Tuesday, October 12, 2010

The first Hey Clinic Clinical Puzzle.. 2 matching curves.

Earlier today, I saw this woman who drove up from Alabama to see us for a
second opinion for her severe scoliosis with large trunk shift.
Surprisingly, her pain is primarily in her neck.

Question: Why is she having neck pain, when her obvious problem is in her
thoroaculumbar spine?

I welcome suggested answers via comments.
First correct answer wins a Hey Clinic T-Shirt!

Other notes this week that are interesting:

Yesterday, I saw a 12 yo girl with a 33.5 degree thoracolumbar scoliosis.
She has occasional low back pain, but it is not limiting. Her folks
initially came up to see me from Florida for another opinion. They now live
in far western North Carolina. Since her curve has been stable since last
visit a few months ago, we all decided to wait on surgery. She still has
some growth remaining, as documented with her iliac wing growth plate
carilaginous edge.

Later in the day, I saw a 19 yo young lady, who had the exact same curve
pattern, and exact same 33.5 degree curve. However, she had a larger trunk
shift to the side, and is having significant back pain throughout the day at
college. It is also starting to greatly affect her posture and standing
appearance. She was braced for quite a while during her younger teenage
years, which she did NOT like! Even though her curve is under the 40 degree
measure where surgery is considered, her quality of life at this point is
unacceptable and getting worse.

The main point of this comparison is to show the importance of taking more
than just the curve measurement into consideration ---- age, symptoms,
progression, and other factors should be taken into consideration. We need
to be careful to take care of the "whole person", not just the Cobb angle of
the scoliosis curve.

Have a great rest of your week!

Dr. Lloyd Hey
Hey Clinic

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