Friday, December 30, 2011

What's up with all these scoliosis young ladies towering over me? Erin back from College As My Helpful Shadow.

Saw lots of smiling teenagers yesterday afternoon and today in clinic back with their parents for postop adolescent idiopathic scoliosis (AIS) and kyphosis visits. Saw some new families for scoliosis consultation.

To my left here is Taylor, who had a 77 degree kyphoscoliosis. It was awesome to hear her talk about how her life has changed since her surgery. She's gained a couple inches in height, (now taller than me!), and finds it easier to play her horn in the band since her breathing is easier. She also shared how it has improved her posture and appearance, which has helped her self-confidence. Go Taylor!!

I also saw Jessica back for her scoliosis postop visit. She's going to be a lawyer, and is smart as a whip. We saw her little sister as well who has scoliosis and some kyphosis, but the curves look like they are going to be amenable to conservative management.

I see a consistent problem now.... these young ladies are all now taller than I am! Bumma! Need to find some of my smaller guests.....

NOW I'm feeling a little taller.... Logan, my 11 yo early onset scoliosis surgery patient was back for her six week follow-up visit doing very well getting back into her usual dance and other activities. Logan wants to be a marine biologist.... I want to get her and her family to visit my friend who is semi-retired Professor at the Duke Marine Lab down in Beaufort NC this summer.

Yesterday in clinic, I had Erin shadowing me --- Erin had scoliosis surgery with me five years ago and now is a freshman in college. Erin ended up being able to help several scoliosis families who had lots of questions about possible surgery for their sons or daughters. Erin actually wrote a book about her scoliosis surgery journey back when she was 13 -- a book that has been at Hey Clinic ever since. She used the book in clinic yesterday to show the realities of scoliosis surgery. Erin could then also answer questions ---- including showing how she can put her hands flat on the floor, bending all the way down to the ground even though she is fused from T5-L3! Erin's willingness to help other people and sharing her journey was inspiring. Her mom has also chosen to help several scoliosis families over the past few years, including accompanying one family during their child's surgery. Inspiring loving service to total strangers, who end up becoming trusted friends.

Happy New Year to All!

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery
on twitter @drlloydhey

Tuesday, December 27, 2011

Christmas gift from Lexi's family from Maryland

Last week I received this wonderful Christmas gift from Lexi's parents, Mark and Michelle from Maryland. I did Lexi's kyphosis surgery last year, and she has been able to return to high performance sports within the first few months after surgery.

In this beautifully framed collection of three photos, we see Lexi swimming, running track / cross-country, and playing lacrosse! All awesome pictures -- Michelle is gifted sports photographer.

They sent it along with a Christmas card which said:

"The pictures in the frame were all taken within six months post-surgery!! She is doing great both in school and on the field. God bless you and your family and your staff. -- Mark and Michelle"

Mark and Michelle -- Thank you for this very thoughtful gift. I love to hang up pictures like this in the clinic to remind all of us how restoring proper alignment and stability not only can allow a stable posture, but can allow people to return to the things they love to do.

I know one of the worries / concerns Lexi and her family had before her adolescent kyphosis surgery was how long she would be out of sports. We start getting most adolescents back into their sports training within the first few weeks after kyphosis and scoliosis surgery. We even have some physical therapists who focus on spinal deformity and work with your local trainers and / or physical therapists if needed to help design a postop program. One of these therapists, Rob Wiese, from Duke Raleigh Hospital, just recently helped one of my postop kyphosis patients from Tokyo Japan ----- Rob taught him special exercises with 2-way Skype Video!!

Thanks again Lexi, Mark and Michelle for your special gift. We look forward to see Lexi's academic/career as well as athletic life continue to grow and prosper! Keep the pictures coming.

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery

Sunday, December 25, 2011

Merry Christmas Activities At Hey Clinic.

We've received so many caring Christmas / Holiday cards from many of our Hey Clinic guests from all over. We've also received many Christmas good wishes via email as well. Thanks to everyone who took the time to share with us. We do hope all of you are having a good holiday with your family and friends. I've been rounding this weekend at Duke Raleigh Hospital for our guests who are still recovering in the inpatient environment, but still have had some time to celebrate Christmas with my family.

We had just a half day in clinic on Friday, letting the Hey Clinic staff head home for the holidays. Friday afternoon, I did an anterior cervical discectomy and fusion (ACDF) surgery for a lady in severe pain and trouble using one of her arms. She did great, and went home the next morning with relief. A good gift!

I got a chance to see one of our adolescent idiopathic scoliosis guests back for follow-up 6 weeks after his surgery. He is doing very well, and is two inches taller -- which makes him way taller than his mom (who is still boss!)

He has been able to resume his normal activities, and is kicking butt in school.

I also saw this gentleman and his wife back for follow-up. He had an extremely severe spinal stenosis and spondylolisthesis and could barely walk preop with severe pain.

He is now walking great, standing up straight with pain relieved, and very thankful.

This lady had a complex revision kyphoscoliosis reconstruction with a history of broken spinal rods with a thoracic fracture. I used a special "triple rod" technique to help reinforce that high load area. She is now well healed, standing up straight, and doing very well.

This gentleman was referred to me by a neurologist, since the patient was losing control of his arms and legs due to severe cervical spinal stenosis.

He has regained the use of his arms and legs, and is celebrating his one year anniversary of his surgery. He actually wept for joy on his first postop visit, and thanked God for his returned neurologic function.

Before surgery, both his arms and legs were very weak and clumsy. His surgery was a multilevel cervical laminectomy with posterior cervical fusion.

Best Christmas / Holiday Wishes to all our Hey Clinic Guests and Families.

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery

Friday, December 23, 2011

FW: Kelli: Post Op Update. Our Adolescent Scoliosis Patient From Tampa Florida -- Mom Update!

Received this note today, which Jill said was absolutely OK to share with all of you!  Many thanks to the entire Hey Clinic and Duke Raleigh Hospital Team that makes exceptional care like this happen for our precious guests and families, many of whom choose to travel to receive such care for their loved ones.

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery

On Dec 23, 2011, at 2:03 PM, "Jill " <> wrote:

> Dear Dr. Hey,
> Just wanted to say Thank You once again. We had a smooth flight back to Florida on Tuesday. Kelli is moving around (cruising) better each day. It is going to be very Hard holding her back from the Ball and Glove. She actually said to me last night, "I feel as though I could go throw soft toss with dad right now"!!
> As I reflect back on our experience over the past week, I feel a strong sense of relief as well as tremendous gratefulness to you, your staff and Duke Raleigh Hospital staff. The compassionate, caring  professionals who worked with Kelli were like no other!! I know you are very proud of your entire team and you should be.....The care Kelli received was EXCEPTIONAL! I have worked as a Registered Nurse and I can honestly say I have never seen a more competent group of health care professionals.
> Please express our Sincere Gratitude to Everyone and once again Thank You & Merry Christmas
> Jill

------ End of Forwarded Message

Thursday, December 22, 2011

Flat back syndrome fix for today

Scrubbing in for anterior ALIF for this 56 yo w Harrington Rod Scoli fusion flat back syndrome.

I on twitter @drlloydhey.

Everett does great job with presentation this morning

Everett, premed from NC State gives presentation on DVT prophylaxis at Hey Clinic Quality Meeting. Great job Everett!!

Wednesday, December 21, 2011

FW: Merry Christmas. Haley's return to dance / ballet 4 weeks after adolescent idiopathic scoliosis surgery

Haley’s folks sent this nice email and photo for me to share with our staff and followers on the Hey Clinic Blog.
Merry Christmas Haley!  You look beautiful!

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery

------ Forwarded Message
From: Lisa >
Date: Wed, 21 Dec 2011 10:21:27 -0500
To: Lloyd Hey <>
Subject: Merry Christmas

Hello Dr Hey
We wanted to wish you and your staff a very Merry Christmas and Happy New Year!
Our daughter Haley was diagnosed with scoliosis when she was just 5 years old. We spent 8 long years dreading the thought of surgery and tried a number of different braces and forms of physical therapy, trying deparately to change the final outcome.
Unfortunately her curve progressed, her back pain increased and she ended up having surgery in Dec of 2010. We were fortunate everything went well - thanks to you and your staff.
This has been an incredible year for Haley. It's like a weight has been lifted from her spirit. We'd didn't fully appreciate the emotional and physical toll scoliosis had taken on her. Haley was back to school and her passion - ballet - in just 4 weeks after surgery. She is completely pain free and feels like a "normal" teenager. It's also amazing how much her dancing has improved, now that her spine is straight.
Enclosed is a photo of Haley from last weekend's performance of the Nutcracker by Cary Ballet - she was a sugarplum fairy.
All the best
The C’s

------ End of Forwarded Message

14 yo w adolescent idiopathic scoliosis straightened up this am

Just finished fixing 14 yo w scoliosis straightened up this am. Surgical time 3 h EBL 500cc

Tuesday, December 20, 2011

Physician Assistant Rachel Robinson finding scoliosis on vacation!!

Got this text from Rachel this morning!!

I'm even looking for scoliosis & kyphosis when I'm on vacation :) ! Here I am at the smithsonian museum of natural history in DC.

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

Monday, December 19, 2011

FW: Holiday Greetings! Professor of Surgery postop from Spondylolisthesis and Stenosis Surgery Doing well years later.

Ares is a Professor of Surgery, who had a high grade L5S1 spondylolisthesis that I fixed for him several years ago now.
He is incredibly athletic and active, and is also very good about staying in touch each Christmas to let us know how he is doing.
I think he’s having a heck of a lot more fun than I am, and he is burning 150 cal more than I can on the elliptical for 30 minutes every morning!

He gave his permission to share this latest update with all of you on the blog.

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery

From: FACC Ares
Date: Sun, 18 Dec 2011 16:40:29 -0500
To: Lloyd Hey <
Subject: Holiday Greetings!

Dear Lloyd, We Wish You and Your Family Joyous Holidays!
[I am currently doing 500 Cal/30-min on the treadmill daily, and walk for about an hour as well.  You did a fantastic back surgery on me, thank you!!!!!!!!!!!! ]


Saturday, December 17, 2011

"Flat Back" Friends and Co-Workers Meet up by chance postop and straight up at Hey Clinic Friday

We had a lot of great visits at Hey Clinic on Friday, including Cathy, who was back for her postop visit from anterior-posterior reconstruction for flat back syndrome below her old Harrington rod fusion. She’s doing very well and it was good to see her back.

As I was opening the door to see Cathy, one of my other patients named Jennifer was walking the hall, and gave Cathy a big “hello”! It turns out that Jennifer knows Cathy as a co-worker at American Express. After Cathy did well with her flatback surgery, Cathy recommended Hey Clinic to her friend, who also suffered with flatback also due to an old non-instrumented fusion done many years before for adolescent idiopathic scoliosis.

So we ended up having an unexpected very happy reunion there, and actually got all three of us together for a photo together. It is amazing how often patients find us through friends, family, and co-workers.

Both young ladies have very nice standing postures, and are getting along with a better quality of life.
Friends helping friends.

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery

Nice shirt!!

10 yo POSTOP scoliosis feeling great after shower!

Wednesday, December 14, 2011

48 hours after scoliosis Surgey: looking great and straight walking halls-- home today

They let me share this picture w all of you!
Our 31 yo scoliosis young lady from Monday 12-12-2011!

42 yo woman w painful 58 deg progressive adolescent idiopathic scoliosis fixed! 3h

58 deg Preop curve now looking very straight!
Ebl 400 cc.
No blood transfusions.
Surgical time 3.0 hrs.

She got her Christmas wish!!

Our 10 yo arthrogryposis scoliosis from yesterday is doing well and slept through night in PICU. Family thankful.

Emergent surgery last night for woman losing use of right hand is doing very well this am with returning function.

Tuesday, December 13, 2011

10 yo boy arthrogryposis w severe congenital and early onset scoliosis fixe today

Ebl: 1200.
Operative time: 3 hr 45 min
Many answered pressures for this family!

Friday, December 9, 2011

6 week postop from adult scoliosis surgery for origianal adolescent idiopathic scoliosis.

Mary had scoliosis surgery with us 6 weeks ago.
She is doing great and very thankful, and has come off all narcotics.
Below she gives short video with her husband on her progress and the difference the surgery has already made for her quality of life and posture.

Thursday, December 8, 2011

49 yo man w history discecomies w years of severe pain helped today

L4-iliac windg instrumentation and fusion w revision decompression laminectomies and discecomies and 2 level TLIF spacers.

Surgical time 3 hr 20 min.
Complications: none.

Wednesday, December 7, 2011

Dr. Hey is tweeting!!! Drlloydhey. Today's Surgery and great visit with Mike Levin from MIT College Days, Theta Delta Chi.

I just got home after very long day. Whoop tired, but a great day!

Did big anterior posterior scoliosis reconstruction in 44 yo woman today, then a complex proximal junction kyphosis correction this evening using navigation technology from Brainlab and bone cement , pmma. I WANTED TO SEND OUT A VERY BIG THANK YOU TO NURSE KELLY, WHO CAME IN AT 2PM AND STAYED THROUGH DINNERTIME TO HELP US WITH THIS COMPLEX SURGERY TO HELP A VERY NICE LADY FROM SPRUCE PINE NEAR ASHEVILLE, NORTH CAROLINA! KELLY, YOU ARE A GEM!

In between surgeries, I saw a 12 yo boy and his dad with new diagnosis of 55 degree scoliosis. My nurse practitioner, Brittaney, asked me to join her for visit when she saw how big the curve was. The boy is big, and growing fast, and hid the curve with his big size. Dad looked a bit like a deer in the headlights, which I can completely understand. Had to be gentle, spent a lot of time. Curve too big for bracing. Gave them a bunch of good info, and both seemed peaceful and well informed by end of visit. We can talk more later. Surgery later this winter, to do what is right in long run. Showed them picture of 55 yo who never had scoliosis fixed on my blog, from Mississippi, who then was suffering with terrible collapse in his lumbar area, and faced strong possibility of not being able to work due to constant pain. This boy also has a very unusual left thoracic curve pattern that we will also work up with an MRI. There may be a congenital scoliosis component to this as well, which we will see better on MRI.

Yesterday spent a LOT of time with another family with a teenage sophomore with a 55 degree congenital proximal thoracic scoliosis, seeking to help them to make choice. Very smart family. Boy is big time athlete.. More to follow.

I've been experimenting w Twitter. Find me at drlloydhey. Might be helpful since it is really hard for me to sit down and take time to write a full blog entry. Met a friend who is a blogger who researches and writes for 4-5 hours every day. Yikes!!! No time for that! I can't tweet while doing surgery, but I have had Howard, my instrument rep Tweet for me on my iPad while I was doing surgery.....I am amazed to see how much some people Tweet -- like Ken Rosenthal from Man, that guy is Tweeting every 2 minutes! Wow!

Had dinner Monday night w Mike Levin, a fraternity brother from MIT visiting from California. He contacted me out of the blue, finding me through the MIT alumni website. Wow, it is amazing how fast 27 years has gone by since graduation from MIT! Those were very special years, with very special people that I wish I had stayed in better contact since then.

Mike and I had a great visit! He also inspired me to use the MIT Alumni website, and my old fraternity team photos to reach out to several of my old fraternity brothers, including Dr. Joe Sabik, my big brother, now at Cleveland Clinic in Ohio. Heard back also from Bruce Schena, my "little brother" out in the Bay Area of San Francisco, who has been very successful entrepreneur and inventor, including doing a robotics startup with Mike Levin. Bruce emailed me back, and has great family, and is still "tinkering" in the machine shop, while working with daVinci Robotics for surgery!

Mike told me about his several successful companies he has helped start, and is on yet another startup now which is going very well in the computer sector. I got a chance to show him Chapel Hill, and also go over to see Duke Chapel and the other "Duke Chapel": Cameron Indoor Stadium for basketball and Coach K!!!!

Mike shared how many of our fraternity brothers have gone off to do successful startup companies, including Mike Saylor, who I've followed in the news, as well as my classmate Pete Diamandis --- the Space guy. We used to call him "Pete in Space!!!" --- and he definitely has kept his focus on space ever since. This was an inspiring group of guys to spend time with. Thankful for Dean Koutsoubis, who first invited me to pre-Frosh gathering at his home before going to MIT, as well as my old roommate and friend Khanh Hoang, who was also my sailing partner on the MIT sailing team. David DiPietro was one of my "little brothers" along with Tom Esselman, now in Minnesota and Bruce Schena as mentioned above. I also sent word out to Joe Parrish, who apparently is doing extremely well.

Hope to connect with more of the Brothers from the Theta Deut Chapter of Theta Delta Chi at MIT. So thankful for the upper classmen who mentored me, like Guido, Dino and Ed --- 3 seniors who shared a Quad with me my first semester freshman year! My bed that first year sat on a door which rested on 4 paint cans. Every night at midnight, the 3 seniors would open up the front window on the Flag Room, and play REO Speedwagon at about 110 dB and yell at people walking down Memorial Drive. I sat at my desk, and wondered if I'd ever pass Calculus! I still listen to REO Speedwagon really loud sometimes and fondly remember those days in college, looking at the Boston skyline from Memorial Drive.

I shared this Fraternity Brother photo with Mike when we got together from 1984, the year of my graduation from MIT. Also found a bunch of other photos, including taking hikes in New Hampshire with the Brothers, and Lindsay Russell, our elder mentor for many years at Theta Delta Chi.

Thanks again Mike for getting in touch.

If any of the other Theta Delta Chi brothers from MIT (Theta Deuts) who are coming to RTP / RDU area, let me know.

Would love to see you and possibly share a meal!

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

Monday, November 28, 2011


From: M
Date: Mon, 28 Nov 2011 21:27:29 -0500
To: Lloyd Hey <>
Subject: Re: 1st Place in Thanksgiving 5k 45-49 Females!

Hahaha! I feel like 34! You're so sweet! By the way, last time you referred to me as "M" on your blog- so let's stay with that for now.
Thanks Dr. Hey! I am so proud!

Connected by DROID on Verizon Wireless
-----Original message-----
From: Lloyd Hey <>
To: M
Sent: Tue, Nov 29, 2011 02:18:26 GMT+00:00
Subject: Re: 1st Place in Thanksgiving 5k 45-49 Females!

This is awesome news!

I will put this on blog tonight.

Only one questions: --- why were you allowed to run in the 45-49 yo group when you are only 34?

Dr. Hey

From: M
Date: Mon, 28 Nov 2011 08:39:21 -0500
To: Lloyd Hey <>
Subject: RE: 1st Place in Thanksgiving 5k 45-49 Females!

Good Morning Dr. Hey!

I hope your Thanksgiving was great and you enjoyed precious time with your family. Well I wanted to pass along another first place run on Thanksgiving day in Raleigh for “Just Think First” 5K.

· 1st Place in Females 45-49—1st/ 29 in class-Time- 25:19!

· 22/244 females overall

· 90/440 runners males and females

· 22/244 females overall

I am so thankful! I actually run faster after my surgery!
J…I think you made me the “bionic woman”!!!

Many blessings Dr. Hey

------ End of Forwarded Message

--- “M” has shared with us before --- she really does look 34, and continues to do well after having her adolescent idiopathic scoliosis fixed when she was in her 40’s. It’s cool when we see our adolescent patients going back to sports/training within the first few weeks/months after kyphosis and scoliosis surgery, but it is also amazing what a lot of our adult patients do as well. The self-image / posture improvement experienced by these younger adult patients is also a real kick, since many of them have been self-conscious about their posture for a long time. The patient I saw originally from Chicago last week, who I fixed her kyphosis years ago told me it totally changed her outlook and confidence.

Hope you all had a good Thanksgiving. I did, thankfully, with family. Good break with beautiful weather. Today did very complex revision scoliosis this morning, and an extension fusion for proximal junctional kyphosis on a nurse from South Carolina. Both surgeries went well, but was a long day. Big anterior / posterior tomorrow am, so time for bed!

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

Tuesday, November 22, 2011

11 yo with 50 degree early onset scoliosis (EOS) idiopathic curve fixed yesterday. Other patients seen today.

This young lady’s curve has progressed rapidly over this past year up to 50 degrees, with 20 degree progression since last October 2010!

Fortunately she has grown enough that we can do the definitive scoliosis instrumentation as opposed to the Shilla Technique, which is a special growing rod technology we use for smaller children --- this allows ongoing growth with hardware sliding over time.

Her surgery yesterday went great! Estimated blood loss 250 cc.  Her “hump” on the right side was gone after surgery.
This morning she looks great in the PICU at WakeMed Children’s Hospital — a great unit and great hospital.

This morning, I saw a 12 yo boy with 33 degree curve with first diagnosis, and had long talk with patient and mom going over bracing options vs. observation, and gave them several good resources available through our blog and at for further info.  It is important to think through and educate the families about the pluses and minuses of bracing before starting the process.  This boy is in a 50%+ risk category for progression, given the size of his curve and the number of years remaining.  The brace can help in some cases to slow the curve progression, but does not actually make the curve smaller.

Mom and patient felt good about discussion.

I was next greeted with a big hug from  my wonderful patient originally from Chicago that I fixed years ago with her 90 degree kyphosis.  Her story and video is out there on my web archives somewhere!  Her kyphosis surgery with me years ago @ Duke solved her neck pain which was a mystery to doctors in Chicago who kept MRI’ing her neck!  The neck pain was actually secondary to the hyperlordosis her neck had to do to make up for her kyphosis.  She looks great today, and is still very with her awesome posture and pain relief.

Her daughter Charlotte is a Pre-Med at NC State, and is super bright.  She does research with us now.  Very bright future for this young lady!

Will be doing anterior/posterior reconstruction today for good part of day.

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery

12 yo girl with severe 75 degree congenital and idiopathic scoliosis fixed last Wednesday.

Last week we straightened up Emory, who is 12 who had complex congenital scoliosis measuring about degrees at Wakemed.    Due to complexity of her deformity, I did extensive preop planning, including 3 dimenensional analysis of her cervical and thoracic spine using special software.  I actually presented her case at Boston Children’s Hospital special Fellow Reunion Conference right before the Grice Dinner and Lectures.  Many thanks to Dr. John Emans, and others who helped give their input!

Intra-operative O-Arm Navigation and 3D analysis was also performed.  I took the preop 3D analysis I did for each pedicle level, and actually arranged them into a PowerPoint presentation which I then printed and posted on the wall in the operating room!  That was very helpful.   Surgery was T1-T12 instrumentation performed along with several osteotomies.  WakeMed OR team did great.

Her surgery went well, with 3 night stay at WakeMed Raleigh Children’s Hospital, going home on Saturday doing well.
This surgery helped with her severe shoulder obliquity caused by the severe scoliosis.

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery

Tuesday, November 15, 2011

55 yo w painful collapsing degenerative scoliosis and stenosis fixed this am

23 degree Preop curve w Spondylolisthesis and stenosis.

L1-iliac instrumentation and fusion w multilevel laminectomies.

Surgery time: 3 hrs 10 min.
Ebl: 800 cc.
Complications: none.

Sunday, November 13, 2011

FW: playing soccer pics 4 mo post op (returning to sports after adolescent idiopathic scoliosis surgery)

------ Forwarded Message
From: Judy W
Date: Sun, 13 Nov 2011 19:07:35 -0500
To: Lloyd Hey <>
Subject: playing soccer pics 4 mo post op

Here's a few pictures of Brynna playing soccer.  Her team won the U16 Girls NC Challenge State Cup today!

Thanks for the fantastic success of the operation.  7/7/11.  You are welcome to use these photos. 

Judy W
------ End of Forwarded Message

Judy --- thanks so much for sharing these great photos, and giving your permission to share them on the blog.
Congratulations Brynna!

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery

Friday, November 11, 2011

Janelle Doing Ballet Hey Clinic after Shilla Procedure Early Onset Scoliosis

Here's Janelle's Video Doing Ballet down hallway of Hey Clinic today!!!
Janelle is just about a year after Early Onset Scoliosis (EOS) with Shilla Technique with Dr. McCarthy at Arkanas Children's -- a surgery I got to participate in, and learn from!
Dr. Lloyd Hey, Hey Clinic for Scoliosis and Spine Surgery

Question: Is it possible to do ballet after a Shilla Procedure for Early Onset Scoliosis?

Janelle answered this question as a definitive "YES!" today in clinic, as she danced right down the Hey Clinic hallway this afternoon.

Janelle and her family were back for her one year anniversary from her Shilla Procedure I performed with Dr. Dick McCarthy out at Arkansas Children's Hospital.

She is doing just great, and her posture looks super.

Janelle also made me a wonderful drawing while she was in clinic. It shows a beautiful fall scene here in North Carolina, with beautiful tree, sky, sun and bushes. She signs her artwork beautifully as well!

We definitely encourage the arts at Hey Clinic!!!!

Thanks for the great picture, Janelle!

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery

Thursday, November 10, 2011

Do. Done. 17 yo w AIS fixed today

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery

17 yo w adolescent idiopathic scoliosis for surgery today

High thoracic curve.
Mom, a nurse, will be sending out updates during day.
Using 3d navigation in operating room like O-arm from Brainlab.

Sunday, November 6, 2011

A Hey Clinic Guest's Story of the Mysterious Spinal "Clunk"

I received this write up from one of my patients this past week. As she says- -- I had never seen anything quite like this before!!   I think you will all enjoy it!
Things have been very busy as Hey Clinic routine.  I did two surgeries yesterday on Saturday, but thankfully was able to catch my breath and enjoy the beautiful North Carolina fall weather today.  

Hope you are all doing well.
Dr. Lloyd Hey — Hey Clinic for Scoliosis and Spine Surgery —


My Back Story:  Susan

In early 2010, I didn’t consider myself as someone with “back problems”.  Sure, my back would feel tired if I stood for a long time, but I figured that was just a part of being on the high side of my 40s.

In March 2010, I leaned over while sitting at my desk to adjust the small heater at my feet, when I felt something wierd.  There was no pain, no noise, but a feeling that I almost got stuck in that twisting, bent over position.  It was fleeting, so I didn’t give it much more thought, but it felt strange enough to be memorable.  

In the following couple of months, I developed a random “clink” sound in my back when I bent over to reach something in a lower drawer or off of the floor.  This “clink” was a precursor of the “clunk” that developed soon after.  It was a loud clunk, but it occurred randomly in the spring of 2010.  It was loud and uncomfortable enough to mention to my rheumatologist during a routine visit in late May.  I described it as occurring in my mid-back and I wondered out loud to him if it could be related to my RA.  I was confidently told that it very likely was NOT RA-related since the thoracic part of the back typically isn’t affected by RA.  I was not able to reproduce the clunk during that doctor visit, but he ordered an MRI to evaluate it further.  

My insurance company agreed with me that this seemed to be coming right out of the blue.  So much so, that they opted to cover a flexion/extention x-ray rather than MRI.  These x-rays showed displacement as I bent over and arched back.  

By this time it was June/July.  The clunk was much more consistent and louder and generally more “violent” for me to experience; along with a noise, I experienced a jolt-type sensation with the clunk that seemed to shake me right through my legs, with knees buckling, giving me an instant’s sensation of my legs giving out on me - though I never actually fell down, it seemed darned close a time or two!  The noise was loud enough for others to hear from another room.  I would be dressing in our closet when my back would clunk and my husband would ask from the kitchen table “Was that you!?”.  In July, I was able to get an MRI to further evaluate what in the world my back was doing.  Through all of the evaluations, it was noted that it was a pretty strange level of my back to be having problems.  The instability demonstrated on x-ray was at T10-T11 rather than in the lower back region.  It didn’t seem too strange to me, since that was the area where I always experienced aching and tiredness when I stood for a long time.  

By August, I had about had it with the clunk!  It seemed to be progressing at a pretty good clip in terms of how loud it was, how often it occurred, how it seemed to shake through my whole body.  And then I began to have an odd pain in my lower ribs; like someone was stabbing me with a knitting needle verrrry slowly.  No change in position would alleviate that pain.  Finally, when I met with my rheumatologist to review the back MRI results, we chose to explore surgical consultation since I additionally described vague urinary symptoms of feeling the need “to go” recently after using the bathroom (and ruling out UTI).

By August, the clunk would occur with laughing and sneezing as well as with forward bending, which I tended to avoid at this point.  Fortunately, I learned how to make my back clunk “on demand” so that the doctors could witness it:  I would distract myself by pretending to bend over my purse to get something out of it.  It worked every time!

I met Dr. Hey in September 2010 and was able to demonstrate “The Clunk” for him with the purse trick.  By this time, my mid-back would not only clunk while bending forward, but clunk again while straightening back upright again.  Ewww!  It was all very uncomfortable!  

I was relieved to learn that though Dr. Hey readily stated that he had never seen anything like my condition, he was very confident about how to correct it and offered a detailed explanation with a visual model that helped my husband and me understand exactly what he offered to do for a surgical repair of this awful clunk.  I was absolutely ready to do what was necessary to eliminate this quickly progressing problem and Dr. Hey was the surgeon to do it.  We immediately made arrangements to schedule this for the following month and voila!  I haven’t “clunked” since, nor had any other creepy pains or problems!  

In terms of thinking about how or why this occurred at this unusual level of my back; I have a theory that an old injury that was never evaluated became aggravated by age.  When I was in sixth grade, while doing intramural gymnastics, I was doing multiple back handsprings in a row.  I was in “the zone”!!  I could’ve done back hand springs all the way home!  Except I realized that I was probably fast approaching the end of the mat and had no confidence in my co-sixth grader spotter to let me know that.  When I had that thought, I over arched my back in an attempt to have my hands land on the mat.  Instead, my fingers hit the back of my legs rather than the floor and I hit the floor with my chest with my legs over my head and kind of “sproinged” my back in that arched position.  The fall definitely took my breath away, but I felt silly for causing this and immediately jumped up and acted like I was fine before the coach noticed my boner of a fall.  No specific injury ever occurred from that fall.  I didn’t hurt enough to let my coach or parents know what happened - ever.  But I can’t help thinking that any slight damage from that fall could have made that particular thoracic level be the “weak link” to cause problems later in life.  

Now, thanks to Dr. Hey, the top half of my body is securely attached to the bottom half!  All is well healed and no more problems!

Monday, October 31, 2011

Jessie sends us her wedding photos to show her nice posture and incision.

I just got out of 6.5 complex spinal deformity scoliosis reconstruction surgery, and wandered back to the clinic for a diet Pepsi, see a couple clinic guests, and catch my breath.

When I popped open Jessie’s beautiful wedding photos on my email just now, my energy level definitely came back, and it brought a definite smile. I straightened up Jessie’s adolescent idiopathic scoliosis back in December 2005 (approximately 6 years ago)when she was 22 years old. She’s from the Washington, DC area. Wonderful family.

What a joy it is when our guests take the time to send an encouraging word, and a photo of them back to playing sports, jumping on a trampoline, getting married, or going to the prom, etc.

Thanks Jessie for sharing this with all of us!
You look beautiful!
Congratulations on your big move to San Francisco, CA!

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery

From: Jessie
Date: Sun, 30 Oct 2011 18:22:14 -0700
To: Lloyd Hey

Absolutely! I actually asked my photographer to take a picture of my back to show the minimal scar to share with you all. I would be happy to send it your way up accompany the short blurb.

The extra time you take, from consult, through surgery, and to follow-up, meant the world to me and my family. I am certain the confidence I had from your staff going into the surgery allowed for a smoother recovery. Thanks again.


Sunday, October 30, 2011

NOT ashamed of her body and scar in wedding dress after scoliosis surgery

From: J
Date: Sun, 30 Oct 2011 15:09:16 -0700

Dear Dr. Hey,

Many thanks for your help. I look forward to connecting with Dr. Berven.

On a separate note, I wanted to thank you for allowing me to feel confident in my low-back wedding dress. Prior to coming to you, I would have never selected a similar cut because of my scoliosis. Your successful surgery and the extra time you took to give me a careful closure allow me to show my back with pride. I now wear the minimal scar proudly as evidence that I made a decision to improve my back and refuse to feel ashamed of my body. What a wonderful feeling of empowerment.

Thank you again.

Best regards,
Absolutely! I actually asked my photographer to take a picture of my back to show the minimal scar to share with you all. I would be happy to send it your way up accompany the short blurb.

The extra time you take, from consult, through surgery, and to follow-up, meant the world to me and my family. I am certain the confidence I had from your staff going into the surgery allowed for a smoother recovery. Thanks again.


On Oct 30, 2011, at 5:40 PM, Lloyd Hey wrote:

You will really like Dr. Berven. We worked together at Boston Children’s and Harvard Combined Orthopaedic Residency Program many years ago.....

That’s awesome Jessie! You made my day!

Tuesday, October 18, 2011

Catching up. Young and middle aged adults trying to decide what to do about their scoliosis. "Black Clouds" and Preventive Interventions.

I have seen three patients from South Carolina within the past week, all of whom had scoliosis.  H
The last one I saw was a very nice 31 yo woman from Charleston, who came in for second opinion for possible surgery for her scoliosis.
She had X-Rays with her from 2004, 7 years ago. Since then, her curve has progressed 20 degrees and is now and is now 53 degrees.
She is starting to have some back pain, and is just a little self-conscious about her posture.
She’d like to start a family soon and have children, and she was at the appointment with her husband who is very supportive.

She had don a TON of research on the Internet, and felt very unsure going into our appointment what she wanted to do.
My nurse practitioner Brittaney and I went over her whole story, physical examination and imaging and answered all of her questions.

Given the large amount of curve progression she has had as an adult (5 degrees per year is a lot),  and the current curve size, I thought it made more sense to get the scoliosis fixed now when she is younger, and avoid issues down the road when life is more complex during pregnancy and after pregnancy with kids!  Her lower lumbar area right now looks quite good, and fixing the curve when she’s younger could result in a shorter surgery with less fusion.

We talked a little about the “Black Cloud” of decision and worry that seemed to be hanging over her --- which I’ve seen many times before.  Her husband definitely smiled and agreed with this assessment of his wonderful bride!  It is definitely worth the time to research your scoliosis, find out your options, and find a surgeon and hospital you are peaceful with.  But at some point it’s good to just decide what you feel is best for the LONG RUN (like through the rest of your whole life --- maybe 50+  more years ) rather than spinning your wheels and just being overwhelmed with worry.

One thing for sure this case illustrates is the importance of following your scoliosis over time, even after you are an adult.
That X-Ray she brought with her from 2004 from South Carolina was so helpful to prove that her curve is collapsing and progressing as an adult.

Today I did huge scoliosis surgery on a 55 yo lady, who has developed very severe progressive back pain til the point she can’t work.  Her X-Rays show that her lumbar area is collapsing and degenerative, even though her original adolescent idiopathic scoliosis was thoracic only.  I did T3-L4 instrumentation and fusion, which could have been fixed with 3 levels less if fixed before this lower curve became degenerative and collapsed. Sometimes I actually have to fuse all the way down to pelvis when there is severe collapse and stenosis below.  Her surgery went well, and we got a very nice correction, but I would have rather fixed this curve at age 15, 25, or 35 or 45 rather than 55.  But 55 is still better than 65 or 75!  Her bone quality was still quite good, and she only had 700 cc blood loss. Surgery was about 4.5 hours.  She was able to go to a non-ICU bed postop.

Just after doing her scoliosis surgery, I met a very nice 51 yo woman with a painful 38 degree scoliosis, who also has severe right arm pain with a C56 C67 disc herniation and foraminal stenosis.  Her scoliosis may be actually making her arm pain worse due to the angle of her upper thoracic spine, which might close down the neural foramen on the right side.  She’s in agony with her right arm pain and actually has triceps weakness.  After one more shot at conservative treatment, we will likely fix the C56 C67 disc herniations with an anterior cervical discectomy and fusion (ACDF), and then may end up needing to address her scoliosis which is also becoming painful for her, even though her curve is not huge.

This afternoon I fixed a giant lumbar disc herniation at L5S1 which a lady in her 20’s had been suffering with for over a year!  Yow.  That sucker was huge, and was tenting the S1 nerve root.  She looked great in recovery room.

Tonight talked to mom from Arizona about her 14 yo daughter with scoliosis who had sent me some films to look at.  Look forward to see them for consultation sometime this fall.

Now it is definitely time for bed.  Really big scoliosis in the morning to fix, then a guy with severe thoracic myelopathy with a T10-11 severe spinal stenosis.

Duke Raleigh Hospital had their Talent Show this evening.  I saw some of it, but missed seeing our Motorcycle Dan do his rendition of “Country Boy” on his guitar....  “People say I’m No Good, Crazy as a Loon.....”  I remembered most of the words to the song as we all sang along at end of surgery yesterday listening to Pandora.  Nurse Kelly was impressed with my singing as much as Dan’s!

Hope you are all doing well.  Will try to be more consistent with writing.....but it’s tough.  This is not my main job!  I met a blogger this past weekend who writes for 4.5 hours every day!!! Yikes!!! I would get no sleep period!  :)

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery