Thursday, October 25, 2007

Great Motivation to take your calcium every day. Today's urgent surgery for L1 burst fracture with severe osteoporosis with L1 vertebroplasty

This afternoon, we helped a 70 yo woman, who had a fall back in July with increasing back pain.
Her husband had been noticing some increasing kyphosis over past couple of years.
After the fall this July, she started to have severe debilitating back pain.
A week ago, she had vertebroplasty done for fracture at L1.
Her pain got worse, not better, and she was admitted to outside hospital where she was in so much pain, she could not even sit up.

Her studies showed an unstable burst fracture, with 50 percent canal compromise and evidence of toggling at that level.  She also had severe thoracic kyphosis and lumbar scoliosis with severe osteoporosis.
Basically, what she really needed was a total spine replacement, which is not possible.

To fix this problem, a short fusion would not work, given her poor bone quality and deformities.
We were able to stabilize the fractures and improve her deformity by performing a T3-Iliac wing instrumentation and fusion, with L1 decompression.
Her surgery went very well, and took about 4 and a half hours.

Her family was very thankful.
She is doing well in ICU tonight.
Tomorrow, she can start to get up, now that her spine is stable.

Please be sure, whatever your age, that you take calcium with vitamin D every day.
It is a great investment to help prevent this type of pain and suffering in the long run.

Lloyd A Hey, MD MS
Hey Clinic for Scoliosis and Spine Surgery
Raleigh, NC  USA

Can you be active after scoliosis surgery? Lou from Pinehurst would tell you "Yes", on his 10 yr Scoliosis Surgery Anniversary with Dr. Hey. Lessons learned listening to your patients.

This week, my friend and patient Lou, from Pinehurst NC came back for his 10 year anniversary appointment for his scoliosis surgery I performed for him back at Duke Medical Center in Durham.
Lou, a retired CEO of a stainless steel company, really took me by surprise during our initial meetings. After he had decided that his quality of life was unacceptable, and that his curve indeed was progressing, and that the conservative treatments had failed, he had told me that he wanted to move forward with surgery.
I vividly remember a very interesting interchange regarding his questions about postoperative activity:
LOU: “How about golf?”
DR. HEY: “No golf for one year, until fusion is healed.
LOU:  “That is not acceptable!”, [said firmly, as if he was striking his fist on the conference table at same time]
DR. HEY: [Eyebrows go up in surprise ... Speechless]
LOU:  “Are you a golfer? Have you studied the mechanics of the golf swing?  It seems to me that it should be possible to play some golf during the first year.  I will send you some articles.
DR. HEY: OK, Lou.

LOU:  What about SCUBA diving?  I have a big SCUBA trip planned for 2 months after surgeryto the Cayman Islands.  I plan to still go.
DR. HEY:  Lou, I don’t think that’s a good idea.  The SCUBA tanks are really heavy, and that could put a lot of load on your lower back fusion.
LOU:  Do you think I would do that?  I already have it figured out.  I will have them pass me the SCUBA tank when I am in the water, and then put on my tank.  Once I am in the water with the tank, the tank is effectively weightless.  Problem solved.
DR. HEY: Sounds good to me!

1 week later I receive a fairly good size box with a half a dozen golf magazines in it, with several chapters labelled which described in detail the mechanics of the golf swing.
Wearing my engineering hat, I studied these documents carefully, and came up with a new regimen, which allows for gradual advancing golf program over one year period.
That golf program allows people to start back to golf at 6 weeks, and then advance up to full swing by a year.  I have used that program effectively for hundreds and hundreds of golfers ever since Lou’s forceful meeting.

Lou did just great after his surgery.
He went on his SCUBA trip, advanced quickly on his cycling and walking, and then golf.
A few months later, he went with some friends up to Canada, where he went “Heli-Hiking” along the top of the Canadian Rockies!

For the past 10 years, I have seen Lou and his wife Nancy back for follow-up every year or 2.
They have become good friends, and have helped many of my patients and their families over the years.

I have learned a lot from Lou, and many of my other patients, and these lessons learned have turned around to help other patients and their families.
The learning never stops.
Happy Anniversary, Lou.  I thank God that you have been able to enjoy a better quality of life these past 10 years.

Keep it up, and come by anytime.

Lloyd A Hey, MD MS
The Hey Clinic for Scoliosis and Spine Surgery
Raleigh, NC  USA

Monday, October 22, 2007

C34 ACDF for severe arm weakness: stronger the next day before going home from Hospital. Hey Clinic Surgery Patient week of Oct 18

We took care of this gentleman last week who had a severe spinal cord compression at C34 with severe arm weakness, including loss of fine motor.
About 18 hours after surgery, on the first postoperative day he was showing off to my 2 physician assistants how strong his pinch grip had improved overnight.
He went home very thankful, and on the way to recovery.
Surgical time was 90 minutes.

Lloyd A. Hey, MD MS
Hey Clinic for Scoliosis and Spine Surgery
Raleigh, NC USA

Oct 22 Hey Clinic Surgery 82 yo with 2 level spondylolisthesis, scoliosis and severe stenosis

This afternoon we helped an 82 yo woman with progressive leg pain, and back pain and trouble standing or walking for more than just a couple minutes.
She had a collapsing scoliosis with 2 level severe spondylolisthesis with severe stenosis.
She underwent a L2-5 decompression and fusion this afternoon, and is doing well now postoperatively.
She will be up walking tomorrow.

Lloyd A. Hey, MD MS
Hey Clinic for Scoliosis and Spine Surgery
Raleigh, NC - USA

"Quad Rod" T12 fracture with kyphosis reconstruction for broken hardware: Nancy's 6 week follow-up at Hey Clinic 2.5 inches taller, and smiling!

Today we saw Nancy and Bob back for 6 week follow-up.
Nancy had a severe fracture of T12 with kyphosis, and had broken her rods at the fracture level on 2 occasions, breaking standard rods, and “triple rod” constructs.
She was not willing to undergo an anterior-posterior reconstruction.
I wrote a long Blog a few weeks ago explaining a new ‘Quad Rod” technique which has drastically improved the strength of her posterior reconstruction.
She looked just great today in clinic, with a big smile, wonderful posture, and wonderful gait.
You look great, Nancy!

Dr. Lloyd A. Hey
Hey Clinic for Scoliosis and Spine Surgery

Saturday, October 13, 2007

Great to see you back, Karen! Karen's miraculous recovery over 9 months. Going back to the hospital and clinic to say "Thanks"

On Friday, we saw Karen, one of our dearest patients back for follow-up with her mom.
She has had an amazing recovery from major thoracolumbar kyphoscoliosis surgery as well as anterior/posterior cervical spine reconstructive surgery for vertebral discitis with severe myelopathy with severe quadriparesis.
It was a long, tough battle, and at times seemed fairly hopeless.  But now, months later, she is back on her feet walking, living at home, and using her arms and hands again.
Karen is an amazingly driven young lady, and is a blessing to all of us.
Karen and her mom made a special point to go over and see the nurses, physical therapists, hospitalists, and other care-givers that invested their lives into Karen and her family over many weeks.
Everyone was just so amazed to see the “New Karen” --- what an encouragement to those who work in the hospital, who are often seeing patients at their worst.

Many years ago, after my own long recovery after being hit by a car, I made a point to go back and visit my old hospital every year when I was in college.
I am sure I was probably quite a burden for some of those nurses and aids, and therapists during my 3 and a half month hospitalization.
Like Karen on Friday, it always brought great joy to the staff to see someone come back healed after a long ordeal.

Remembering to turn around and give thanks for those who helped you through the toughest time is a good lesson for all of us.

Lloyd A. Hey, MD MS
Hey Clinic for Scoliosis and Spine Surgery

14 yo young man back for postop follow-up to Hey Clinic after R thoracic scoliosis corrective surgery.

We saw Craig and his dad back for follow-up just a few months after his scoliosis surgery this past summer.
He is back to school, doing well, and obtained a very good scoliosis correction and final appearance.
Lloyd A. Hey, MD MS
Hey Clinic for Scoliosis and Spine Surgery
Raleigh, NC USA

Danciing after spinal surgery

Postoperative visit interview with this gentleman sharing his experience at recent wedding.

Lloyd A. Hey, MD MS
Hey Clinic for Scoliosis and Spine Surgery
Raleigh, NC USA

Pedicle Subtraction Osteotomy (PSO) to correct "Flat Back Syndrome": Hey Clinic Surgery Oct 8 2007

This 61 yo woman had a long spinal fusion performed down to the pelvis elsewhere, and has had severe flat back syndrome, with leaning forward posture, upper and lower back pain, and bilateral thigh pain and difficulty walking more than short distances. She suffered with severe fatigue, needing to walk with her knees slightly flexed.
To fix this problem, we performed a L3 pedicle subtraction osteotomy (PSO), where a wedge of L3 was removed, and the gap was then closed to recreate her lumbar lordosis. Her preoperative lumbar lordosis was less than 15 degrees. Her intraoperative lumbar lordosis after performing the osteotomy was 62 degrees. At the end of surgery after the incision was closed you could immediately see the results. Preoperatively, her thoracic and lumbar spine were totally flat, along with her buttock ("washboard") After surgery, she had a nice gentle curvature in the lumbar spine, with a more normal-appearing buttock.
Her surgery went quite well, taking approximately 5 hours, with 1200 cc blood loss, using cell saver machine to recycle the blood on the surgical field.
Postoperatively, she has done just great. On her first day after surgery, she stood up perfectly straight, and her leg pain was gone. She was all smiles.
She went home Friday, on her fourth hospital day at Duke Raleigh Hospital. On Friday, she was just beaming, feeling that she was starting a whole new life.

Lloyd A. Hey, MD MS
Hey Clinic for Scoliosis and Spine Surgery
Raleigh NC USA

Friday, October 5, 2007

23 yo woman from West Virginia talks about life before after recent scoliosis surgery. Hey Clinic Postop Visit

We saw a 23 you woman back for her 3 month scoliosis visit.
In this short video, she shares her experience before and after surgery.

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery
Raleigh, NC USA

13 yo girl with severe thoracic scoliosis for Surgery w/ Hey Clinic Sep 27 2007

Sept 27 2007 we helped a 13 yo girl who had a very large R thoracic scoliosis with documented progression. We used thoracic pedicle screw instrumentation and were able to keep the fusion relatively short, T5-L1.
Her surgical time was approximately 2 hours and 45 minutes, and we used "cell saver" and no blood transfusions.
Her correction was approximately 90%.
Her postop course was unremarkable, with her whole family staying with her in the large private orthopaedic room at Duke Health Raleigh Hospital.
Her rib hump is gone, and she went home 3 days after surgery with her family
doing well.

Dr. Lloyd Hey

Sep 26 2007 Hey Clinic Surgery: 38 yo woman with severe low back pain with severe degeneration L45 and L5S1

On Sep 26, we helped a 38 yo Raleigh nurse who had severe progressive low back pain, and poor quality of life with 2-level severe disc degeneration and facet arthritis (spondylosis). She underwent a 2-level instrumentation and fusion, replacing the L45 and L5S1 discs with TLIF spacers and bone graft, and also supporting the fusion with posterior instrumentation from
L4-Iliac wing. MRI shows the severe degeneration L45 and L5S1 with severe disc space narrowing L5S1. She had central annular tear L5S1 with central disc herniation.

She is now recovering at home, and advancing on her activity program.

Lloyd A. Hey, MD MS
Hey Clinic for Scoliosis and Spine Surgery
Raleigh, NC 27609