Tuesday, May 6, 2014

a great appointment.... and some answers (finally)

I wrote here about the problems M's been having with his back, and the frustration I felt trying to get some answers as to what is the matter... Yesterday he was seen at the Spine Clinic at UCHSC and I finally feel like I'm understanding what is going on. Up until now I felt like I was being told different things by different people, and nothing made sense... nothing seemed to fit together.  After talking to the doctor M saw yesterday it feels like things are finally fitting together and making sense.. which feels really good.

It looks like M has a stress fracture (spondylolysis) in one of his vertebra. It sounds like it could be genetic, although I've wondered if his skeletal problems might also be connected to his FASD. (Since prenatal alcohol exposure can affect bones...)

From Wikepedia:
Spondylolysis (spon-dee-low-lye-sis) also runs in families and is more prevalent in some populations, suggesting a hereditary component such as a tendency toward thin vertebral bone.
Although this condition can be caused by repetitive trauma done to the lumbar spine or strenuous sports such as football or gymnastics, anatomy also plays a major role. According to research done in 2007, genetic make up of the lumbar spine has much to do with the occurrence of spondylolysis in certain individuals.[citation needed] A study done on 115 male skeletons with L5 spondylolysis was proof that a slight tweek in the anatomy of the spine can increase the likelihood of spondylolysis. In those with spondylolysis, many times the inter-facet region of vertebra L4 is more trapezoidal in shape with a larger width than that of a normal vertebra. This also changes the iner-facet height, making them shorter and narrower. With this defect in the spine, a normal load applied to the spine will be greater compared to those without it. This is due to reduced surface area and torsional range of motion during twists and bends.
Apparently, the spondylolysis is probably the cause of the "focal sclerosis" that showed up on the CT scan. If there is a fracture, his body's response would be to lay down bone in the area of the injury. That abnormal bone growth is the focal sclerosis. 
All this has to be confirmed with a bone scan that M will have done in the next couple of weeks. After the scan we'll follow up with the spine doctor. It looks like treatment is probably just enough time to let the bone heal, and possibly a brace if it doesn't seem to be healing well. The doctor did mention the possibility of surgery to screw the pieces of bone together, and M looked about ready to head out the door. After his hip surgeries, M is very afraid of surgery... especially anything involving screwing bones together. (M still has screws in one hip from his first hip surgery!) I told the doctor that surgery wasn't something we wanted to consider or talk about right now and he quickly backpedaled... 

So... all in all a great appointment... we both like the new doctor and feel good about the direction things are going. 

Enough about medical stuff... tomorrow this blog will be back to it's regularly scheduled programming! 


1 comment:

Jen said...

Wow, I'm glad you have some answers. I wish they'd have been answers with easier fixes, though. Hugs all around!