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Old 24-09-2010, 03:07 PM
Dr Scoliosis Dr Scoliosis is offline
 
Join Date: Apr 2009
Posts: 187
Default Re: Your valued opinion please

Thank you for your further enquiry.

You are correct that it is not possible to give "opinions without seeing x-rays etc" and indeed it would be unprofessional to do so. The object of Dr Scoliosis' role in the forum is to give advice or comment on general principles only. This can sometimes allay anxieties and improve understanding.

I note your daughter is now 15 years old and is refusing to have the surgery. If she was 6 years old you would make the decision for her. In due course it is she who will make a decision about placing you in a Sunshine Home. However, if she is at the stage where she is refusing to undergo the surgery then you have very little room in which to manoeuvre.

You have been told that she is a Risser 5 which simply means that vertebral growth will have ceased. That is not the same thing as skeletal maturity and it is a rough guideline most commonly used at a point when a curve which is being managed by brace-wearing can move to part-time bracing under close supervision. Many curves will still progress to a variable degree after Risser 5 has been attained and this is the fusion of the iliac apophyses (see our website on the role of the radiologist for an explanation of the Risser sign).

If a patient is thought to have acute appendicitis, that is an emergency and the appendix must come out as soon as it can possibly be arranged and almost invariably that day. Scoliosis surgery is never an emergency. In general terms scoliosis surgery is a truly elective procedure, that is, the surgery is carried out at a time which is convenient to both the patient and the surgeon. The Dr Scoliosis on duty frequently schedules a very large part of his clinical load over the Christmas holidays which gives the patients time to recover well before returning to school. Hence, and you should confirm this with your surgeon, it will probably not affect the long-term outcome to any significant degree if the surgery is held over until your daughter has finished schooling. There may be another reason for early intervention and this you should clarify.

We trust this advice is helpful.