Friday, June 25, 2010

Gift from Charlene, scoliosis postoperative guest from Florida

We saw Charlene and her daughter and grandson up from Florida today
for postoperative followup doing great. She brought me a Manatee t-
shirt, and this wonderful plaque for my wall that she made up herself.

Great to see you Charlene!
Dr. Lloyd Hey
Hey Clinic

Thursday, June 24, 2010

12 yo young lady from Voula Greece w adolescent idiopathic scoliosis fixed today

T5-L3 instrumentation and fusion.
Ebl: 475 cc
Blood transfused: none.
Cell saver 120 cc.
Complications: none.
Correction: excellent.

To all of Claire's family back in Voula--- she did great!

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery

Wednesday, June 23, 2010

14 yo girl from WV w 55 deg double AIS scoliosis curve fixed this afternoon

Surgical time: 4 hr 10 min.
Ebl: 800.
Blood transfused: none.
Complications: none.
Correction: excellent.

Dr. Lloyd Hey
Hey Clinic.

Courtney and her family from Chesapeake West Virginia here in Raleigh NC for scoliosis surgery

Courtney is 14 and has a large double curve adolescent idiopathic
scoliosis (AIS).
Her mom asked for this team photo of all of us together in preop so
fily and friends back home can see!!

Just finished 14 yo scoliosis correction. We are about half way
through out 9 scoliosis surgeries for this week. 2 adolescents and one
21 yo are recovering well upstairs w 2 from Monday surgery going home
today, weds after 2 nights in hospital w their parents in large
private room duke Raleigh hospital.

More later!

Dr. Lloyd Hey
Hey Clinic

Monday, June 21, 2010

18 yo young lady w painful thoracolumbar scoliosis fixed this afternoon.

Preop curve 32 degrees. Severe low back pain, failed conservative
therapy including brace, physical therapy and medications.

Fixed today T10-L3.
Surgical time: 2 hrs 27 minutes.
Complications. None.
Ebl: 440 cc.
Blood transfused: none.
Correction: excellent.
The skin crease she had under r rib cage was gone by end of surgery.

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

17 yo Brittany gets way straight this am

Vacation is officially over. Had good break and great Fathers Day.
This am we straightened up Brittany who was 60 degrees preop w her
thoracolumbar curve e a huge trunk shift.
Not any more!

T5-L3 instrumentation and fusion.
Ebl: 450 cc.
Blood transfused: none.
Complications: none.
Correction: 100%.
Surgical time: 2 hrs 30 min.

It is good to be back w our A Team!!

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery

Tuesday, June 15, 2010

Re: Hey Day #6! -- grateful adult scoliosis patient 6 years out from surgery doing great.

That is awesome!
Thanks for sharing!  
Happy Anniversary!
Dr. Hey

On 6/15/10 9:55 PM, "Lynn W”

Hi Dr. Hey,
I can’t let the day go by without saying hello and letting you know that I am celebrating my 6th anniversary since you performed the miracle surgery on my back. I am living life to the fullest, and still not a day goes by that I don’t think of you and thank my lucky stars that you performed the miracle on my back.
Hope all is well with you!
Love and gratitude always and forever,

Saturday, June 12, 2010

Angela and her family, visiting us from Poplar Bluff, Missouri.

Every week at Hey Clinic, we get a chance to interact with families from all over the country, and sometimes overseas as well, which really keeps things interesting. I really enjoy learning more about where people are from. In the past couple of weeks, I have been in touch with folks from Greece who are bringing their daughter for adolescent idiopathic scoliosis surgery later this month, as well as doing surgery on a cardiologist from Idaho, teenagers from Knoxville Tennessee, and Georgia, as well as Alabama, Florida and California. My staff does a lot to help our many potential guests, including helping with transportation, reviewing films and records ahead of time, hotels, ground transportation and the like. We've even help coordinate visits to Hey Clinic with college visits to UNC, Duke, NC State and other local universities, or with trips to the beautiful North Carolina coast or mountain areas. Recently we have been able to coordinate some special flight arrangements to help get our patients home quicker and safely to their home towns. This has really helped improve comfort, and decrease the time traveling, to minimize DVT/PE risk.

This past week we took care of Angela and her family from Poplar Bluff, MO. Poplar Bluff is a small town of about 17,000 people. Tyler Hansbrough, a very famous recent UNC Basketball player, grew up in Poplar Bluff.

Angela brought her whole family with her, including her kids, husband and many others, who all made the 13+ hour drive to Hey Clinic and Duke Raleigh Hospital. Angela had an anterior scoliosis surgery and a revision posterior hook TSRH surgery done years ago, and now, in her 30's was really suffering with flat back syndrome and adjacent level failure and progressive scoliosis and kyphosis above and below her old fusion.

This past week I performed an anterior-posterior spinal reconstruction, all on one day, and got things fixed up.
We are pictured here with her whole family right before her surgery. She did well with her surgery, and is progressing well with her postop recovery.

If everything continues to go well, she'll be flying back to Poplar Bluff early Monday morning with her husband. The rest of the clan will drive on ahead and meet her there when she arrives. We will do most of her postop follow-up by getting xrays done locally, and sent to us with contact via email and phone and Skype. This follow-up method has worked especially well for our most distant guests, including a massage therapist from Hawaii, that I performed a revision scoliosis and kyphosis surgery for a few years ago!

Get well soon Angela!

Dr. Lloyd Hey


Kayla's 6 week follow-up visit after correcting 90 degree R AIS scoliosis. 3 inches Taller!

We saw Kayla and her family for follow-up this past week, and she looked awesome!
She had a very nasty 90 degree scoliosis which we were able to get an excellent correction using a powerful double rod Pursuader Technique.
In Clinic, her posture and incision looked great. She gained 3 inches in height! Her trunk is now well balanced, and she had a very big smile.

While it is great that we are able to get dramatic corrections with these big curves, it is MUCH better to catch and treat the curves when the curves are smaller, preferably less than 50 degrees. This makes the final correction better, with less surgical time and risk.

But, sometimes curves do get missed, and it is nice to know there is still hope.

Great to see you Kayla!
Have a great summer.

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery

Can your adolescent athlete return to competitive sports after scoliosis surgery?

I got a chance to see this young man and his mom back for follow-up on Friday.
He had a huge adolescent idiopathic scoliosis curve that we fixed last year.
He was able to go back to very competitive soccer rapidly, and plays without restrictions.
His mom was kind enough to email me several pictures from his his soccer games, and said it was ok to share them via the Blog!

With newer surgical techniques and stronger hardware constructs with thoracic pedicle screws, cobalt chrome rods, and other advances, most athletes can return to sports as soon as they feel able.

About 5 and a half years ago, after I had been using the new stronger thoracic pedicle screw constructs for a while, I was caring for a 15 yo young lady with a fairly severe right thoracic scoliosis who was a VERY competitive swimmer. Her mom brought her in for a second opinion since they were told that she needed surgery, but the surgeon had told her that swimming would be out of the question for a full year until fusion was completely healed. The idea of giving up swimming even for a few weeks was heart breaking for this young lady and her family. I was able to use the newer surgical techniques, and we got her back in the pool within 2 weeks of surgery, actually diving and doing kick turns and several laps! That started a whole new wave of competitive athletes who were able to get straightened up but rapidly back to sports. Other patients have gone back to cheer leading practice within 2 weeks of surgery, without a brace or significant restriction. Basketball, tennis, golf, and baseball are other sports where we have been able to advance up our kyphosis and scoliosis patients rapidly and get them back in the game!

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery

Wednesday, June 9, 2010

Wake County Physician's Magazine Article

By Lloyd A. Hey, MD, MS*

Consultant’s Corner


It is late on a Friday afternoon, and an
anxious call comes into Hey Clinic
from a pediatrician that she had an
urgent spine consult for a young man with
an apparent rapidly growing spinal tumor
growing out of his lower back. My staff
made arrangements to get this young man
and his mom into see me right away. The
adolescent indeed had a fairly large hump
on his left lower back. X-Ray revealed a
very large thoracolumbar scoliosis as the
cause of the hump. The mom was actually
quite upset to the point of tears: “Why
wasn’t this picked up earlier? Don’t they
screen for this?”

Many of us adults remember being
screened as a middle schooler in gym class
or by our school nurse. Gym teachers
or school nurses often would have large
groups of children bend forward, examining
the upper and lower back for asymmetries
(humps) that would then result
in a letter going home with the child to
have them seek further evaluation and an
X-Ray. It seemed like a good idea from a
public health standpoint: early diagnosis
could lead to earlier treatment with molded
scoliosis braces, and the possible avoidance
of surgery.

Dr. Ralph Coonrad, cared for thousands
of children and adolescents with scoliosis
from all over Durham, Orange and Wake
Counties for over thirty years. Back in the
1970s, Dr. Coonrad along with other physicians,
nurses and school administrators who
helped develop and implement the scoliosis
screening programs in the Triangle area and
even around other areas of North Carolina.
Most, if not all of the local school districts
had some form of screening program in
place by the end of the 1970s. Similar
screening programs were implemented
across the United States.

While scoliosis screening was done
consistently during the 1970s and
1980s, many school districts moved
away from scoliosis screening during
the 1990s in part because of the United
States Preventive Services Task Force
(USPSTF) began to raise questions
regarding the effectiveness of such
screening. In their 1996 report, it was
their belief that there was insufficient
evidence to warrant the costs associated
with widespread scoliosis screening in

As a result, many school districts
began to discontinue their scoliosis screening
programs during the 1990’s, including
most school districts in North Carolina. By
2004, this same organization updated its
opinion to state that scoliosis screening was
considered “Grade D: Not recommended,
with fair evidence that the screening was
ineffective or harms outweigh benefits.”

Many States used this document to eliminate
the requirement for scoliosis screenings
in their schools, and as a result, school
scoliosis screenings have become quite
variable nationwide. As a result of this
dramatic drop in school screenings, overall
awareness of scoliosis among families and
even some physicians has dropped.
Now that school scoliosis screenings have
been largely eliminated, what role, if any,
does the pediatrician, family physician, OB/
GYN and orthopaedic surgeon play in the
detection of scoliosis? Many are choosing
to include scoliosis screening as a part of
their usual physical examination for children,
adolescents and adults. Many are also
using the Scoliometer, which is a tilt gauge
tool that helps define paraspinal asymmetries
that are large enough to warrant an
X-Ray evaluation. In my discussions with
many Wake County pediatricians, they have
found that the Scoliometer has been very
helpful to help add an objective high tech
measure to their documentation to show that
they checked for scoliosis. It also gives our
well-educated Wake County population,
(who also like objective measures) some visual
proof that we checked their child/teenager
thoroughly and that nothing is being
overlooked or missed: they will remember
that you put a device on their child’s back,
whereas they may not remember that you
eye-balled them for potential rib hump.
Screening for scoliosis is becoming even
more difficult as obesity becomes more
prevalent in the adolescent and adult population.
Very large, well-balanced curves
can be nearly completely invisible. As
shown below, two young ladies have similarly
appearing backs on clinical exam, with
possible slight curve. The one on the left
actually has an 80 degree scoliosis, twice
as large as the young lady on the right who
has a single 40 degree curve. The scoliometer
has proven to be helpful in this obese
population as well.

*Hey Clinic for Scoliosis and Spine
Raleigh, North Carolina

Wednesday, June 2, 2010

Sweet Home Alabama!

Late this afternoon and evening we strraightened up 23 yo Sara from
Alabama who had very painful and deforming 63 degree right thoracic
idiopathic adolescent scoliosis which has continued to progress as an

We got an awesome correction w surgical time of 4.5 hours. No blood
transfusions. She will go up to her private room where her new husband
and mom await!

Drew, our scoliosis surgery from this morning is doing well this
evening w his whole family in their large private room here at Duke
Raleigh Hospital, next to Hey Clinic.

A long but great day!

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery

This am surgery

No time to write much now. Gotta get to clinic!

Putting this up so Drew's friends and family back in Tennessee will
know everything went well w his scoliosis surgery this am. His parents
asked me to post right away.

Dr. Lloyd Hey
Hey Clinic