Dr Stuart Weinstein, MD, The Natural History of Scoliosis and the BrAIST study, by Dr. Derek Lee

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  • เผยแพร่เมื่อ 17 ต.ค. 2024

ความคิดเห็น • 19

  • @DerekLee
    @DerekLee  2 ปีที่แล้ว

    This interview is for educational purposes and covers information provided by Dr. Stephanie Da Paz regarding her opinions on Lateral Disc Release and Hybrid VBT with Apical Fusion Scoliosis Surgery. This video is not an endorsement. Viewers should consult their physicians and treating team accordingly. See highlights via timestamps below.
    Chapters
    0:00 Introduction.
    0:43 Evolution of Hybrid VBT with Apical Fusion.
    1:23 Hybrid VBT with Apical Fusion technique.
    2:49 Case Study: Hybrid VBT with Apical Fusion.
    4:34 Determining spine flexibility on bending x-rays.
    5:06 Discectomy with Apical Fusion.
    5:41 Preparation of the disc space for fusion.
    7:19 How long does it take for the apical segment to fuse?
    7:52 Why not bone on bone apical fusion?
    8:53 First Hybrid VBT with Apical Fusion at 1 year.
    9:15 Is there less tether tension with apical fusion?
    9:55 Hybrid VBT with Apical Fusion for lumbar curves only.
    10:13 Stability of the apical fusion device.
    12:27 Maturity Parameters for Hybrid VBT with Apical Fusion.
    13:03 More details on evolution of Hybrid VBT with Apical Fusion.
    15:28 Intraoperative video of Lateral Disc Release with VBT.
    18:42 Tether tensioning post lateral disc release.
    20:04 Why 2 types of screws with double tethers?
    21:30 Anterior screws of 2nd tether is tensioned 50%.
    22:16 Is tensioning the tether altered by the apical fusion?
    22:55 Disc release controversy.
    23:56 Why are lumbar disc release more problematic than thoracic disc releases?
    24:21 New tether technology?
    25:35 Hybrid VBT with apical fusion is not for everyone.
    26:24 Non-fusion scoliosis surgery is dependent on spine flexibility. VBT cannot give you spine flexibility if the spine is already stiff.
    27:58 Can disc release improve spine flexibility?
    facebook.com/groups/1198200727630801/
    drdereklee.com/

  • @somewhereinthemidwest9827
    @somewhereinthemidwest9827 6 หลายเดือนก่อน +1

    I’m a 64 year old with scoliosis (I didn’t know until my 50’s that I had the condition)
    Tried spinal injections, PT and all the tests. Neurosurgeon has been my last stop.
    Pinched nerve, numbness in my feet, sciatica.
    At this point, a local neurosurgeon says that I have two options for surgery. Fusion of L4 to L5 or fusion from T12 to L4.
    I’ve not scheduled surgery because I’m not ready.
    I’m thinking of going back to conservative care..
    I’m at 27 degrees.
    Thank you for this wonderful video.

    • @DerekLee
      @DerekLee  6 หลายเดือนก่อน

      Feel free to join my private Facebook group. I have expert surgeons and physical therapist who can answer questions. 🙂. facebook.com/groups/1198200727630801/?ref=share

  • @kararice9756
    @kararice9756 ปีที่แล้ว +1

    Thank you both for taking the time for this interview and allowing the information to be shared to the general public. I have learned so much in the one month that my son has been diagnosed and that would not have been possible without true experts reporting their scientific evidence-based findings. Parents are often stuck with the emotional weight of making the “right decision”, which is difficult especially since I have seen 4 different experts for my son’s new diagnosis and all 4 provided different approaches:
    1) wait and see
    2) night time bracing
    3) night time plus soft day brace
    4) bracing 20 hours
    Without information like this interview being available I would have a very difficult time deciding.
    Thanks again.

    • @DerekLee
      @DerekLee  ปีที่แล้ว

      Thanks for the kind words! That was my whole motivation for doing these interviews. Happy you are finding them informative.

    • @DerekLee
      @DerekLee  ปีที่แล้ว

      Also, feel free to join my Facebook group.
      facebook.com/groups/1198200727630801/?ref=share

  • @Andrea-ug2wk
    @Andrea-ug2wk ปีที่แล้ว +2

    Hi Dr. Lee! I immensely appreciate your channel and your work. In this video you mentioned that curves under 30 degrees generally don't get worse after skeletal maturity is reached. But what about 30 degrees curves? I have an S shape scoliosis and my thoracic curve is 30 degree while my lumbar curve is 27 degrees and I am a 21 years old male. I've been physically active my whole life, I've been in competitive swimming till I was 18 and now I go to the gym to keep my muscles strong and give support to the spine. I very rarely have back pain.
    Am I in a limbo regarding the future of my spine? (in terms of worsening of the curves)
    Thank you a lot

    • @DerekLee
      @DerekLee  ปีที่แล้ว

      Feel free to post your question in my private Facebook group where spine surgeons are members.
      facebook.com/groups/1198200727630801/?ref=share

    • @pambradshaw6081
      @pambradshaw6081 ปีที่แล้ว

      Your curve is similar to my 21 yr old son, we to have questions and concerns of his curve worsening too. It's great you stay active.

  • @laurenkoch3120
    @laurenkoch3120 6 หลายเดือนก่อน

    I'm turning 60 had Herrington rod surgery when I was 12.2 children and breast later, I am now having issues 😢and I don't know what to do

  • @aryoseno11
    @aryoseno11 ปีที่แล้ว +1

    Hello, I have a 33 degree thoracolumbar curve at risser 5 skeletal maturity, I'm really worried whether or not I should have surgery now or just later cause it's a gamble between having to do surgery with less complications now or having to do it when I'm older where there's more likelihood of complications arising...

    • @DerekLee
      @DerekLee  ปีที่แล้ว +1

      Most surgeons won't consider surgery until your curve is 50+ degrees.

  • @vikkiprevette2934
    @vikkiprevette2934 ปีที่แล้ว

    What do you do when a doctor doesn’t think your curvature has anything to do with your pain.? I went to a chiropractor prior to ever having these issues now.. please - thoughts?

    • @DerekLee
      @DerekLee  ปีที่แล้ว

      Find another doctor. Opinions vary with different doctors.

  • @truusvandenhoek8484
    @truusvandenhoek8484 2 ปีที่แล้ว

    Very interesting as always! First time I understand a bit more about the higher progression risk for Thoracic curves, at least in theory. I'm not sure it is what I see in my practice though... At least with the many women over 50 I see my impression is that many of them come from around 30/35 degrees and find themselves back at a 50 degree curve because of disc degeneration and a rapid progression. What's your impression Derek? What is very interesting as well is the gentle way dr Weinstein is guiding patients towards their decision. In my experience very often the pressure to have surgery is higher. So I like this shared decision making! Thanks again Derek!!

    • @DerekLee
      @DerekLee  2 ปีที่แล้ว

      Hi Truus! I also thought it counter intuitive that thoracic curves would progress the most compared to lumbar curves. But, the research I've looked at does seem to indicate that thoracic discs and vertebrae are more rotationally unstable, and the facet alignment does seem to make thoracic rotation easier compared to the lumbar facets.
      Regarding your clinical observations, are you talking about lumbar curves degenerating quickly vs thoracic curves?
      He has a wonderful approach to guiding patients. His patients are lucky to have him.
      In my opinion, for parents to effectively advocate for their kids or for adults to advocate for themselves, they have to do 2 things.
      Educate themselves to find a treatment consensus they are comfortable with. And then, find a surgeon/practitioner to create a team where shared decision making is for the benefit of the patient.

    • @truusvandenhoek8484
      @truusvandenhoek8484 2 ปีที่แล้ว

      @@DerekLee Hi Derek, I think the progression I see in the Lumbar curves is indeed following a more rapid disc degeneration. In the younger population the Thoracic and Thoracolumbar cuves progress more than the Lumbar ones so that perfectly makes sense. Especially the ones with a lot of rotation seem to be more progressive and even more if the kids are very flexible...

  • @vikkiprevette2934
    @vikkiprevette2934 ปีที่แล้ว

    The degree doesn’t always tell the story of the pain the person is in- no one thinks a moderate curves cause issues? Please help

    • @DerekLee
      @DerekLee  ปีที่แล้ว

      Of course mild and moderate curves can cause pain. Why wouldn't it?
      Also, feel free to join my Facebook group where scoliosis surgeons, physios and orthotists are expert members.
      facebook.com/groups/1198200727630801/?ref=share