Thursday, February 26, 2009

Amazing Disappearing Juvenile Scoliosis!

Abigail is a young lady who was placed in a brace 3 years ago at age 7 and has decreased her curve from 40 degrees to 4! This is an interesting example of a juvenile scoliosis case, which you typically see in children between 5 and 7 years old. Unlike congenital, adolescent scoliosis and adult scoliosis, some juvenile scoliosis curves can improve or even resolve as they get older. Even though some juvenile scoliosis curves will improve, careful follow-up is always indicated when you have any form of scoliosis to document curves over time.

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

Wednesday, February 25, 2009

South carolina gentleman w failed unilateral instrumentation and fusion done elsewhere fixed today

Xrays show halo effect around screws.
Pain was severe.
Surgery this afternoon went well.
Screws grossly loose and replaced.
L4-iliac wing revision decompression and fusion w bmp.
Surgical time: 2.25 hrs.
Blood transfused: none.
Room aura:excellent.
Estimated hospital stay: 2 nights

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery

Anterior-posterior ALIF spinal reconstructive surgery for flat back sydrome fixed today for woman years sp L2-5 fusion done elsewhere

Surgical time 5.5 hrs.
Anterior L5 S1 ALIF, posterior osteotomy and decompression and L2 to iliac wing instrumentation w bmp.
EBL 1200 cc
Complic: none.
Correction of Lordosis: excellent.

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery

Tuesday, February 24, 2009

L1 laminectomy this afternoon for gentleman w clumsy legs

After finishing our big kyphoscoliosis reconstruction around 1:30, I talked to very thankful husband, grabbed quick lunch, then saw 12 yo girl in clinic w scoliosis which has progressed frome 26 to 44 degrees in 6 months. Nice family from Wilmington NC.

After that, I went back over to OR, where we just helped this man with severe leg clumsiness with a minimally invasive lumbar decompression laminectomy. You can see the severe stenosis on the mri above.

A very good day.

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery

Major kyphosis and spondylolisthesis correction for this 60 yo woman today

Preop kyphosis was 79 degrees.
T2-Iliac wing instrumentation and fusion. L5 Gill procedure.
Did well.
Surg time 5 hrs.
Excellent correction. No more "hump"!

Dr. Lloyd Hey
Heyclinic for scoliosis and Spine Surgery

Monday, February 23, 2009

Today's afternoon surgery: L3-5 decompression and fusion for lumbar spondylolisthesis and severe stenosis

EBL: 200 cc
Surgical Time:  1 hour 45 minutes
Segments: 3.
Complications: none.
Blood transfused: none.
Postop location regular ortho floor, private room.
Est Length of stay: 2 nights.

Dr. Lloyd Hey

13 yo 56 degree scoliosis fixed this morning w near 100 per cent correction

EBL 725 cc
Cell saver 235 cc
Surgical time: 3 hour 10 minutes
Blood transfused: none.
Complications: none.

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery

Wednesday, February 18, 2009

Today's surgery

This morning we did an anterior posterior lumbosacra ALIF instrumentation w exploration of fusion mass and posterior reinstrumentation. She did well. Surgical time 4.5 hrs. EBL 500 cc. No blood transfused.
This afternoon I saw one of my former Duke scoliosis surgical patients who drove all the way down from Potsdam NY (789 miles, 13.5 hrs!). I did her scoli fusion many yrs ago as a young adult, and now she has some increased back pain w spondylolisthesis down at L5S1.

This afternoon we helped a gentleman w severe cervical myelopathy using use of his hands (similar to surgery yesterday). He had 2 level acdf and did great. Surgical time 90 min.

Our surgery from mon is doing well and acdf from yesterday had excellent recovery of her arm function and went home this am.
Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine surgery

Tuesday, February 17, 2009

Yesterday's Scoliosis Surgery

Yesterday we helped a gentleman from New Bern, NC who had severe collapsing lumbar scoliosis with flat back syndrome and severe multilevel stenosis.
I performed an L1-Iliac wing reconstruction with multilevel laminectomy.
Surgery time was approximately 3 hours and 30 minutes.
He is doing well postoperatively!
He has a daughter in California who wanted to get an update and see the pictures -- so sorry for the delay!

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



C56, C67 (C5-7) ACDF w plate

This morning we helped this woman w severe clumsiness in both hands due to severe cervical spinal stenosis.
We fixed it this morning w 2 level anterior cervical decompression and fusion w allograft and plate.
Surgical time was 2 hours.
No complications.
Home tomorrow.

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery

Thursday, February 12, 2009

Degen scoliosis and failed laminectomies done elsewhere fixed today

OR time 2 h 30 min
EBL 350 cc
Blood None
This guest had 2 prevoius laminectomies and got better for a short time after each one, then got much worse due to ongoing scoliosis collapse w restenosis.
Got excellent 4 level revision decompression w correction and stabilization of the deformity which will help prevent recurrance.

Tomorrow she will stand up and walk better.

Will spend 2-4 nights in hospital.

Dr. Lloyd Hey
Hey Clinic

Yesterday's front and back flat back correction surgery smiling and standing up straight 15 hours after surgery!

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery

Morning rounds: love that hat! Heading home postop day 2 after scoliosis surgery.

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery

Wednesday, February 11, 2009

Wow, good posture!

Brittany is excited with our final awesome result w today's flat back reconstruction!

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery

From Flat Back to "Nice Back" today with anterior/posterior reconstruction.

Diane is 41. Over 10 years ago, I I'd a lumbar scoliosis extension fusion down to L5.  She did great for quite a while
Over past couple years, she developed severe pain w flat back syndrome w collapse L5-S1 disc.

Today I did anterior L5S1 ALIF, jacking open bottom disc. We then turned her over, took out old hardware and did 2 posterior osteotomies ansd laminectomiers w extension instrumentation and fusion from L1 down to Iliac wing.
Iliac wing screws took extra work since she had bilateral iliac crest bone grafts taken many years ago as teenager.

Surgery went great. As shown on before-after X-rays, her lordosis was improved from 25 degrees to 68 degrees. Her posture from side view looks much better, with normal "sway" and more prominent buttock.

surgical time anterior : 50 minutes.
Posterior surgical time: 5 hrs 15 minutes. Total time: 6 hours 40 min
EBL: 1600 cc
Cell Saver 730 cc.
Blood transfused: none.
Complications: none.
BMP medium and Tisseal used at end surgery.

Tomorrow she gets to stand up straight, which is always a joy to see!!

Dr. Lloyd Hey
Hey Clinic

Dr. Hey reviewing x-rays after surgery in morning light!!!

Tuesday, February 10, 2009

2 level severe spondylolisthesis and kyphosis (flat back syndrome) and stenosis fixed this afternoon

Surgical time 2 hrs 5 minutes.
L3 to Iliac wing (5 segments) w 3 level osteotomies and laminectomies.
Estimated blood loss (EBL): 350 cc
Did well.

Good room aura!

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

58 yo man w degen scoliosis and stenosis sp previous laminectomies done elsewhere

Fixed this morning.
Did well.
OR time 2h 55 min.
No transfusions.

Dr. Lloyd Hey
Hey Clinic for scoliosis and Spine Surgery.

Monday, February 9, 2009

Severe spondylolisthesis , and scoliosis and stenosis status post previous laminectomy elsewhere

In agony preop.
Fixed today T12-Iliac wing instrumentation and fusion w revision L2-L5 laminectomy.
Surgical time 4.5 hrs.
EBL 1,300 cc.
Did well!!
Lessons to learn: laminectomy alone for stenosis w listhesis and or deformity usually should be accompanied w instrum and fusion to prevent recurrance and further instability.

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery

Sunday, February 8, 2009

AJ is now very, very straight!

Last week, we operated on AJ, a 30 yo real estate agent, who had a severe collapsing kyphoscoliosis.
I have been working out a new surgical technique for correcting these more serious deformities, using what I call a “simultaneous rod technique”.  
This new technique allows me to derotate and correct each segment at a time, gradually untwisting the “slinky”, and getting a better correction.  I also performed some posterior osteotomies to help with the correction.

We got a 90-95% correction in this young lady.
Before and after X-Rays are shown, as well as the response of the AJ’s husband and sister when they saw the “New AJ” X-Rays right after surgery!

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery

Polly's standing up straight and walking much better!

Last week I saw Polly back in clinic.
She’s a retired nurse from South Carolina who had several scoliosis and other spinal surgeries over the years.
I did a tough reconstructive anterior-posterior total spine reconstruction for her, and she is now doing very well.
She thanks all of the caring staff from Hey Clinic and Duke Raleigh Hospital in the brief video.

You look great Polly!

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

Barbara doing well after lumbar-sacral-iliac wing reconstructive surgery

Saw Barbara back the week before for her postop check, walking well and standing up straight and back to an excellent quality of life.
Take care, Barbara!

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

Seven years out from complex kyphosis surgery, and still standing up straight and thankful

On Friday, I also saw Tammy back in clinic with her husband.
Tammy had a very severe thoracolumbar kyphosis, that included a spinal fracture.
She was in severe pain, and was severely kyphotic, looking down at the floor, on a lot of narcotics.
Now she is doing great, off all narcotics, and working full-time as an X-Ray technician at a very busy hospital about 2 hours away.
She even says she lifts up / rolls over 500 lb patients to slide in her cassettes!
Tammy got motivated to become a radiography tech after her kyphosis surgery with us several years ago.

You look great, Tammy, and thanks for sharing your story briefly with the video today!

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

Successful complex spinal reconstruction for young man who had 5 lumbar surgeries elsewhere and could barely walk.

On Friday I also saw Jeff and his wife back for surgery.  We shared about Jeff’s saga a few months ago, and showed him walking up and down the halls in the hospital after surgery.
Jeff’s a very large young man, who had 5 previous surgeries done elsewhere, but still was getting worse, on very high dose narcotics, and barely able to walk even with 2 crutches!  His quality of life was horrible and getting worse, and the pain medication had become ineffective.  He had severe spinal stenosis and degeneration at multiple levels, and I did a several hour complex spinal reconstruction of the entire lumbar spine, all the way down to the pelvis / iliac wings.

He has done just great, and now can walk without falling, and really doesn’t need his crutches anymore.
He has tapered off the narcotics, and both he and his wife are starting a new life together.
Many answered prayers here.
They share their thanksgiving in this short video.

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

Successful lumbar-iliac wing reconstructive surgery with multilevel laminectomy. Allie and her son tell their story.

Friday was indeed a busy postop day at Hey Clinic!
We also saw Allie and her son in clinic.
Allie is looking just great after complex lower lumbar instrumentation, decompression and fusion down to the iliac wing.
She now walks well and has very little pain.
Both Allie and her son express their thanks for the Hey Clinic and Duke Raleigh Hospital staff.

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery

Sarah's got a beautiful posture now!

In clinic on Friday we saw some very happy scoliosis follow-up patients ranging from the teens,  then Candice who is in her 20’s, to a nurse in her 50’s and Sarah, shown here who is going to be 80 years old this year!
Each one is thankful for their new posture, and better quality of life and appearance.

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery
Member, Scoliosis Research Society (SRS.ORG)

ICU nurse manager back to work within 2 months after major scoliosis surgery. Her Testimony

On Friday, we also saw a very pleasant nurse manager from a couple hours away, who is just a few months out from basically an entire thoracolumbar spine reconstruction all the way down to the sacrum and iliac wing.
In this Blog, she shares a brief video of the difference the scoliosis surgery has made in her life.

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery
Raleigh, NC USA
Member, Scoliosis Research Society (SRS.ORG)

Candice looking great after scoliosis surgery

We showed Candice’s back a few months ago.  She had a very severe case of hypokyphosis with her thoracic scoliosis, which caused her lung volumes to be quite small, and also caused her chest to look quite “sunken in.”
I saw her back in clinic on Friday along with a bunch of other scoliosis postoperative patients, and she looks and feels great!
Her chest is now quite symmetric, and has the more proper shape.
She is finishing up school as speech therapist, and has a bright future ahead of her!

Take care, Candice!

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery
Raleigh, NC  USA
Member, Scoliosis Research Society (SRS.ORG)

Thursday, February 5, 2009

Kyphosis and thoracic spinal stenosis w myelopathy fixed today

Today we helped a gentleman who developed adjacent level spinal stenosis and kyphosis above a previous scoliosis fusion. He had developed bilateral lower extremity clumsiness due to the spinal cord pinch.
Today I fixed the stenosis w a 2 level thoracic laminectomy and a revision T10-Iliac wing extension decompression and fusion w BMP.
Surgical time: 3.25 hrs.
Room Aura: Excellent.
Scrubbed: Jaclyn, Gilbert, Charley.
Circulator: Nurse Kelly.
EBL:  1,300 cc.
Blood transfused: none.
Complications:  none.

He should be able to stand up straight with less clumsiness over next few days.
He will be in hospital probably 3 nights.

Dr. Lloyd Hey

Wednesday, February 4, 2009

Dr. Hey @ Costco getting supplies for Hey Clinic.

Meredith said she couldn't imagine it, but here he is!!
Whatever it takes.....
Dr  Hey :)

Fixing scoliosis w microsurgery this afternoon!

This afternoon we helped relieve severe R leg pain for this 50 yo woman who had laminectomy done elsewhere w persistent leg pain. MRI shows severe R L5S1 stenosis. Her X-rays show lumbar scoliosis, which is actually due to her sciatica, as she tries to lean away from pain, opening up neural foramen. Remove he pinch, remove the pain, removes the scoliosis.

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery

48 yo w lumbar spondylolisthesis and stenosis fixed today

This morning we helped a gentleman w severe back and leg pain w diagnoses above.
I did a L4 and L5 laminectomy and L4-Iliac wing instrumentation and fusion.
He did well, and no transfusion was needed.
We'll start to get him up this afternoon.

Our postop women who had scoliosis surgery on Monday and yesterday are both doing well upstairs.

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

Tuesday, February 3, 2009

33 yo realtor w very painful 48 degree scoliosis now very, very straight after surgery just now w Dr. Hey

We just finished helping this young woman w severe collapsing kyphoscoliosis.
She has had to take major league pain medications past few months due to progressive pain.
Her surgery today went great. I used a new simultaneous rod insertion technique that I developed, that gives a segmental correction helpful for getting a better correction. It worked like a dream.
Surgical time: start 0854. Finish 1225. 3.5 hours
Estimated Blood Loss. 1100 cc
Cell Saver Recycled: 360 cc.
Blood transfused: none.
Complications: none.
Room Aura: excellent.
Circ nurse: Nurse Kelly.
New recruit: Michael. Strong Work.


Levels fused: T5-L4. (12 segments).
Correction: excellent. 48 preop to near zero (95 pct) correction.
BMP used to help fusion at base.
Screws used: 20.
Rods used 2 330mm cobalt chrome.
2 cross-links.
Evoked potentials: normal.
Can't wait to see what husband's reaction when I show her correction in a few minutes!!
Dr. Lloyd Hey
Hey Clinic

Monday, February 2, 2009

61 yo with severe 3 level lumbar spinal stenosis w back and leg pain fixed today

... W 3 level spinal microsurgery laminectomy.
The laminectomy is sorta like a "Roto-Rooter" to clean out the three tight spits that I am pointing out on his MRI. Surgical time 1 h 49 minutes.
Should be able to stand and walk much better and will go home tomorrow.
A good day.

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

47 yo w collapsing lumbar scoliosis fixed this morning.

This morning we helped a 47 yo young lady w collapsing scoliosis. She probably had asymptomatic curve as adolescence, but then in past 5 to 10 yrs, degeneration led to curve progression, obvious visible posture problems, and pain.
Her surgery went very well today.
Levels fused: T11-Iliac wing (9 levels)
Osteotomies: 3.
Surgical time: 4 hours
Est Blood Loss: (EBL): 850 cc.
Cell saver 375 cc.
Blood transfused: none.
Complications: none.
Correction: 35.6 to close to zero (95 per cent).
Lordosis: Excellent
Postop location: PACU --- to private ortho room.
It was a blessing that she got this fixed while she was younger and her curve was more flexible. Some people are naturally more flexible than others.

I think she will really enjoy her new shape!

I'm the patient's husband and have just finished meeting with Dr. Hey. We've reviewed the films and the "before-and-after" comparison of the correction is just amazing! The result is a straight in one plane and naturally curved in the other. It is wonderful and we'll be so happy with the result! Thanks to Dr. Hey and the Hey Clinic.

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