Every Tuesday night several teenagers come to my clinic. Some of them on brace are for regular follow-up, while one or two look for help the first time.
Last night a 14 y/o girl came to me with her parents. She was told to have scoliosis, Cobb angle 44 degrees, 3 months ago. Her father believed that chiropractic could be helpful. After 3 months of treatment, they wanted to check how amazingly it worked.
The Cobb angle became 50 degrees. I told them surgery was needed before the deformity further deteriorated. The mother cried out and couldn't stop tearing.
I think that I broke down what they believed, but I couldn't help it. It was my duty to remind them.
That girl made me think of this picture that I took during my missionary trip. She was just 10-year-old. The brace, which she had worn since she was 6, couldn't fit her.
I told the mother that the girl was too young to recieve surgery. The crankshaft phenomonen was concerned. The mother asked me when I would come back to see the girl again. All of a sudden I couldn't utter a thing.
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I also have Scoliosis, 70 degree. I had the spinal surgery at 10 years old in Taipei in 1970 by the best surgeon at the time.
Why is it that I had my operation at 10 if as you mentioned it is too young?
What is the crankshaft phenomonen? Why is it a concern?
By the way, I am female, 45 with Core Pulmonale.
I don't have a good term for crankshaft, maybe 曲柄.
There are three joints for each vertebra: two facet joints posteriorly and the disc anteriorly. Ten year old is too young because the growth potential is very high.
If we fuse the spine posteriorly, surely the posterior aspect of the fused segment is fixed but the anterior part of the spine keep on growing. You can imagine when the kid turns out to be adolescent, the spine twists around the fused segment and the implanted rods. There deformity becomes more and more severe.
The only exception is when the Cobb angle is too large, maybe more than 80 degrees and deteriorates rapidly. We certainly fuse it before everything is out of control.
Thank you very much.
This would explain why my height stayed pretty much the same ever since the operation.
Three of my vertebras were completely fused on one side at birth. There was no separation between the 3 vertebras on the left side. They had to be "separated".
I suspect that's why the surgeon decided to go in when I was just 10.
The most sad thing about my experience with the whole ordeal was: no one ever took any time to explain to me as a scared to death little girl why I needed to have the operation and what would be done to my body.
After 30 years, I hope the kids today get better psychological preparation for undergoing such a difficult, painful process.
Thanks again for taking the time to answer my earlier message.
i have scoliosis too. wore a brace when i was 14 or 15.
i haven't heard from wh. maybe i'll see her later this year in the States.
mh
You are very welcome, ma'am.
You got 3 hemivertebrae. That's extremely rare and of course, the deformity progressed outrageously.
This is the first time in my life learning the term "hemivertebrae".
While searching on the web to find out how rare this condition, I came across this paper:
Antenatal Diagnosis and Ultimate Outcome of Fetal Hemivertebrae
http://www.spineuniverse.com/displayarticle.php/article1812.html
The conclusion of the abtract states:
CONCLUSION:
"In general sonographically detected isolated fetal hemivertebrae carry a good prognosis. Ultrasound appears accurate in the diagnosis of both the level and type of congenital malformation. The value of very early surgical management needs continued assessment."
Obviously 45 years ago in Taiwan, there wasn't very comprehensive prenatal screening. My big question is, if the detection of the hemivertebrae is so great and going to doom the baby a life of suffering, what would you advice the parents?
Please feel free to disregard this very unfair question to ask of a medical professional and and a deeply religious person.
Yours truly
I won't make choice but leave it to the parents. It's so difficult to me, I mean, if I am the parents.
It would be impossible for me if I were in the position of the parents, religious or not.
I struggle with this question all the time as someone living with severely impaired physical condition. On my good days I am grateful to have the chance to exist on this earth and live a decent life despite all the pain and difficulties.
On my worst days I do wonder if it would be easier if I took a pass on this body and never be born in the first place.
Five years ago my heart and lung failed. As the last resort, I was trached and went on the ventilator with low expectation that I would ever get off it. Somehow after over a year I was able to get rid of the trach. tube.
The interesting thing about coming back again is that my feeling is still the same on this question: whether I should stay around to see what else is in stored for me, or whether I should just beg for mercy for the "Entity" in charged of this universe to call me back home.
It is such a difficult question to answer, Ma'am.
I have a friend who is an artist in painting. She had scoliosis and received operation when she was a 5th grader in the elementary school.
At that time only Hollington rod could be used to keep the alignment of the spine. she received another surgery using modern implants 3 years ago in Taipei. That surgery further corrected her deformity and back pain. She feels better now.
But it means she has no problem of her life? I am not sure.
I pray God's mercy for some patients in my clinic. They are not necessarily having severe physical disability or pain but they just could not escape from the miserable situations they feel.
Recently I heard a news that much to our surprise, the traumatized patients who loses their legs can recover from their sadness in just two weeks. Very few people suffered from pain all their life.
All my life till now is very fortunate and smooth, so I don't think I am good to say something useful to you. Yet if you want my answer, I would say...
Your life can be an art. However, being an artist yourself, you can't indulge in despair. Your family, your friends and even yourself may give up but God never gives up. Don't let go!
For "Jesus Christ is yesterday, today and tomorrow." Do you get it?
If you believe in Buddhism, then always say something good and do something good. No matter how bad wtihout hope this life, you can have an eternal life.
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