How can we care for scoliosis and kyphosis and spondylolisthesis better with conservative care like physical therapy, high-tech scoliosis braces, exercise and other techniques? What can be done to improve surgical care, and understand choices for surgery, learning from those around the world? How can we learn from aviation and from Deming's principles of "Standard Work" to constantly improve spine and all healthcare?
Tuesday, September 4, 2007
Kathryn doing well after L5S1 anterior fusion for discogenic pain
I saw Kathryn back for follow-up recently with her mom.
She had suffered for years during her teen-age years with severe back pain, and an MRI showed a severely degenerative L5S1 disc. She tried all conservative therapies over more than 2 years, and her quality of life was getting progressively worse, making it tough to get through her classes in college.
She had an anterior L5S1 removal of the degenerative disc, followed by fusion with an interbody cage with BMP, and an anterior plate. No posterior incision was performed, and the anterior incision is small, and along bikini line, transversely.
She is now doing well, working as an RA this semester, doing some lifting and moving, but keeping it to a minimum until her fusion completely heals, and she is getting back to class and exercise, glad that she finally got this degenerative disc removed.
I am a great believer in the body's ability to heal itself across degenerative segments, with the body doing a "fusion" of it's own in the very large majority of cases. That is why I do so few fusions for degenerative disc problems, focusing primarily on the spinal deformities which are much more complex and troublesome. However, patients like Kathryn are a good example of that small percentage of people who should consider surgery when all else fails, and the degeneration is limited to one or possibly 2 levels, and the quality of life issue is just getting intolerable despite conservative therapy.
Dr. Lloyd A. Hey
Hey Clinic for Scoliosis and Spine Surgery
http://www.HeyClinic.com
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