Nantes Study on the ST and SS ligaments

[Charlie]

Excellent points by Karyn,NyT,Violet and ofcourse HerMajesty.The biggest problem is it is coming from the Nantes team which has openly denied any forms of Pelvic instability like SIJD,tailbone pain Priformis muscle after they sever the ligaments especially the Sacrotuberous ligament.Then if young kids need those ligaments then why not older people because their cells,tissues,bones,ligaments are all wearing off with age.It makes no sense.

I agree, they are good points. From what I understand the pelvis changes at puberty and the pelvis solidifies. At this point you no longer need those ligaments. Your pelvis is not going to return to its juvenile state as you get older. This is what I have heard. I am not saying it is necessarily right.

Professor Robert has denied and none of his patients ever developed any form of Pelvic Instability which isn't true.And then why work on Cadevars when you have 2300 cases of surgical results.
Charlie made a good point that the Cadavers can't experience pain hence the research paper is useless in my opinion because it comes from Nantes and it has some bias in it.

Thanks but I also made another point after that as well which was that although they could not report pain the study still demonstrated that instability was not apparent in their experiment.

I think the Nantes defense may be that is easier to see the effects on stability using a cadaver as you can see the structure more clearly. You are right to point out it is a small sample.

Also you state that there have been 2300 surgeries performed. I have no idea of the figures myself. Would n't the amount of people who have had the surgery be an argument against the idea that it causes instability? If you combine Houston's surgeries as well should we not see a deluge of people on these forums reporting instability? I don't see that. You can have a look at the french forums and again I don't see many people reporting instability.

You have posted a paper about ligaments. I don't see how that contributes as it is not specific to the ST ligament. If you were arguing that it is wrong to cut all ligaments then I could see how it would help your case but your not doing that. Your saying it is okay to cut the SS ligament but not the ST. You can't have it both ways. You can't say it is terrible to cut ligaments and then say except the SS ligament which is perfectly okay to cut.

We should not ignore the report you posted from Pierre and you are right to post it up. We should not bury our heads in the sand and ignore it. However at the same time we also can't ignore the people that did not report instability and also sometimes recovered. The trouble with anecdotes is that people use them selectively and it is one of the reasons they can't be used as scientific evidence. Testimonials and anecdotes are banned from scientific papers.

Unless we did a formal study accumalating all the reports of Nantes surgeries we can't really come to a conclusion. Of course this has actually already been done as the Nantes team have done controlled studies. You will perhaps say that these studies are biased or been manipulated.

I am not naive. Studies can get manipulated especially by drug companies, even ones that have the supposed reassuring stamp of 'peer reviewed' . Maybe the French did manipulate it but I doubt it. I think if you are going to manipulate a study why not really boost the results and give yourself a phenomenal success rate in the 80, 90% rate, a la Dr Filler.

I don't see any evidence that can support the claim that the ST ligament is crucial to pelvic stability.

[GregT]

Ali,

You left out Pierre's comment about the reattached ligament not working. Always remember to include all context. Plus, you are aware that Pierre has no formal medical training, don't you? He's just like us, a person with PN.

Also, the ligaments are important as a person is growing. Unless we have any children who have PN, the significance of the ligaments is drastically reduced.

[AliPasha1]

A lot of patients have discussed with Dr. Hibner including myself because of our concern regarding the incontinence issue.Dr. Hibner told me as well as others that there was no conncection between the pain pump and incontinence.

I know a lot more cases than Pierre QC who developed different Pelvic issues after Traditional TG issues,some of them are still in additional Pain and never recovered and some are having redos with Dr. Hibner.

All the best in your surgery and I hope that everything turns out to be allright for you in the end and you can lead a normal life like anybody else.

Regards,
Ali

[Charlie]

Pierre said:

Living with a lax sacroilliac ligament can be as problematic as PNE. Your pain is in the anus and back of the buttock, lower back and feets instead of more forward and deep in the perineum. Exchanging one problem for another is not better.i

Another problem with this report is that pain in the anus and back of the buttocks can be caused by PNE. I disagree that PNE pain always has to be 'forward and deep in the perineum'. I don't have perineum pain. As for lower back and feet pain I have met people with this who get that and they have not even had surgery. The surgery was not a success but I don't think you can be sure that this pain is caused by the severing of the ligaments.

All the best in your surgery and I hope that everything turns out to be allright for you in the end and you can lead a normal life like anybody else.
Ali

Thanks for the best wishes Ali. Sadly this is not only a horrible illness to have but one where we all have to make big decisions over the treatment we choose. We may disagree on this one issue but I genuinely hope Hibner works for you.