Dr. Lloyd Hey -- http://www.heyclinic.com
Wednesday, February 29, 2012
Monday, February 27, 2012
Maggie's amazing height change after "Hey-U-Rod" Surgery
She has severe osteoporosis, and developed kyphosis after Shilla Procedure, which I fixed using a new technique to help spread the load over multiple levels, using sublaminar fixation, and a special "U-Rod".
Thanks for sharing Lisa, and family!
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Lloyd A. Hey, MD MS
Hey Clinic for Scoliosis and Spine Surgery
http://www.heyclinic.com
Thursday, February 23, 2012
What we fixed this morning
Way tight stenosis multilevel w retrolisthesis and facet gapping.
Dr. Lloyd Hey -- http://www.heyclinic.com
Tuesday, February 21, 2012
Degenerative lumbar scoliosis w 4 level severe lumbar spinal stenosis fixed this afternoon
L1-iliac instrumentation and fusion w L2-5 laminectomies
Ebl 450 cc
Blood transfused. None
Complications: none.
Surgical time: just under 3 hours.
Just before her surgery saw a nice woman and her engineer husband from Savannah, GA about 5 hour drive from Raleigh with the same problem. She also has a friend who needs 5 level decompression fusion who was told her only option was a spinal cord stimulator. Better to get another opinion from surgeon with deformity and/or multilevel spine reconstruction experience before signing up for stimulator.
Dr. Lloyd Hey -- http://www.heyclinic.com
38 yo w pars fracture (spondylolysis) and spondylolisthesis fixed this am. Early morning 3rd opinion for adolescent w possible pars fracture
Had severe back and leg pain and numbness.
Fixed w Gill procedure laminectomy and L5-iliac wing instrumentation and fusion.
Ebl 200 cc
Surgical time 2 hr.
Complications: none.
This morning saw 15 yo cheer leader and her mom for third opinion.(following Duke second opinion) for low back pain and possible pars fracture. First surgeon from Raleigh recommended surgery for pars fracture.
It is not clear on her imaging or exam that she has a pars fracture, so they decided to take my advice and use our special lumbar brace, see our recommended physical therapist / trainer, abd take. Nsaid x 1 mo.
Sure beats surgery!
Mom and patient were psyched.
SPECT bone scan would be next step if pain is severe and unrelenting -- very sensitive study for fractures.
Dr. Lloyd Hey -- http://www.heyclinic.com
Tuesday, February 14, 2012
27 yo "Whole New Life" after Scoliosis Surgery
This past Friday I saw this 27 yo woman back for follow-up. She had a huge thoracolumbar curve preop, and had significant pain, and very severe posture / self image issues.
She is now doing great, and told me that the scoliosis surgery has allowed her to start "a whole new life!"
Here I am pictured with her and her sister. A very joyous graduation day!
It is always a blessing when we can catch these curves when people are younger, where the scoliosis can be fixed with a smaller surgery, preserving motion segments and making for an easier recovery, and many more years to enjoy a better posture.
Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery
http://www.heyclinic.com
Valentine's Day Secret Compassion witnessed at Hey Clinic
The great thing about true compassion is that true compassion happens behind the scenes --- not looking for recognition or "credit".
Today I just happened to catch one of these secret compassionate moments. When I was between surgeries today, I saw my nurse practitioner come out of an examination room, and go to her desk and pick up a small vase with her Valentine flowers from her fiance'. She then walked back into the exam room.
I later found out that this particular patient was really having a hard time, not just with her spine, but life in general.
Brittaney gave her the flower and vase, and shared a little love and encouragement with a fellow human being who was hurting. She also helped connect this person to the psychological services she needed for a next step.
Strong work Brittaney. You went the extra loving mile.
Thanks also for doing such a nice job on the presentation Monday night.
Dr. Lloyd Hey -- Hey Clinic for Scoliosis and Spine Surgery -- http://www.heyclinic.com
8 yo Maggie's U-Rod! New Treatment Option for Early Onset Scoliosis with Severe Osteoporosis.
Some of you may remember Maggie, who I performed a Shilla Growing rod procedure on last May. Maggie has done great postop, but over the last few months has developed some progressive kyphosis at the top of her thoracic spine. This is largely in part to her severe osteoporosis, which was allowing her spine to sag forward into kyphosis. This caused the Shilla hardware to become more prominent under the muscle and skin to the point where I was concerned it may cause skin breakdown. Sunday Maggie's mom sent me some new clinical photos of Maggie's back, which made it clear that I needed to do something now before her hardware got exposed and infected. So,
Sunday night I went into planning and action mode to get this done. Booked the surgery at WakeMed. Contacted my patient that was supposed to have surgery with me Monday afternoon and asked her to move to different date.... booked the special equipment I needed from the vendors, and planned out the surgery.
Fortunately I have been working on a new technique, called the "U-Rod" over this past year to help revise patients with severe kyphoscoliosis who have less than optimal bone quality. The U-Rod uses sublaminar fixation with FiberWire, which is extremely strong, but gentle on the spine. This U-Rod technique is really an evolution of the old Luque Box technique that was used with stainless steel sublaminar wire. I've come up with a fairly unique way of fastening the Fiber
Wire around the lamina and the rod which allows it to hold snugly, but really spread out the load. This Luque Box technique is what I used on the lady highlighted on my blog a couple sessions back who
I straightened up 15 years ago, and is still doing well.
Maggie was an absolute super star trooper Sunday and Monday getting ready for surgery. She won the hearts again of the Hey Clinic staff and the WakeMed Children's Hospital! Calm, cool and collected -- ready to get straightened up!
Her surgery yesterday afternoon took about 4.5 hours overall, and I was able to get a really good correction using the U-Rod. Maggie is recovering well in the hospital, and should be home soon.
Many thanks for the Hey Clinic staff and WakeMed Children's Hospital staff who pulled together to make this work out well for Maggie and her family! Many thanks also for the many friends and family who kept Maggie and her family and I, and our whole team in prayer. Many answered prayers here!
Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery
http://www.heyclinic.com
Thursday, February 9, 2012
44 yo from Wilmington NC did well today w 2 level TLIF
Suffered for years after laminectomies w back and leg pain and very poor quality of life. Surgery today went well.
Dr. Lloyd Hey. Hey Clinic for Scoliosis and Spine Surgery
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Sunday, February 5, 2012
Thoughts shared from an adult patient treated with non-instrumented spinal fusion as an adolescent years ago.
On Friday at Hey Clinic, I met Linda a 60 year old young lady, who had an adolescent idiopathic scoliosis surgery years ago, done without instrumentation. Things sure have come a long way since then! Now we even have high performance athletic adolescent patients returning to sports within weeks of surgery. Years ago, as you will read below, adolescents were in a body cast for a year!
Linda now has concerns about her scoliosis progressing below her fusion, and her quality of life being affected.
She emailed me back this weekend with a writeup of her story, and what she learned from her clinic visit with us.... she wanted to share this with all of you!
Thanks Linda for sharing. Dr. Lloyd Hey -- Hey Clinic for Scoliosis and Spine Surgery
http://www.heyclinic.com
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On Sun, Feb 5, 2012 at 12:33 PM, ---- wrote:
Hey Dr. Hey!
Here is some information about my life with scoliosis. Please feel free to share it or not. It was a pleasure to meet you on Friday. My husband and I both came away feeling better about our knowledge of the problems with my back and also feeling that we are in good hands. Thank you for that.
Linda
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Many moons ago, at the age of 13, I was diagnosed with idiopathic scoliosis.
The first orthopedic surgeon I saw recommended two surgeries over a period of two years. The second one recommended either one surgery or possibly a Milwaukee Brace. This surgery would be followed by casting and most of the next year in bed. As you can imagine, I was very scared.
In August, 1966 the surgery was performed at UNC. Initially, I was placed on a Stryker Frame which could turn me over like a pancake. Then after about two weeks, I was placed in a body cast. And finally, back home again. For my sophomore year of high school, I had a homebound teacher. And luckily, I had three siblings and great parents to help me get through this time. Unfortunately, we had just moved to NC the same month I had the surgery, so there weren’t any friends close by. One friend from our old home wrote to me every day that year-what a blessing. She is still my friend.
After six months strictly in bed, I was able (sort of) to get up and walk—no PT.
Then I could be up for a total of about 2 hours a day. And a year after the surgery, the cast was removed. The surgery was a success. My thoracic curve had been reduced from 45-50 degrees to 25!
Fast forward 45 years to the present. My thoracic curve now measures 64 degrees and my lower curve 55 degrees. I have had remarkably little pain associated with my back over the years and have been active. In the last 18 months, I’ve developed some pain in my hips. This has been diagnosed as bursitis, which is related to the scoliosis. About this same time, I first came to the Hey Clinic. I came to the clinic because I want to be proactive about my scoliosis as I get older. I’ve seen two of Dr. Hey’s associates, but today I saw him for the first time. He encouraged me to write this blog to share a little about my history and also to write about what I learned today.
THINGS I LEARNED TODAY AT HEY CLINIC VISIT
- My two curves are well balanced which can be a good indicator of fewer problems to come.
- What facets are and how the breaking of these probably caused my spondylolisthesis which is Grade 1 (out of four). This can also contribute to loss of height.
- That your spine can fuse itself in some areas (somewhat) to help prevent worsening of pain and further damage.
- The importance of monitoring curve progression as well as other measurements like trunk shift in determining treatment for adult scoliosis.
- Humans adapt to gradual health changes by changing their everyday habits, so things like walking shorter distances or leaning on the grocery cart when shopping may indicate worsening problems with your back.
- Keeping a log of good and bad days can help monitor changes in quality of life.
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