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Post-op: Rounded shoulders , neck jotting forward, abdominal protruding

Hello, I am a 58 year old female. I’ve had scoliosis as a child, never had treatment until I was an adult.  I’ve had back pain for about 20 years, which had progressed.

 About seven years ago, I notice the hump on my left upper back was becoming worst, also my right hip was sticking out more than ever, and my back pain was increasing. It showed in almost everything I wore.  I went to a neurosurgeon who felt I should try more conservative treatments before surgery. At that time my curve was 31 degrees. I had various injections, physical therapy, medications over the years. My back condition had become  much worse by 12/2017. When I went back to the neurosurgeon with new X-rays and MRIs, my curve was now 67 degrees, and I was also having leg weakness. I should’ve gone back years sooner.

Moving forward, I had surgery 5/21/18, spinal fusion from T4-pelvis. I have started physical therapy 2weeks now. Since the surgery, I’ve notice both shoulders are very rounded and my neck now sticks out forward. I look almost hunched over shoulders and neck. In PT, they are showing me exercises to help pull my shoulders back and to tuck my neck back. It feels as if there is a big, heavy rod laying across my shoulders, and pushing my neck/ head forward. Also, I find the right side of my abdomen protrudes out now. I do not have any problem with my bowels, I even had a CT Scan with and without contrast done, which was normal. 

My surgeon said all my X-rays look good and that I am healing very well. I didn’t worry about any of this too much for the first 3 months. I thought this was just part of the healing process, and that everything would return to normal position. It is now a little over 4 months, and it’s still the same. I am very happy my upper back hump, back/leg pain, and most of my leg weakness are gone, but what happened to my shoulders and neck??

Has anyone experienced this?


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1

Comments

  • WLLadyWLLady Ontario CanadaPosts: 1,493

    hiya me again!

    so.....when your body was all shifted and out of alignment (mine was too) and then straightened as much as possible overnight (literally) the rest of the body needs time to catch up and readjust to the new you.  i had (and still do) problems with "head forward" posture, which physio really really helped!  i was in physio for 1.5 years post surgery-it's not a quick fix!  my other problem was my hip!  my right hip pushed out, and my left hip got used to being rotated out to compensate, i walked on the inside of my left foot and the outside of my right foot....and my left hip is finally, after 2 years, just now getting back to where it should be.  it takes a lot of time for all the muscles and tendons to lengthen, shorten and get strong again and find new homes....if your xrays are good, and you are doing physio, give it time to realign-believe it or not, you are still fairly early days since surgery!  and physiotherapy i'm sure will help you lots and lots.  i found that doing some of the exercises was really really tough, and painful, but kept at it and it got better and better, and now i can adjust my posture pretty well when i find myself slacking and slouching in my shoulders and neck.  it really is a lesson in patience.....keep working at it with your PT and you may not notice changes very quickly but then one day you'll get up and have a shower and look in the mirror and go "oh! wow!" because you look like a totally different person, straight and not slouched and not hunched and definitely not S shaped anymore!  I'm very very glad that the surgery helped the pain and weakness!  But - and i can't believe how much i hate saying this - be patient....i got so tired of hearing "be patient" during my recovery, and even now....almost 2 years out....be patient....this takes forever to heal, but it will get better!!!!  my PT was the best, and helped me so much, that i can actually see being "mostly" normal going forward....LOL.  i would say my hip and shoulders finally settled about 4 months ago-so about 1.5 years post surgery.  give it time....

    Kathy
    Veritas-Health Moderator
    ---------------------------------------------------------------
    Dec '16 T10-S2 fusion with pelvic fixation. Laminectomies L2, L3, L4, L5, facet removal, cages L4-5, L5-S1, severe scoliosis, arthritis and stenosis repair. 

  • hi your story is so much like mine..i found out about my scoliosis  when I was 17..32 degrees  then in 40s it jumped to 46 degrees, then in 50s pain injection and other stuff, finnly at 58 60 degrees bottom curve 22 top curve I had fussion from t9 to s2 with pelvic fication. now post surgery, my shoulders round in, if you look at the xrays from top of bar my back now curves inwards like a half moon, I just talked about this today with the surgeon..i need to keep putting back to wall with butt and shoulders touching..this should of been address with in a few months of my surgery..now it will be harder to try and fix. I also asked him today about my stomce protruding..more on on side then the other. he said he had mix feelings about it..i am the first to mention it so he thinks I need to ask va for a follow up with GI doctors and see what they say. so yes I do have that also.

    also now my body slants to the left, so sitting it looks like I am leaning a little to the left..same with standing..and I still have 20 degree curve on the bottom so they were not able to correct mine as much as others. I agree with WWLady..you need more time to heal, and pt or physio, what ever you can get..have then address the posture NOW before it becomes perminte..I fear because of the 6 months on the cane my bad posyure was born and not addressed till now. dec 14th I will hit the 2 year mark..hang in there if you hear anything about the abdominal protrusion let me know..and if I would ever get to ask a GI doctor I will let you know..hang in there, don't stop trying.

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  • Hi, thank you both so very much for your advice and for sharing this with me! At PT, they are concentrating on my posture, I will definitely practice the exercises more at home now, knowing that they do work. I really  needed this encouragement that my neck/shoulders can improve, but it takes lots of patience.

    When I look in a mirror now, I am still shocked NOT SEE my right waist sooo curved in. It is almost symmetrical to the other side (after surgery the surgeon told me that my right pelvic was almost under my rib,  thats how curved I was). WLLady, I look forward to the day when I look into the mirror, and say “oh wow”.  Although I say that now about my waist , and don’t want to be ungrateful, but I do want my neck/shoulder to normal position ( and abdomen). So it’s really great and gives me hope, to hear  that you control your posture with ease.

    Xrobynx  I cant really see your Xray too clearly. I also have all  my X-rays, but my computer cannot play the CDs for some reason. I wanted to take my time and to see the anatomy and hardware placement. Yes, I wish I had started these exercises sooner, but surgeon did not want me to do exercise for 3 months at all, only walk, and I didn’t know it would still be like this. I could’ve started to try and straighten my shoulders back.... hopefully not too late. Also we do sound very similar, my torso tilts slightly to the left. Surgeon said it is a bit of “ trunk shift”.  I try to be aware of it, when sitting I have to move my torso back to the middle. It takes always trying to be aware of my posture, keeping shoulders/neck  straight and back , AND torso in the middle. All in all I am also glad I had this surgery ( really had no choice). As for the abdomen, surgeon told me it is most likely result of having to “ pull” my lower spine all the way from the left back to the middle, and therefore that elongated waist area on the right side. Not sure I completely understand that, still trying to view X-rays to understand. Will definitely let you know if I find out anything. One question, is your protruding side tender? Mine Is decreasing in tenderness, and maybe only little less of  protrusion than right after surgery.

    Again ladies, thank you both so much for giving me such encouragement.

  • WLLadyWLLady Ontario CanadaPosts: 1,493

    hey!  i'm going to join the "left leaning" club if that's okay!  i also lean a bit to the left standing and sitting.  so to compensate i tend to sit and stand on my right hip/leg more.  as time goes on after surgery it's starting to really bother me....so at my next follow up i'm going to ask for sure.  i have a hunch that my left leg may be (or appear) shorter, or that i'm still a little twisted enough (i still have about 4-5 degrees of rotatory scoli after the surgery) that that is doing it.  my sugeon at my last appointment wanted me at 2 years post surgery before he "worried" about it.  so.  my 2 year is coming up (actually at 2 years and a month about)....so.  i'm going to ask.  also, my waist used to stick out on the left and wildly curved in on the right.  now my left is more straight up and down while my right side looks like i should....but still the fact that it's not symmetrical is starting to bug me.  so then i just remember i was headed to a wheelchair, and then i'm happy again, so i hope i can keep remembering what it felt like to know i was headed to a wheelchair.....because then i won't get upset but as time goes on it's harder and harder because i just want to be normal (or as normal as possible) again.  and yes, my stomach does stick out a little bit, and my surgeon said that it's likely because as my bones were shifting my internal organs also shifted (one of the problems with scoliosis is losing space for your heart to beat right and your lungs to expand right). my rib cage was rotated and the rib hump thing and i had noticed my breathing was "off" before surgery-it was hard to take a deep breath, almost impossible because my lungs couldn't expand enough because my ribs were not in the correct position anymore.  so i actually think that given the stomach issues i had before surgery (not hungry, couldn't eat much before feeling like i'd eaten a huge meal etc) that my stomach actually was also turning....it's gotten quite a bit better over time, but i think it might always be like that now.....again, mental note to self, i was headed to a wheelchair....so it's okay....

    With the cd, try putting the CD in and the opening the file folder to view the files.  see if there is an executable (.exe) file....if there is then there's a program loaded onto the CD that will need to be opened first before you can open the images.  all my imaging has the program right on the disc, because they're specialized file types that don't open with anything normal....


    Kathy
    Veritas-Health Moderator
    ---------------------------------------------------------------
    Dec '16 T10-S2 fusion with pelvic fixation. Laminectomies L2, L3, L4, L5, facet removal, cages L4-5, L5-S1, severe scoliosis, arthritis and stenosis repair. 

  • Wow headed for a wheelchair, yes with my leg weakness before surgery I also saw that road ahead. Maybe that’s why my leaning isn’t my worst concern right now. You are over 2 years, congratulations, I know how happy you feel being able to stand mostly straight and breathe again! I’m also very grateful, I hear you....

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  • the side of my stomack that sticks out the most is not tender. I feel my right sit bone but not my left so when I sit and lean to the left, to more more weight on the right sit bone, well it all ready hurts if I sit very long so I can not do that. I still have a 20 degree curve and because of how much I lean to the left now that part on on left side that sticks out is even bigger post surgery..i try not to look ast it in the mirrow cuz it just brings me down each time I see it..i look way more deformed now then before the surgery. if I would of waited till it was harder to walk before I had this surgery I think I would be better excepting of all of this..also so if I would of been told a lot more about pelvic fixation before surgery I would of been prepare more to except all that has happened..this is why I beg folks to try and make there doctors talk to them. I know its just too hard for some docs and I have one of them...lol

    now my shoulders are rounding in more and when I looked at my side ways x-ray and saw how much I am now curving forwards it scared me..why didn't any of the doctors or my PT folks say anything to me..at no point in all most 2 yrs of recovery has anyone ever said ONE word to me about posture..so sad..i realy do feel like my post surgery care was bad and just totally lacking in so many ways.

    this is where all my anger comes from..lack of information and post care..i had to fight to even have permition to talk to this surgeron to begin with I fought for 2.5 yrs. the VA wanted to give me a FREE walker and put me in dippers.  then said if I needed a wheel chair down the road that woyuld be free also. they did not feel I should even think about surgery for my scoliosis. they felt I was too old. I guse I need to be happy that I got any care at all. and now that I want to get better and stronger..they think there is something wrong with me..they want me to act my age..i sure hope no one else ever gets treated like I did..sorry for the mini vent./.it still gets me going when I talk about it.

  • Hi xrobynx, I’m sorry it has taken me long to reply. Hey I I didn’t know how you felt about your outcome from surgery and the aftercare. I know you are still such a positive person, I have read your posts to others, and you always give so much comfort. I just can’t imagine what you must have felt during the 2.5 years  with the VA. I’m so sorry you had to go through that.

    Maybe if you had waited longer for this surgery, like you said, when it was harder for you to walk, you may have had weakness in your legs in addition. Maybe your surgery time prevented that? I really don’t know, but I truely do understand a lot of what you’re saying. Xrobynx, at PT they have me stand with a small rolled up towel behind the lower part of my head, I then press my head against the towel for 5-10 secs and repeat 20 Times. It is supposed to help tuck the neck back while trying to straighten the shoulders against the wall. Of course my shoulders can never straighten against the wall fully. This exercise does feel good, but of course you have to keep doing it  at home also. Maybe it’s not too late for your neck/shoulders, muscles CAN be trained, that’s what my PT keeps telling me.

    Although I am grateful my huge upper left back hump is gone, and sciatic pain is gone, and I can walk ,  I have to fight to be aware of my leaning to the left, my neck sticking out, my shoulders slumped, and my abdomen protruding. So decent posture is a hard job for me. I’m now almost 6 months post-op, and I am now seeing different things about my body. I know these are the results of this surgery, for me there wasn’t any choice. But yes, I am now going through some anger, maybe I should’ve researched more about pelvic fusion. Everyday I’m getting stronger and trying to do normal things again, however, I realize that I just cannot do even the simplest things anymore! I’ll never be able to just tie my shoelaces, lift my leg, (went to the gym for the 1st time a few weeks ago, and couldn’t even get my leg over one of the machine pads) have not gone back since. My husband keeps telling me not to worry, that in a few months I’ll be able to do these things. Well no, I never will. My PT explained to me that you can lift your leg in any direction, but only to an extent, because you need to have some pelvic flexion in order to lift/raise your leg. I have absolutely no pelvic flexion, I am fused!  This was never explained to me, I’m really limited from what feels like my hips down. I suppose one has to weigh the benefits vs the side effects of surgery. Bottom line:  I’m 58 and want some of my flexibility back.....



  • Sammy you sound like me I so share your anger. if they would of told us at the beginning, it would all be so much easyer to deal with. but on my first go round with PT, they didn't even explain the pelvic thing to me. I found that out here. and I say it is ok to be angrey..we need to axknolge our emossions so that we can deal with them. as time gos by I am not so angrey and more eccepting of how things are..but I still get sad from time to time, and no one unless they have had this done to them can understand it. so I will allways come here for support from folks who understand what I feel. we will all be stronger one day and able to except it all better..its been said but needs repeating..we have to heal both physicly and mentaly and emossionly.

  • WLLadyWLLady Ontario CanadaPosts: 1,493

    sammy, keep working!  at 6 months i couldn't get my leg over the atv, let alone drive it, or stand the bumps.  at 2 years it's not an issue anymore-i can drive it and ride it across the field (okay the bumps still are annoying so i go slower than i used to) and sometimes i have to pull my leg over the seat, but i can do it.....!!!!  it does take a lot of time!  I had a great PT i went to and said "i cannot do this" (pull the door open, or tie my shoes etc) and he would figure out what i needed to do in order to get there.  i can tie my shoes now, and put on my socks and cut my own toenails....all because my PT taught me how to do it, and built the muscles i needed and figured out how to move so i could.....if i cannot lift my leg out to go over the ATV or the weight machine then i turn my body so that i can lean forward at the hip to raise my leg back and then turn on my foot with my hip and get my leg over.  it's just a different way of doing it, with the same result.  i'm not graceful, but i get there!  and that's what matters to me is getting there.  although i do have to say the fixed pelvis is a tad irritating most of the time!!!!!

    Kathy
    Veritas-Health Moderator
    ---------------------------------------------------------------
    Dec '16 T10-S2 fusion with pelvic fixation. Laminectomies L2, L3, L4, L5, facet removal, cages L4-5, L5-S1, severe scoliosis, arthritis and stenosis repair. 

  • Yes, thanks for your wise words. It will all take time to accept....

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