Mon Jan 21 afternoon surgery: Revision surgery for broken rods in woman who had severe fall 10 months after scoliosis surgery. Developing better solutions for future scoliosis surgery through biomechanical research.

Monday afternoon we helped Mary, who I had corrected a huge scoliosis 10 months ago.
She did very well until a month or so ago, when she took a very severe fall, falling down several stairs.
She subsequently developed increasing back pain.
Her X-Rays and CT confirm that she broke both of her rods near the base.
I revised her instrumentation and fusion on Monday, with a new triangular construct, and improved biological healing using bone morphogenic protein, (BMP).
She subsequently did very well, and went home at the end of this week.

As many of my patients and readers know, I have a background in engineering, and have had a long-term interest in reconstructive surgery with a high emphasis on biomechanics.
I work closely with our instrumentation vendors, to ensure that we have the strongest materials available.  However, having strong materials is not enough: we need to continually figure out better and better CONSTRUCTS, and to improve the biological healing properties of the fusion.  We also need to help our patients to understand what to do, and not to do after surgery, especially in the older patient, who has a large surgery: “Avoid Bending, Lifting and Twisting.”  However, even with all of the right surgery and precautions, things like severe falls do happen, which can push the spinal constructs beyond what they were meant to handle, during the critical first year of bone healing.

Hey Clinic is working with the Department of Engineering at NC State on developing better computer models for guiding spinal instrumentation, and also on lab testing for new scoliosis constructs that should improve corrections and fusion rates, and provide solutions for tough revision deformity cases with proven mechanical strength and longevity.  Associate Professor Andre Mazzolini, one of our academic collaborators, has a deep interest in the spine, scoliosis and spinal instrumentation, with some direct family experience with scoliosis.  We are also working with instrumentation companies, including Synthes Spine, in order to evaluate and develop better solutions for spinal surgery.

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