Re: Live Broadcast of Scoliosis Surgery

[Guest guest]

Is the live broadcast only available through Internet access.

Unfortunately, I have an iMac computer and it won't download this type of

broadcast. Will

it be on TV or is there any other way to view it?

[Guest guest]

,

Thanks for this information... I think! I have mixed feelings about

watching this. While it sounds like it would be fascinating, I am

nervous that it would also make me feel very emotional. I am going to

" tune in " and then see how I do with it. My husband and I have

discussed this before because he was invited to " observe " one of my

surgeries - he flat out declined! Just a little too personal, I guess?

It's a strange thing...

Kelley

>

> Akron Children's Hospital to Air Internet Broadcast of Spinal Fusion

> Live From the OR

>

> AKRON, Ohio, Aug. 23 /PRNewswire/ -- On Friday, Sept. 8, from noon to

> 1 p.m., doctors, parents and patients from across the globe can watch

> a live surgery to correct scoliosis - from the convenience and comfort

> of their own homes or offices. The one-hour live webcast will show

> Akron Children's Hospital's Musculoskeletal Health Center Director

> Schrader, M.D., and Riley, M.D., surgically correcting

> a scoliosis spinal deformity.

>

> For most patients, scoliosis requires only observation and repeated

> examination in the growing years. However, a small number of cases

> need medical intervention, such as bracing or surgery.

>

> Bracing is often prescribed for children who are still growing and

> have a spinal curvature between 25 and 45 degrees. Surgery is

> generally recommended for curves greater than 45 degrees. Surgical

> treatment is specific to each patient's situation.

>

> During the webcast, the pediatric orthopedic surgeons will use a

> series of rods, hooks and screws to straighten the spine, including

> the latest pedicle screws, which eliminate the need for postoperative

> bracing or casting and increase the overall rate of correction and

> healing.

>

> " Pedicle screws provide very stable purchase to the vertebra, " Dr.

> Schrader said. " In fact, they've been shown to improve correction of

> the spine by as much as 30 to 50 percent over previous systems. "

>

> If left untreated, scoliosis exceeding 50 degrees can lead to

> long-term issues, such as diminished lung capacity and the development

> of restrictive lung disease.

>

> To watch the preview video or to tune in to the live webcast, go to

> www.akronchildrens.org/story/ and type " scoliosis " for the keyword.

>

[Guest guest]

Hi ...

I don't know anything more than what was in the announcement and on

the website. I have a Mac and am able to view the preview, and assume

I'll be able to view the actual event.

--

>

> Is the live broadcast only available through Internet access.

> Unfortunately, I have an iMac computer and it won't download this

type of broadcast. Will

> it be on TV or is there any other way to view it?

>

>

>

[Guest guest]

Did anyone watch this live webcast? I

watched parts of it (very little because I had to give my daughter lunch) –

but it was a bit much. I think I could watch it again but only in small doses.

Lorrie Snyder

From: [mailto: ] On Behalf Of Racine

Sent: Wednesday, August 23, 2006

6:16 PM

Subject: [ ] Live

Broadcast of Scoliosis Surgery

Akron

Children's Hospital to Air Internet Broadcast of Spinal Fusion

Live From the OR

AKRON, Ohio,

Aug. 23 /PRNewswire/ -- On Friday, Sept. 8, from noon to

1 p.m., doctors, parents and patients from across the globe can watch

a live surgery to correct scoliosis - from the convenience and comfort

of their own homes or offices. The one-hour live webcast will show

Akron Children's Hospital's Musculoskeletal Health Center

Director

Schrader, M.D., and Riley, M.D., surgically correcting

a scoliosis spinal deformity.

For most patients, scoliosis requires only observation and repeated

examination in the growing years. However, a small number of cases

need medical intervention, such as bracing or surgery.

Bracing is often prescribed for children who are still growing and

have a spinal curvature between 25 and 45 degrees. Surgery is

generally recommended for curves greater than 45 degrees. Surgical

treatment is specific to each patient's situation.

During the webcast, the pediatric orthopedic surgeons will use a

series of rods, hooks and screws to straighten the spine, including

the latest pedicle screws, which eliminate the need for postoperative

bracing or casting and increase the overall rate of correction and

healing.

" Pedicle screws provide very stable purchase to the vertebra, " Dr.

Schrader said. " In fact, they've been shown to improve correction of

the spine by as much as 30 to 50 percent over previous systems. "

If left untreated, scoliosis exceeding 50 degrees can lead to

long-term issues, such as diminished lung capacity and the development

of restrictive lung disease.

To watch the preview video or to tune in to the live webcast, go to

www.akronchildrens.org/story/ and type " scoliosis " for the

keyword.

[Guest guest]

I did watch the webcast later in the day. It may still be available

for viewing. It was a lot to take in, but I did learn and understand

more about what my doctor is talking about, even though revisions have

additional challenges. It is hard to watch if you are squeamish. For

those who want to learn more about the technical aspects, I'd say it

would be useful.

Annette in Arlington

Revision date Oct 2

[Guest guest]

The webcast is available on their archive at:

http://www.or-live.com/akronchildrens/1563/

--

On 9/9/06 2:24 PM, " aebaker716 " <aebaker716@...> wrote:

I did watch the webcast later in the day. It may still be available

for viewing. It was a lot to take in, but I did learn and understand

more about what my doctor is talking about, even though revisions have

additional challenges. It is hard to watch if you are squeamish. For

those who want to learn more about the technical aspects, I'd say it

would be useful.

Annette in Arlington

Revision date Oct 2

[Guest guest]

A very interesting broadcast. It was pretty graphic...but I thought it

did a great job demonstrating most of the procedure that most of us

undergo in revision...setting the implants, attaching the rods,

managing the patient. For me it was great to see.

Kind of interesting when the doc was asked about discs above and below

the fusion....I thought he kind of " soft sold " it....and didn't really

say much about the period after 25 or 30 years...but I guess I didn't

really expect a different answer.

If you haven't seen the vid, and blood/gore doesn't bother you too

much...highly recommended! Its an hour long.

Thanks for putting up the link !

Cam

[Guest guest]

I was the " viewer that sent in the question about the discs above and

below the fusion level and I didn't get the answer I was hoping for

either! I wrote back in after he answered it and made the question more

specific to " degenerative changes " , but they never got around to

answering it. I don't like to hear that they tell parents that it's

" OK " for kids to get back into sports 6 months after the procedure,

either.

It was very interesting to watch them trying to snap the rods into place

and how they bent themto shape to make it work. I would have liked to

see more of the surgery to understand how they do the de-rotation of the

vertabrae.

It was only a bit unnerving for me with all the blood, etc. - I found

myself biting my nails in a few places when they were manipulating the

spine (glad to see they " rest " for the soft tissues to adjust). )

Kelley

>

> A very interesting broadcast. It was pretty graphic...but I thought it

> did a great job demonstrating most of the procedure that most of us

> undergo in revision...setting the implants, attaching the rods,

> managing the patient. For me it was great to see.

>

> Kind of interesting when the doc was asked about discs above and below

> the fusion....I thought he kind of " soft sold " it....and didn't really

> say much about the period after 25 or 30 years...but I guess I didn't

> really expect a different answer.

>

> If you haven't seen the vid, and blood/gore doesn't bother you too

> much...highly recommended! Its an hour long.

>

> Thanks for putting up the link !

>

> Cam

>

[Guest guest]

,

I kind of figured it was someone from this group that sent that

question in! I didn't see it live so I didn't send any in. Let us know

what further responses you get.

I agree completely with you....I thought it seemed a little

irresponsible to indicate that most kids could go back to contact

sports as soon as 4-6 months. I realize that the technology has

changed but I don't think the reality that every unfused segment takes

up a bigger load has. Maybe they won't get flatback....but they still

are probably at risk for early degenerative changes...so why not steer

them away from those sports at high risk for injury?

Take Care,Cam

[Guest guest]

Hi Kelley...

Toward the end of the broadcast, they make it sound like there had been no derotation yet, but I believe that’s at least partially incorrect. When he attached the big rod holder to one of the rods and pushed on the rod holder (while the second surgeon pushed on the patient’s opposite side, that’s how the spine is derotated. By rotating the rod 45 degrees, the curve of the rods that match the scoliosis curves became the lordosis and kyphosis curves. If you look at the broadcast at around 24:00 and at around 53:00, you can see them doing it. When curves are more flexible, the derotation procedure goes much faster.

I noticed that the surgeon did mention that with having a fusion go as low as it did in the specific patient, it probably wasn’t a good idea to play contact sports. And, he did mention that if there was no curve left in the discs above and below the curve, the discs usually stay healthy.

Regards,

On 9/11/06 4:24 AM, " kmrevised " <kelleymoore@...> wrote:

I was the " viewer that sent in the question about the discs above and

below the fusion level and I didn't get the answer I was hoping for

either! I wrote back in after he answered it and made the question more

specific to " degenerative changes " , but they never got around to

answering it. I don't like to hear that they tell parents that it's

" OK " for kids to get back into sports 6 months after the procedure,

either.

It was very interesting to watch them trying to snap the rods into place

and how they bent themto shape to make it work. I would have liked to

see more of the surgery to understand how they do the de-rotation of the

vertabrae.

It was only a bit unnerving for me with all the blood, etc. - I found

myself biting my nails in a few places when they were manipulating the

spine (glad to see they " rest " for the soft tissues to adjust). )

Kelley

[Guest guest]

,

Don't you think it is probably premature for the doctors to say

anything about the long term health effects of fusion on the discs

above and below? I am thinking....gee....I had my original fusion in

1973...pretty early on, and I and only 50.....barely into AARP

range...so the population with the segmented rods and shorter

fusions are mostly in the mid to late 30's hardly enough longevity

to say what the effects on their discs might be....saying the discs

usually stay healthy....until when...50 or 55? I thought the doc

that answered that question looked a little uncomfortable. Longevity

expectations in this country is 78 for men and 80 for women. Since

even our " cohort " isn't there yet...they can not have the

statistical basis for making this statement...can they?

I realize they have wrestled the flatback issue to the ground in

terms of knowing how to prevent that....but one reason the docs are

trying to develop the artificial disc is to prevent exactly this

kind of wear and tear on other joints...right?

I can see that this doctor mainly deals with pediatric patients, and

I can understand why he would no want to hurt the self image of the

kids by unnecessarily limiting them....but is that really being

honest with the patients? I think I would have preferred he say

something along the lines that they can not be sure over the

patients life time who will encounter the usual effects of an aging

body and spine...and so they recommend that their fused patients

engage in non-contact sports and persue athletic endeavors that

minimize the trauma of concussive wear and tear on the remaining

mobile discs.

At least if the patients disregard that advice they do so at their

own peril. I wish my surgeon had been clearer on this point...even

if, for me, it wouldn't have changed a thing...I realize I probably

still would have had to deal with flatback in any event.

Take Care, Cam

>

> Hi Kelley...

>

> Toward the end of the broadcast, they make it sound like there had

been no

> derotation yet, but I believe that¹s at least partially

incorrect. When he

> attached the big rod holder to one of the rods and pushed on the

rod holder

> (while the second surgeon pushed on the patient¹s opposite side,

that¹s how

> the spine is derotated. By rotating the rod 45 degrees, the curve

of the

> rods that match the scoliosis curves became the lordosis and

kyphosis

> curves. If you look at the broadcast at around 24:00 and at

around 53:00,

> you can see them doing it. When curves are more flexible, the

derotation

> procedure goes much faster.

>

> I noticed that the surgeon did mention that with having a fusion

go as low

> as it did in the specific patient, it probably wasn¹t a good idea

to play

> contact sports. And, he did mention that if there was no curve

left in the

> discs above and below the curve, the discs usually stay healthy.

>

> Regards,

>

[Guest guest]

Hi Cam...

I don’t know for certain, but I believe that when surgeons see patients with very old fusions, for which the first uninstrumented disc and vertebrae are level, they rarely see degeneration. It’s those of us whose first uninstrumented top or bottom disc and vertebrae are tilted that seem to have the problem of degeneration.

Regards,

On 9/11/06 12:40 PM, " cammaltby " <cammaltby@...> wrote:

,

Don't you think it is probably premature for the doctors to say

anything about the long term health effects of fusion on the discs

above and below? I am thinking....gee....I had my original fusion in

1973...pretty early on, and I and only 50.....barely into AARP

range...so the population with the segmented rods and shorter

fusions are mostly in the mid to late 30's hardly enough longevity

to say what the effects on their discs might be....saying the discs

usually stay healthy....until when...50 or 55? I thought the doc

that answered that question looked a little uncomfortable. Longevity

expectations in this country is 78 for men and 80 for women. Since

even our " cohort " isn't there yet...they can not have the

statistical basis for making this statement...can they?

I realize they have wrestled the flatback issue to the ground in

terms of knowing how to prevent that....but one reason the docs are

trying to develop the artificial disc is to prevent exactly this

kind of wear and tear on other joints...right?

I can see that this doctor mainly deals with pediatric patients, and

I can understand why he would no want to hurt the self image of the

kids by unnecessarily limiting them....but is that really being

honest with the patients? I think I would have preferred he say

something along the lines that they can not be sure over the

patients life time who will encounter the usual effects of an aging

body and spine...and so they recommend that their fused patients

engage in non-contact sports and persue athletic endeavors that

minimize the trauma of concussive wear and tear on the remaining

mobile discs.

At least if the patients disregard that advice they do so at their

own peril. I wish my surgeon had been clearer on this point...even

if, for me, it wouldn't have changed a thing...I realize I probably

still would have had to deal with flatback in any event.

Take Care, Cam

>

> Hi Kelley...

>

> Toward the end of the broadcast, they make it sound like there had

been no

> derotation yet, but I believe that’s at least partially

incorrect. When he

> attached the big rod holder to one of the rods and pushed on the

rod holder

> (while the second surgeon pushed on the patient’s opposite side,

that’s how

> the spine is derotated. By rotating the rod 45 degrees, the curve

of the

> rods that match the scoliosis curves became the lordosis and

kyphosis

> curves. If you look at the broadcast at around 24:00 and at

around 53:00,

> you can see them doing it. When curves are more flexible, the

derotation

> procedure goes much faster.

>

> I noticed that the surgeon did mention that with having a fusion

go as low

> as it did in the specific patient, it probably wasn’t a good idea

to play

> contact sports. And, he did mention that if there was no curve

left in the

> discs above and below the curve, the discs usually stay healthy.

>

> Regards,

>

[Guest guest]

When I saw Dr. Hu and she was going over everything she made a brief

comment after asking me how many children I had that some of the

rotation or degenerative changes COULD be caused by childbearing. She

was mostly talking to the intern, so I guess they must think that

pregnancy and childbirth can have some sort of effect on it. Maybe

that's why us poor " women " on this site have more problems than the

men??????? Just a thought.....

Carol V (CA)

> >

> > Hi Kelley...

> >

> > Toward the end of the broadcast, they make it sound like there

had

> been no

> > derotation yet, but I believe that¹s at least partially

> incorrect. When he

> > attached the big rod holder to one of the rods and pushed on the

> rod holder

> > (while the second surgeon pushed on the patient¹s opposite side,

> that¹s how

> > the spine is derotated. By rotating the rod 45 degrees, the

curve

> of the

> > rods that match the scoliosis curves became the lordosis and

> kyphosis

> > curves. If you look at the broadcast at around 24:00 and at

> around 53:00,

> > you can see them doing it. When curves are more flexible, the

> derotation

> > procedure goes much faster.

> >

> > I noticed that the surgeon did mention that with having a fusion

> go as low

> > as it did in the specific patient, it probably wasn¹t a good idea

> to play

> > contact sports. And, he did mention that if there was no curve

> left in the

> > discs above and below the curve, the discs usually stay healthy.

> >

> > Regards,

> >

>

[Guest guest]

Cam,

I always think it's a good idea to err on the side of caution,

especially when it comes to one's health. So much so that I think it's

downright irresponsible of a doctor to tell a scoliosis patient that

it's OK to be involved in contact sports after having a long fusion!

It's been my experience through my scoliosis journey that orthopedic

surgeons seem to avoid wanting to tell me what the future holds for me

in regards to degenerative changes. Do they do it as a sort of

psychological buffer so as not to depress the patient? I agree with

you, Cam... inform the patients of the possible degenerative changes and

let them make their own decisions about their life and their bodies.

(Young adults could peruse: OK... I'm going to give up the skydiving

but stay enrolled in my water aerobics class... and parents of young

kids could ponder: maybe it would be a good idea to invest in a

swimming pool... we could probably pay for it from what we'd save in gas

taxiing the kid back and forth to soccer practice! LOL!)

As far as how healthy one's discs stay after surgery and how that

relates to their condition prior to and after the surgery... well, I for

one don't think that thwarting the existing curve(s) with implants and

fusion necessarily means that they've tamed the scoliosis monster. I

know it's different with every patient, but I have spawned a new curve

above my fusion level - it's like my body is saying " take that! " . There

obviously wasn't room in my lumbar spine, being initially fused to T-3,

for anything but those poor gravity challenged discs to just give up

their game.

I know that Titch mentioned Holly from the MIT list a few posts back as

having been a patient that had her iliac joints fused. If I remember

Holly's story correctly, she was an emergency room nurse and blamed some

of her degenerative changes on the fact that she was constantly lifting

patients on the job. After her revision surgery, she immediately

ruptured a disc above her fusion level (I think it was cervical). I

wonder how's she's doing now? I remember that she wasn't allowed to

stand up for a few months following the surgery and she hired a rather

robust in-home nurse from Russia to carry her around during her post-op

recovery. Anyway, it was Holly's story that made me realize that I

needed to take the road of caution rather than continue my journey of

" live life to the fullest or bust " attitude. It's definitely a personal

choice but I do regret having participated in all those aerobic classes

now (jump and twist and bend and squeeze... come on girls!)

I had both of my children prior to my corrective surgery, but it sure

makes sense to me that the shear weight of a pregnancy would reek havoc

on even a healthy person's discs.

Kelley

>

> ,

>

> Don't you think it is probably premature for the doctors to say

> anything about the long term health effects of fusion on the discs

> above and below? I am thinking....gee....I had my original fusion in

> 1973...pretty early on, and I and only 50.....barely into AARP

> range...so the population with the segmented rods and shorter

> fusions are mostly in the mid to late 30's hardly enough longevity

> to say what the effects on their discs might be....saying the discs

> usually stay healthy....until when...50 or 55? I thought the doc

> that answered that question looked a little uncomfortable. Longevity

> expectations in this country is 78 for men and 80 for women. Since

> even our " cohort " isn't there yet...they can not have the

> statistical basis for making this statement...can they?

>

> I realize they have wrestled the flatback issue to the ground in

> terms of knowing how to prevent that....but one reason the docs are

> trying to develop the artificial disc is to prevent exactly this

> kind of wear and tear on other joints...right?

>

> I can see that this doctor mainly deals with pediatric patients, and

> I can understand why he would no want to hurt the self image of the

> kids by unnecessarily limiting them....but is that really being

> honest with the patients? I think I would have preferred he say

> something along the lines that they can not be sure over the

> patients life time who will encounter the usual effects of an aging

> body and spine...and so they recommend that their fused patients

> engage in non-contact sports and persue athletic endeavors that

> minimize the trauma of concussive wear and tear on the remaining

> mobile discs.

>

> At least if the patients disregard that advice they do so at their

> own peril. I wish my surgeon had been clearer on this point...even

> if, for me, it wouldn't have changed a thing...I realize I probably

> still would have had to deal with flatback in any event.

>

> Take Care, Cam

[Guest guest]

Just catching up on the posts and wanted to comment on Kelley's comment. I don't think the surgeons want to dwell on being over-cautious to the young patients or the patients might be afraid to enjoy their life. Besides the surgeons don't really know who will heal properly or who will have problems, later on, with their healing process. When I talk with young patients and/or parents, in the local support group, I mention that surgeons didn't know that I would have problems later in life, at the time of my surgery, just like a soccer player does not know if they will have knee problems later in life. Everything we may or may not do has a consequence and it's up to the individual to decide if a certain activity is worth the possible sacrifice later in life. The same goes for certain activities during the recovery period from surgery, but I, myself, would restrain from any type of jarring-type activity for the first year. At the same time, the body needs strength/movement activities to rebuild and keep strong.

For the doctors, this is a very fine line for them to say anything either way, since most (if not all) have not had the personal experience to advise the patient. Those of us that have the experience can offer our experiences/knowledge and advise what we would do, given the same situation, keeping in mind that everyone is different in their own situation and the knowledge has expanded in the medical field from when we had our original surgery. The doctor have to show confidence for their patient's sake and by being too over-cautious is not always good for the patient. The medical advisor that I consult with for the local support group, admitted to me that they don't really know the long-term effects of today's surgery method, but it is better than the past. That can be said in any field of medicine/surgery. The mental condition/attitude of a patient is as important, if maybe not more important, as the physical condition in order to have the best quality of life possible.

Llweyn

Cam,I always think it's a good idea to err on the side of caution,especially when it comes to one's health. So much so that I think it'sdownright irresponsible of a doctor to tell a scoliosis patient thatit's OK to be involved in contact sports after having a long fusion!It's been my experience through my scoliosis journey that orthopedicsurgeons seem to avoid wanting to tell me what the future holds for mein regards to degenerative changes. Do they do it as a sort ofpsychological buffer so as not to depress the patient? I agree withyou, Cam... inform the patients of the possible degenerative changes andlet them make their own decisions about their life and their bodies. (Young adults could peruse: OK... I'm going to give up the skydivingbut stay enrolled in my water aerobics class... and parents of youngkids could ponder: maybe it would be a good idea to invest in aswimming pool... we could probably pay for it from what we'd save in gastaxiing the kid back and forth to soccer practice! LOL!)As far as how healthy one's discs stay after surgery and how thatrelates to their condition prior to and after the surgery... well, I forone don't think that thwarting the existing curve(s) with implants andfusion necessarily means that they've tamed the scoliosis monster. Iknow it's different with every patient, but I have spawned a new curveabove my fusion level - it's like my body is saying "take that!". Thereobviously wasn't room in my lumbar spine, being initially fused to T-3,for anything but those poor gravity challenged discs to just give uptheir game.I know that Titch mentioned Holly from the MIT list a few posts back ashaving been a patient that had her iliac joints fused. If I rememberHolly's story correctly, she was an emergency room nurse and blamed someof her degenerative changes on the fact that she was constantly liftingpatients on the job. After her revision surgery, she immediatelyruptured a disc above her fusion level (I think it was cervical). Iwonder how's she's doing now? I remember that she wasn't allowed tostand up for a few months following the surgery and she hired a ratherrobust in-home nurse from Russia to carry her around during her post-oprecovery. Anyway, it was Holly's story that made me realize that Ineeded to take the road of caution rather than continue my journey of "live life to the fullest or bust" attitude. It's definitely a personalchoice but I do regret having participated in all those aerobic classesnow (jump and twist and bend and squeeze... come on girls!)I had both of my children prior to my corrective surgery, but it suremakes sense to me that the shear weight of a pregnancy would reek havocon even a healthy person's discs.Kelley

..