How can we care for scoliosis and kyphosis and spondylolisthesis better with conservative care like physical therapy, high-tech scoliosis braces, exercise and other techniques? What can be done to improve surgical care, and understand choices for surgery, learning from those around the world? How can we learn from aviation and from Deming's principles of "Standard Work" to constantly improve spine and all healthcare?
Thursday, April 26, 2012
38 yo executive with huge trunk shift scoliosis caused by huge disc herniation -- fixed this afternoon
This investor/developer had a disc herniation last year, and now has huge disc herniation at level above. What is interesting, is that he also has a huge trunk shift scoliosis, as a response to the painful sciatica on his right side. This pain causes him to shift his trunk way over to the left to try to ease the pain off his nerve roots that were being crushed.
I just broke scrub after fixing the problem: as you can see below, I pulled out a monstrous free fragment disc herniation which was crushing the nerve roots on the right side, and actually obliterating most of the neural canal.
After he wakes up and gets through recovery room, he should be able to stand up straight again, with the severe sciatica relieved now that his lumbar disc herniation has been removed.
What a relief it is to get this pressure off the nerve. His lumbar nerve roots were tight as a guitar string, stretched over the mountain of the disc herniation. After the disc was removed with microsurgical techniques, you could see the nerve roots lie down flat again, much happier! It is amazing to think that such a small "problem" could literally cause his whole body to be thrown out of whack -- fixable not with a big scoliosis fusion, but by minimally invasive, or certainly much less invasive "pebble removal."
In between surgeries, saw a gentleman who could barely walk with clumsy legs, and severe multilevel spinal stenosis and degenerative scoliosis. We should be able to get him back walking much better in the future -- real hope for this gentleman losing the ability to walk. This morning, we helped a lady in her early 60's with this exact problem, who had a previous laminectomy / discectomy years ago and now had collapsing scoliosis with severe spinal stenosis.
On Pandora on our awesome operating room sound system: "Time for Me To Fly" by REO Speedwagon. Great tunes that remind me of my fraternity days at MIT, where the seniors I roomed with my freshman year at TDC would blast REO Speedwagon every night around midnight, while hanging out the Flag Room Window and yelling at the passers by.... Meanwhile, I was looking down at my calculus book wondering if I'd survive!
Our folks upstairs here at Duke Raleigh hospital are doing well. Our 14 yo scoliosis young lady Julia is getting up and around, receiving lots of messages from her relatives in Europe --- some of which have required translation for the rest of us to understand!
Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery
http://www.heyclinic.com
Subscribe to:
Post Comments (Atom)
No comments:
Post a Comment