Monday, January 25, 2010

Pedicle Subtraction osteotomy with removal of Harrington Rod for this 40 yo woman from South Carolina who broke her fusion mass

Today we helped straighten up Julie, a  40 yo woman who actually fractured her fusion mass at junction between her old Harrington Rod fusion and her extension fusion.
She had developed a large hump on her back and trouble standing up straight, as well as progressive pain.
Right before her surgery, this Julie’s young son gave me a big hug.  I took that to mean that he was trusting and counting on me to take excellent care of his Mom.  While my job can definitely be stressful, in times like this I feel like I am right where God wants me to be, helping to make a difference in the lives of real people and their families.  Sometimes scenes like that stick in my head afterward as an important moment not to be quickly forgotten in the busyness of daily life.   Life is precious.  Moms are precious.  Family is precious.  My entire focus for the next six hours was to take excellent care of his mom!

We solved this today by doing complex posterior reconstruction, which included removing the old Harrington Rod, performing a pedicle subtraction osteotomy at apex of her deformity, and then inserting 2 cobalt chrome rods from T3-Ilium with evoked potential monitoring.  Pedicle subtraction osteotomies are a great way to get a potentially very large correction at one segment, but requires quite a bit of care!

Her “hump” was completely gone at the end of surgery, and we had enough bone graft left over from the osteotomy and decortication of her old fusion mass that she required no allograft.
An approximately 45 degree correction of her kyphosis was obtained, which should allow her to stand up perfectly straight.
We started the surgery at 0855 and finished at 1432, making total surgical time 5.5 hours.
Estimated Blood loss was 2600, with approximately a liter given back to her as cell saver, and 3 units of PRBC transfused.
She was doing very well in recovery room after surgery, and will spend tonight in ICU.
Her husband and young son and other family members were very thankful in the conference room after surgery.
Julie’s son, who gave me the hug hours before gave me a real big smile, confident that his mom was ok.
Julie’s mom joined us by cell phone, and is eagerly awaiting this blog entry so she can see her daughter straightened up!

Best wishes to Julie and her whole family.

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery

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