Thursday, January 29, 2009

Thoracic Kyphosis causing lumbar hyperlordosis, causing spondylolysis in a 12 yo girl.

This morning right before fixing McKenzie’s scoliosis I saw another 12 yo girl named Carson for a second opinion for surgery.  This young lady had a pars fracture, or spondylolysis at L5, with occasional back pain.  A posterior L5-S1 instrumentation and fusion was being suggested.

I did not find any significant spondylolisthesis, but did find that she had a 62 degree thoracic kyphosis with some Scheuermann’s Kyphosis changes in mid-thoracic spine, which caused her low back to go into hyperlordosis, which increased stress at L5, and may have contributed to the cause of the stress fracture of L5.

Carson’s dad showed up about half-way through the appointment, and she was able to explain to her dad the “dominoe effect” of the kyphosis contributing to her lower back issue.

We all agreed to hold off on surgery, but keep an eye on the kyphosis over next few months and years to look for progression and/or pain.

That was very welcome news for Carson and her family!
Strong work, Carson!

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

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