Wednesday, April 25, 2012

Today's Scoliosis News! 5th opinion this morning and Today's Scoli Surgery

On hospital rounds this morning:  Our young man that we removed the huge disc at L5S1 was feeling great this morning, after suffering for 2 years with severe sciatica.  I've had a cervical disc herniation removed, which felt like an ice pick in my left scapula and left arm for a year.  What a blessing it was to wake up in recovery room with that "dagger" removed.  It reminded me of the story of when the lion has the thorn removed from his paw....

Our other inpatients also look good --- the lady who had severe myelopathy due to spinal cord compression in mid-cervical spine is doing much better after her posterior cervical decompression and fusion.  Another lady who had chin on chest kyphosis after a upper thoracic fusion years after a scoliosis fusion now looks great, and is so pleased with her new posture.  We did a C2-T6 extension instrumentation and fusion using our new "U-Rod" technique.  She'll be discharged tomorrow.

This morning I met with Julia and her parents before her scoliosis surgery today.  Julia is 14, and is from France, but lives in South Carolina for part of each year.  She's been braced for a couple years in France, including a night cast, but her double curves have continued to progress up into the 50's.  I asked her this morning how straight she wanted to be, and she gave me the "straight salute" with her hand ---- "I want to be as straight as possible".   "You got it!"  That's the plan!  It was good to see Julia and her parents smile before surgery.  There are a lot of things we do to help make this whole scoliosis surgery journey a positive experience for the adolescent as well as for the whole family.  Having had many surgeries as a teenager, I've seen the good and bad through the patient's eyes. We'll keep her parents in the loop during the surgery each hour and a half. 

While Julia was getting set up for surgery, I got a chance to see a very nice 26 yo woman who had scoliosis surgery done elsewhere years ago, and has been having major pain issues and problems with increasing kyphosis above her fusion, affecting her neck posture.  She has seen MANY doctors about this, including many pain specialists, and is on narcotics on a regular basis.  Her X-Rays show that her hardware goes up to mid-thoracic area, and she has bottom screws at L3 on one side and L4 on the other. 

We explained to her the differential diagnosis for her pain and posture problems, which includes pseudarthrosis, adjacent level degeneration, pain related to prominent hardware, and posture/balance issues.   We're getting her plugged in to our very best "Level 1" program, including meeting with a "black belt" scoliosis physical therapist from Duke, who also works as a trainer.  In addition, we'll get a CT scan of her thoracic and lumbar spine and take a closer look at the fusion and adjacent levels.

I am typing to you now from OR 12, just waiting for prep to drive on Julia, and then we will get to work!

Time now to scrub up.  We've got some beach music on our sound system here in the operating room.  Nurse Kelly is running the show as usual as circulator!

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery

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