Today we helped Alex, a 22 yo woman who I have followed for a couple years with her painful double curve scoliosis.
She has spent the past 18 months in Sudan, Africa, and the pain has really gotten bad in the low back area.
Today I fixed her upper and lower curve T5-L3 at Duke Raleigh Hospital.
She did great during surgery.
Surgical time: 3 hours 14 minutes
Estimated Blood Loss (EBL): 725 cc.
Correction: near 100%
Postop location: Private Orthopaedic Floor Room, with family waiting.
Mom’s reaction when she saw the postop X-Ray with straight spine: tears of joy.
I got a chance to show Alex her X-Ray as well. Her reaction: “Wow!!”
It is important to minimize the number of fused segments. I used some preop bending X-Rays to determine that I could preserve the bottom 3 discs, which is much better for Alex in the long run.
I recently saw a similar curve in a 15 yo girl where they were planning to fuse to L5. Similar bending films revealed that I could fix the curve with a shorter fusion, sparing 3 discs as opposed to only 1 disc. This helps prevent adjacent level failure and maximizes flexibility.
Tomorrow we’ll get Alex up for her first walk.
She’ll be at least an inch and a half taller, and with a symmetric “hourglass figure.”
She’s planning to go back to Sudan in a couple of weeks, and get back to her important work.
Get well soon, Alex!
Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery
Raleigh NC USA
http://www.heyclinic.com
Member, Scoliosis Research Society (SRS) http://www.srs.org
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?
Wednesday, November 26, 2008
Wednesday, November 19, 2008
Hey Clinic Surgery: Monday Nov 18 '08: 20 yo man with severe kyphosis and scoliosis gets corrected
Yesterday morning, we straightened up Matthew, who is 20 years old with a near 90 degree Scheuermann’s Kyphosis.
His surgery took approximately 3 hours, and required no blood transfusions.
We used the cell saver as usual, in our laminar flow operating room.
I did several osteotomies to help with the correction, and used pedicle screw thoracic and lumbar instrumentation from T3-L2.
He has done well postoperatively, with some chest discomfort as his whole chest wall gets used to his dramatically improved shape!
Lloyd A. Hey, MD MS
Hey Clinic for Scoliosis and Spine Surgery
Raleigh, NC USA
http://www.heyclinic.com
Member, Scoliosis Research Society (SRS.org)
http://www.srs.org
His surgery took approximately 3 hours, and required no blood transfusions.
We used the cell saver as usual, in our laminar flow operating room.
I did several osteotomies to help with the correction, and used pedicle screw thoracic and lumbar instrumentation from T3-L2.
He has done well postoperatively, with some chest discomfort as his whole chest wall gets used to his dramatically improved shape!
Lloyd A. Hey, MD MS
Hey Clinic for Scoliosis and Spine Surgery
Raleigh, NC USA
http://www.heyclinic.com
Member, Scoliosis Research Society (SRS.org)
http://www.srs.org
78 yo man from West Virginia 8 days after anterior/posterior spinal reconstruction tells his story
Smoot is 78 yo man from West Virginia that I did spinal stenosis and scoliosis surgery 8+ years ago at Duke Medical Center (DUMC).
He was basically non-ambulatory at that time due to his severe spinal problems. He did great after surgery, but over the past year has had increasing kyphosis, pain and trouble walking.
Eight days ago we straightened him up with an anterior L5S1 ALIF instrumentation and fusion, followed by posterior Lumbo-Sacral-Iliac Wing instrumentation and fusion with posterior osteotomies and lumbar laminectomy.
He has done great after surgery, now standing up straight, and walking very well.
He is flying off to Florida today with his friend's private jet from West Virginia.
This morning before he left, we got a nice team photo, and Smoot tells his story with a short video clip.
Get well soon, Smoot!
Lloyd A. Hey, MD MS
Hey Clinic for Scoliosis and Spine Surgery
Raleigh, NC USA
http://www.heyclinic.com
Member, Scoliosis Research Society (SRS.org)
Monday, November 17, 2008
"Michigan Molly" Teenage Kyphosis Surgery update. FW: ? about Molly Ryan's limitations
Lysanne,
No problem with skiing! Have fun!
Thanks for the great update.
Give our best to Molly and the whole family.
Dr. Hey
------ Forwarded Message
From: Lysanne
Date: Sun, 16 Nov 2008 20:33:22 -0800 (PST)
To: Lloyd Hey
Subject: ? about Molly Ryan's limitations
Hello all,
We hope you are all doing well down there. We are freezing up here and the snow is falling and accumulating.
Which brings me to my question... Skiing. Is this possible for Molly? Her surgery for her 13 level fusion was July 17, 2008...to refresh your memories. We are 4 months out right now. Ski club forms need to be turned in and I am hesitant to pay for Molly as I am not confident it is safe for her yet. We ususally start skiing around mid December. She is an average downhill skier. Doesn't take risks or jump jumps or race. But still... let me know about this, if you can.
She is doing marvelously! Looks great, feels great! And you would never know she had the surgery except for her "zipperback" scar. We call her Zippy sometimes!
I have attached two photos of her from the first day of school in September and a photo of her lounging in Gull Lake, one month post op!
Thank you,
Lysanne
------ End of Forwarded Message
No problem with skiing! Have fun!
Thanks for the great update.
Give our best to Molly and the whole family.
Dr. Hey
------ Forwarded Message
From: Lysanne
Date: Sun, 16 Nov 2008 20:33:22 -0800 (PST)
To: Lloyd Hey
Subject: ? about Molly Ryan's limitations
Hello all,
We hope you are all doing well down there. We are freezing up here and the snow is falling and accumulating.
Which brings me to my question... Skiing. Is this possible for Molly? Her surgery for her 13 level fusion was July 17, 2008...to refresh your memories. We are 4 months out right now. Ski club forms need to be turned in and I am hesitant to pay for Molly as I am not confident it is safe for her yet. We ususally start skiing around mid December. She is an average downhill skier. Doesn't take risks or jump jumps or race. But still... let me know about this, if you can.
She is doing marvelously! Looks great, feels great! And you would never know she had the surgery except for her "zipperback" scar. We call her Zippy sometimes!
I have attached two photos of her from the first day of school in September and a photo of her lounging in Gull Lake, one month post op!
Thank you,
Lysanne
------ End of Forwarded Message
Wednesday, November 12, 2008
Fwd: Update and photos. Scoliosis Revision Surgery Happy On Beach 6 weeks postop
From: Pauline <@yahoo.com>Date: November 12, 2008 8:55:15 AM ESTTo: "Dr. Lloyd Hey" <>Subject: Update and photosDear Dr. Hey,Hope all of Hey Clinic and Hey homestead are good this morning. We are having a wet, cloudy, and cold morning with promises of an even colder mornings for the next few days.However, I am very grateful to be here, feeling great and very graciously thankful for such a wonderful and competent doctor and his staff.I have been meaning to write this note for quite awhile, but it seems that each time I sit down to the computer I think of something that needs to be done in my household chores line!! I take pride in caring for my home. And, for the first time in quite awhile, I am able to do so. I cannot ever repay what you have done for me. You are the great enabler and a wonderful instrument in delivering the word of God as you diligently work to restore your patients to their fullest potential.After we left your office on 10/23 (following my 6 weeks post op visit), we went the beach.I walked on the beach and felt the sand under my bare feet, then I cautiously walked out to meet the waves. This was the first time since 1999 that I have felt confident and physically able enough to do this. This was one of my goals. To be able to feel the sand and water beneath my feet just filled me with over flowing Thanks to Our Maker and YOU. My hubby stood and held me while I cried tears of thankfulness and happiness. I just this minute realized I am crying as I write this! I am unable to tell family, friends and even total strangers how "how spiritual and competent my doctor is." Since my first visit to you at"Big Duke" in December 2002, I knew I had found someone who was capable and willing to help me! Thank you, thank you, thank you!!I hope these pictures turn out OK. The sea was quite turbulent the days we were there but this was also very beautiful.We have so many blessings that it is impossible to list them all but I keep trying every day.I will see you in December for my 3-month post op visit and I look forward to seeing all my extended family at Hey Clinic.God Bless all of you.Pauline A____ from West Virginia
------------------------------
Lloyd A. Hey, MD MS
Hey Clinic for Scoliosis and Spine Surgery
Raleigh, NC USA
Member, Scoliosis Research Society (SRS) http://www.srs.org
Tuesday, November 11, 2008
Fwd: Adult Kyphosis Grateful Patient
From: FrancesDate: November 11, 2008 7:03:44 PM ESTTo: Dr. HeySubject: FrancesDear Dr. Hey,
If you recall, you corrected my nearly 90 kyphosis to a normal 4o degree curve on 10-30-08. I am now about 12 days post op and for the most part feeling quite well. I finally got to really take in my new ( and might I add totally awesome posture) and am both amazed by your skill and greatful to God for leading me into your gifted hands.
It's hard to thank you for such a wonderful gift of healing and there are no words to express my gratitude. Your staff is wonderful and a Brittany is a wonderfull PA and asset to your practice. Brittany has taken the time to calm my frayed nerves and reminded me what a huge procedure my body is healing from and all I need is time.
Thanks again for this life changiing surgery! If you took any photos, I would love to see them. In all my nerves prior to my surgery, I forgot to ask for some pics. The twenty years of medical assisiting have peaked my interest in how the surgery actually looked.
Also, please let your premed student know she can call or email me with any questions. Once I can get into a bathing suit, I will send a pic of my new, great posture.
With Deepest Gratitude,
Frances
------------------------------
Lloyd A. Hey, MD MS
Hey Clinic for Scoliosis and Spine Surgery
Raleigh, NC USA
Member, Scoliosis Research Society (SRS) http://www.srs.org
Saturday, November 8, 2008
Daniel's Adolescent Scoliosis Surgery this Past Wednesday
This past Wednesday, we straightened up Daniel, who is 15 years old, and had a progressive idiopathic scoliosis.
He has a great family, and did great before, during and after surgery.
His surgery took a little less than 3 hours, with an excellent correction, and no blood transfusions.
We did his surgery in our special laminar flow room, with “moon suits.”
He looked great the first night, with his mom and dad staying with him in his private room @ Duke Raleigh Hospital.
He mobilized quickly the first day postoperatively, and went home straight and tall on postop day # 2.
We shot some video at his request in high definition for his high school research project / presentation.
Get well soon, Daniel!
Lloyd A. Hey, MD MS
http://www.heyclinic.com
Hey Clinic for Scoliosis and Spine Surgery
Raleigh, NC USA
He has a great family, and did great before, during and after surgery.
His surgery took a little less than 3 hours, with an excellent correction, and no blood transfusions.
We did his surgery in our special laminar flow room, with “moon suits.”
He looked great the first night, with his mom and dad staying with him in his private room @ Duke Raleigh Hospital.
He mobilized quickly the first day postoperatively, and went home straight and tall on postop day # 2.
We shot some video at his request in high definition for his high school research project / presentation.
Get well soon, Daniel!
Lloyd A. Hey, MD MS
http://www.heyclinic.com
Hey Clinic for Scoliosis and Spine Surgery
Raleigh, NC USA
Thursday, November 6, 2008
Husband's assessment of his wife's adult scoliosis surgery
From: djh >Date: November 4, 2008 9:27:47 PM ESTTo: "Dr. Hey" <h>Subject: 3 months laterReply-To: djh <t>About 2 years ago we met with Dr. Hey for a consultation about Debra's Scoliosis. She's had back problems since she was young. In the last several years we had heard of more promising surgical procedures for Scoliosis. She frequently scanned the web for doctors who could do surgery on adult Scoliosis patients. She found a doctor and clinic who really excited her and requested information on their surgical procedures. The problem was they were well over 1500 miles away. I suggested she looked locally. Fortunately for us we found Dr. Hey and The Hey Clinic right in our back yard in Raleigh NC. about twenty miles from our home. After meeting with him we realized she had both Scoliosis and Kyphosis. Dr Hey also said she was a good candidate for surgery and would she a great improvement on her condition. At that point we were on board and she was VERY excited about actually getting some relief of her back problems. We had two obstacles to overcome. First ,Debra was diagnosed with Multiple Sclerosis in 1998 and we were not sure if surgery was possible with her condition. Dr Hey and Debra's neurologist Dr. Freedman assured us that she could have the surgery. Second, Debra was about two years away in her job from getting extended sick leave which was an additional 3 months sick leave. Two years later July 28 2008 Debra had her surgery. She had an almost 6 hour surgery to correct both of her 50+ degree curves for her Scoliosis and Kyphosis. With her MS creating some difficulties of their own she decided to take 10 weeks off from her work. The first 4 weeks of recovery were challenging and slow going but the results of the surgery were and are amazing.She has grown over an inch and her 50 degree curves are now 17 degrees or less. Friday Oct 31st was the three month milestone and things are great. Although we are about 25% through the first year healing period, Debra already seems a 100% better. We hope this helps other people in making your decision. It is well worth it. Thanks to everyone at The Hey Clinic we will see you in three months. Debra and Matt
------------------------------
Lloyd A. Hey, MD MS
Hey Clinic for Scoliosis and Spine Surgery
Raleigh, NC USA
Member, Scoliosis Research Society (SRS) http://www.srs.org
Tuesday, November 4, 2008
Nov 3 2008 Hey Clinic Surgery: 59 yo nurse manager with severe collapsing double curve
Yesterday, Monday November 3rd we helped a 59 yo woman, who works as a nurse manager for a hospital a few hours away who has a several hear history of severe progressive back pain. She was only recently diagnosed with a severe scoliosis. She likely had a smaller idiopathic scoliosis, but in her past 10 years or so, severe degenerative changes began to set in, causing disc and facet joint breakdown, and subsequent curve collapse with pain. This is a good example of degenerative scoliosis on top of idiopathic scoliosis, becoming symptomatic later in life.
Her surgery went very well today.
Fusion levels: T3-S1-Iliac Wing, with L5S1 L TLIF spacer w/ PEEK, and 2 lumbar osteotomies.
Surgical Time: 5 hrs 30 minutes.
Extubated in operating room, without difficulty.
Surgical correction: Excellent. Approximately 80%. Well balanced. Excellent lumbar lordosis. Humps gone.
Estimated Blood Loss: 1500 cc
Cell Saver Returned to Patient: 650 cc
Blood Transfused: None. Postop Hemoglobin 11.3
Evoked Sensory and Motor Function: Normal.
Postop Check: In good shape. Family Very Thankful. Local referring orthopaedic surgeon called me after surgery to get an update, and was also thankful.
Last week we “straightened up” a medical assistant for a surgery clinic who had a nearly 90 degree kyphosis. The week before that we did a large scoliosis in a nurse from local hospital. Tomorrow afternoon I am doing a thoracolumbar fusion on a retired nurse. Lots of healthcare providers in need of straightening!
--------------------
Lloyd A. Hey, MD MS
Hey Clinic for Scoliosis and Spine Surgery
Raleigh NC USA
http://www.heyclinic.com
Member, Scoliosis Research Society, SRS
http://www.srs.org
Her surgery went very well today.
Fusion levels: T3-S1-Iliac Wing, with L5S1 L TLIF spacer w/ PEEK, and 2 lumbar osteotomies.
Surgical Time: 5 hrs 30 minutes.
Extubated in operating room, without difficulty.
Surgical correction: Excellent. Approximately 80%. Well balanced. Excellent lumbar lordosis. Humps gone.
Estimated Blood Loss: 1500 cc
Cell Saver Returned to Patient: 650 cc
Blood Transfused: None. Postop Hemoglobin 11.3
Evoked Sensory and Motor Function: Normal.
Postop Check: In good shape. Family Very Thankful. Local referring orthopaedic surgeon called me after surgery to get an update, and was also thankful.
Last week we “straightened up” a medical assistant for a surgery clinic who had a nearly 90 degree kyphosis. The week before that we did a large scoliosis in a nurse from local hospital. Tomorrow afternoon I am doing a thoracolumbar fusion on a retired nurse. Lots of healthcare providers in need of straightening!
--------------------
Lloyd A. Hey, MD MS
Hey Clinic for Scoliosis and Spine Surgery
Raleigh NC USA
http://www.heyclinic.com
Member, Scoliosis Research Society, SRS
http://www.srs.org
Monday, November 3, 2008
Pre-Med Student Experience watching Kyphosis Surgery Last week
On Thursday I had the privilege of shadowing Dr. Hey’s surgery on a 40 year old kyphosis patient. As a pre-med student at NC State I was shocked to receive such an opportunity. My dream is to become a surgeon, and it is not often that a physician is patient enough to take an undergraduate student under their wing. During the procedure I observed, Dr. Hey fused the abnormally curved area of the patient’s spine using titanium rods and screws. I was amazed by the procedure, and being able to experience such an incredible thing first-hand has really changed my perceptions about my future.
Going into the surgery I had all but ruled out orthopedics as a career choice. I was also beginning to question whether my lifelong dreams of going into the medical field were worth the cost of pursuing them. However, when I stepped into the operating room I realized two things that settled any and all doubts that I had about my career. First, I began to comprehend how vastly this operation would improve the patient’s life. I also recognized to a new degree how fascinatingly intricate the human body is. Orthopedic medicine has a much greater impact on a patient than I had imagined, and the improvements that can be made in the quality of life have led me to consider this field much more intently.
I would like to sincerely thank the patient and her family for allowing me to observe this surgery, because I ultimately could not have had this experience to learn and grow without their help. It was an honor to be able to witness this procedure, and I hope that the improvement in the patient’s life is as great as the difference this experience has made in mine.
-------------
LLOYD A HEY, MD MS
HEY CLINIC FOR SCOLIOSIS AND SPINE SURGERY
RALEIGH NC USA
HTTP://WWW.HEYCLINIC.COM
MEMBER, SCOLIOSIS RESEARCH SOCIETY (SRS)
HTTP://WWW.SRS.ORG
Going into the surgery I had all but ruled out orthopedics as a career choice. I was also beginning to question whether my lifelong dreams of going into the medical field were worth the cost of pursuing them. However, when I stepped into the operating room I realized two things that settled any and all doubts that I had about my career. First, I began to comprehend how vastly this operation would improve the patient’s life. I also recognized to a new degree how fascinatingly intricate the human body is. Orthopedic medicine has a much greater impact on a patient than I had imagined, and the improvements that can be made in the quality of life have led me to consider this field much more intently.
I would like to sincerely thank the patient and her family for allowing me to observe this surgery, because I ultimately could not have had this experience to learn and grow without their help. It was an honor to be able to witness this procedure, and I hope that the improvement in the patient’s life is as great as the difference this experience has made in mine.
-------------
LLOYD A HEY, MD MS
HEY CLINIC FOR SCOLIOSIS AND SPINE SURGERY
RALEIGH NC USA
HTTP://WWW.HEYCLINIC.COM
MEMBER, SCOLIOSIS RESEARCH SOCIETY (SRS)
HTTP://WWW.SRS.ORG
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