enough for surgical intervention. This is mind blowing to see. My mum trained as a nurse and I have a deep seated passion to become a doctor. I had to put studies on hold after I was hit with several impeding medical issues. Will have to show her this one.


GaryandCarl

I work in a factory that makes spinal orthopedics and I handle the very devices that you see in this picture daily. I love seeing these pictures!


BeardedOutHere

I showed this to my gf and she said, “holy shit that’s metal” and looked at me with the smuggest fucking face ever


Powered_541

this ain't a waist trainer this a backbrace bitch I got scoliosis


scarletts_skin

Anybody know the risk of paralysis in a surgery like this? Like what are the chances, percentage wise — obviously it depends where on the spine the fusion is done, but I’m interested to know how high the risk is.


Gwenny99

I was told less than 1% Edit: But they might have told me that to make the 15 year old me not scared.


Soakd

my little sister got this done. its fucking wiiiiiiiiild. she can't really bend like 'normal' ppl do and its definitely there for life.


Butthead2242

Lmao how tf did we come this far w medical advancements. “Doc my spine is bendy” “Ok , Fuckin I’m going to cut you open and make your spine stay str8 aF” Word


DanSkaFloof

I got this bad boy one year ago, pretty metal (my back apologizes for that shitty pun), and I'm all good. I can't curve my back anymore, but my life is perfectly normal.


falloutjosie

This is actually really cool - I didn’t get to see mine like this. You can’t even imagine the pain for the next week.... Fun fact: they don’t make the incision straight down, but along the c-/s-curve of the spine and it heals straight


treeling96

Once this is done, a person can't bend their spine anymore right?


grandpasTesticle

Looks like a god damn pomegranate lol


sphrasbyrn

This is one of the most r/oddlysatisfying medizzies I've come by


blobfish_brotha

Had this done when I was 11 (20 years ago now), T3-L2. This is the first time I've seen a photo of the actual procedure and it's kind of mesmerizing me. My curvatures were significantly worse than this patient, though. I think mine was an 8 hour procedure.


[deleted]

Wow, look at all that tartar buildup. Someone needs to do a better job of brushing and flossing.


Roseandwolf

I have scoliosis and im like woah they aligned that shit good. Do i need a surgey like that?


_Piilz

hey im getting this done in 5 days and i certainly didnt want to see this. fml


Libranka

Wow. That is impressive work.


[deleted]

Are they going to fix the lower spine, too?


mollynatorrr

My brother had a surgery probably exactly like this a few years ago to correct a massive curve in his spine that was about to start impacting his lungs. No wonder he’s in pain all the damn time.