Mon Jan 21 Hey Clinic Surgery: 22 you Ashley with the 78 degree stiff R thoracic curve and pulmonary problems.

Monday, we helped a 22 yo young lady who had a 78 degree thoracic scoliosis, with some breathing difficulties secondary to decreased pulmonary capacity, exposure to her grandmother’s smoking, with chronic bronchitis, and possibly a mild cystic fibrosis condition.  She had known scoliosis as a teenager, but her parents did not arrange for ongoing follow-up after she finished being followed by her pediatrician.  Over the next 4 years, her scoliosis continued to progress even though she was skeletally mature.  She then experienced increasing back pain, and pulmonary difficulties.  We actually had to postpone her surgery for a couple of months to try to improve her pulmonary function prior to surgery.  She sailed through surgery without difficulty on Monday, with her surgery taking about 3 hours, and no blood transfusions.  Her curve, however, was quite stiff, which took more intra-operative effort to improve her curve.  Her postoperative curve is definitely improved, but her rib deformity is still evident, but may improve a bit over next few months.  However, we definitely would have gotten a better correction if we had fixed this when her curve was smaller, and she was younger and more flexible.  

In fact, on the day following Ashley’s surgery, I corrected a 17 yo young lady’s double curve which was 60/48 degrees, which was still very flexible, resulting in nearly a 100% correction of the curve and elimination of the rib hump.  Just 5 years earlier than Ashley’s surgery.

Parents and other family members, along with pediatricians, OB/GYN physicians (gynecologists and obstetricians), and family physicians can all help to ensure that all children and young adults and older adults get:

1. Screened for scoliosis and kyphosis, including using the scoliometer as an accurate method for determining whether X-Ray is necesssary, and
2. Ensure that all patients identified with scoliosis or kyphosis  receive life-long follow-up, since curve progression can occur at any point either before or after skeletal maturity.
   

Ashley did very well during her short hospitalization, and went home glad to have the surgery behind her, after many years of dealing with this growing problem.

Lloyd A. Hey, MD MS
Hey Clinic for Scoliosis and Spine Surgery
http://www.heyclinic.com
Raleigh, NC USA