She wrote up her life story of her scoliosis, which is quite interesting (shown below), especially as it pertains to the life-long affect of scoliosis --- some patients go for many years being very active, but then experience a sudden drop-off in quality of life in later years, in some cases associated with leg symptoms such as weakness, or sciatic pain or trouble standing and walking. These symptoms are often due to the degeneration on top of the deformity, which progresses, and can cause increasing lumbar spinal stenosis. Her rib discomfort discussed below may be because of her rib cage now hitting her iliac wing -- something that actually is helping to prevent further collapse of her scoliosis.
This is one reason why earlier intervention during the adolescent and young or even middle age adult periods may help suffering later in life, while providing better posture and self image. For our many children, adolescents and younger adults that we straighten up each year here at Hey Clinic, these patients will not have that "black cloud" of future progression of curve and/or decreasing quality of life hanging over them. While it may sound great that Mary Lou was quite active for over 50 years after her scoliosis diagnosis, being confined for most of the day to an easy chair in her 70's is not the kind of quality of life most of us would want for ourselves or for our spouse or child or parent.
Trying to understand the LONG TERM effect of scoliosis and kyphosis is hard, since few of us get a chance to meet someone like Mary Lou, much less do very large long-term follow-up studies to really assess quality of life over an entire lifetime. For example: scoliosis bracing has been shown to have some effect for some patients at least for making surgery less likely before an adolescent finishes growing. However, when you are considering bracing for your child, you aren't just interested in the outcome at age 17 or 18, but at 28, 38, 48, 58, 68, 78, 88, and even 98 year old! The game isn't over until you've gotten through your whole life.
For some patients, sometimes surgery later in life is not even an option, due to other health problems (cardiac, pulmonary, renal, or severe osteoporosis.) In Mary Lou's case, since her quality of life was failing, I did take a lot of time with her and her husband, and reviewed all of the risks and benefits of the possible surgery to help her. This really helped her and her husband to understand the reality of the surgery, recovery, and potential outcomes. People really appreciate our generous appointment times, so they can get their questions asked, and have plenty of time to allow me and my team to get to know them, and their story, and review all their imaging with them. Mary Lou opted not to move forward with surgery at this time, in part because she feels like she is too old to handle the big operation. This is absolutely fine with me -- we actually emphasize conservative therapy for scoliosis. It's just so important to understand your treatment choices in detail. We do offer surgical treatment in cases where conservative measures are failing, and quality of life and/or curve progression is worsening, and patients are medically able to handle the surgery. We are also happy to continue to follow Mary Lou over time with repeat X-Rays and potentially try other conservative measures. If her leg weakness and trouble walking progresses, we will work up her lumbar area with an MRI. If that shows a severe stenosis (nerve pinch), that may influence her treatment choices moving forward. Bone density studies (DEXA scans) can often be helpful for your scoliosis doctor / surgeon to assess your bone quality for handling the surgery, and holding the hardware. Osteoporosis can sometimes be reversed with special medications given over several months if surgery is indicated, to strengthen the bones.
Enjoy her life story and the story of her family! Thanks for sharing Mary!
Dr. Lloyd Hey, Hey Clinic for Scoliosis and Spine Surgery. http://www.heyclinic.com
I was born in Florida in 1941 and scoliosis came into my life around 1952, right when polio was rampant. My parents took me to Emory University Hospital in Atlanta, where the doctor believed I had contracted a mild case of polio. Back then the best place for polio rehab was Warm Springs, Georgia, at the residential treatment facility founded by Franklin D. Roosevelt. I was there for about a month and for the entire time, 24/7, I wore a back brace--a corset of sorts with a rod sewn in the back and head traction from a rod attached to my brace --and was bedridden almost the entire time. For a precious four hours a day I was allowed out of bed, albeit in a wheelchair. At this point I had experienced no aches or pain from my condition.