She has severe flat back syndrome, degenerative scoliosis, spondylolisthesis, L5S1 disc degeneration with vacuum disc phenomenon.
She also has rheumatoid arthritis, which contributed to her original degenerative scoliosis.
I removed the degenerative disc anteriorly, and jacked it open, and replaced the disc with an ALIF spacer with bone morphogenic protein (BMP) and anterior instrumentation to prevent cage migration.
I then removed her old unilateral instrumentation, explored the fusion mass, and found loose hardware and instability at L12.
The spinal stenosis at L12 and L5 was relieved with laminectomies, and posterior osteotomies were performed to help further improve her lordosis.
She did well with surgery, and her lordosis was dramatically improved.
After her surgery, I spent an hour with another nurse ICU manager (in her 50’s) who has a double curve 50 degree scoliosis surgery to discuss her potential upcoming surgery.
She was told by local neurosurgeon that “nothing could be done” except pain management for her scoliosis, but her primary care doctor researched it further, and suggested that she be evaluated by a scoliosis center.
She was glad to hear that there was hope, since she has become increasingly symptomatic during past couple of years, and is strongly suspicious that her curve is progressing.
Lloyd A. Hey, MD MS
Hey Clinic for Scoliosis and Spine Surgery
Raleigh, NC USA
http://www.heyclinic.com
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