Thursday, November 29, 2012

15 yo young lady with 46 degree progressive painful thoracolumbar adolescent idiopathic scoliosis straightened up this morning

Olivia's surgery went very well this morning.  Estimated blood loss 350 cc, 115 cc returned with cell saver.  Correction really nice in both sagittal and coronal plane, with her preop "hump" now gone.

Surgical time was 3 hours and 10 minutes.
Evoked potential monitoring normal.

We have several postop scoliosis and other postop spine patients upstairs at Duke Raleigh Hospital, none currently at WakeMed Raleigh.  Olivia will go to a private orthpaedic room upstairs where there is a separate bed for mom or dad.  No ICU or PICU needed.

This afternoon we are helping a man who is losing the use of his arms and legs with severe cervical spinal stenosis.

Time to go talk to Olivia's parents and show them this X-Ray!  I think they will be happy.  Olivia told me she wanted to be "as straight as possible"!

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery
"Experience, Service, Compassion and Results".  --

Wednesday, November 21, 2012


I just got a chance to put my feet up for a few minutes this evening and chill out a little.  We have family starting to gather for holiday weekend.   It's been a good week, filled with lots of special people.

Monday we straightened up a 22 yo young lady with a painful 49 degree progressive painful adolescent idiopathic thoracic scoliosis from Charleston, SC.  We also helped a lady with a degenerative scoliosis from Virginia Beach, with collapse above an old L4-S1 fusion done many years ago.   Both are recovering well and will go home sometime this week.

Today I did a half day clinic with a bunch of adolescent and young adult scoliosis follow-ups.  Highlights included college swimmer from Virginia Tech now 6 months out from her scoliosis surgery swimming now 1.5 hours per day, and starting major weight training after Thanksgiving break.  Also saw one of my dear younger adolescent young ladies from Morehead City, about 3 hours away, who had severe double curve now 8 weeks postop, and 4 inches taller after her surgery!  She's back to school now doing well, and thankful for her new posture.

We also got to see Marie back for follow-up.  She's a lady around 50 who is now 6 weeks postop from a thoracolumbar fusion for a painful progressive kyphosis secondary to a spine fracture.  She is now doing very well, standing up straight with good relief.   Her before and X-Rays are shown on he lef side.

After clinic today, Leslie and I helped Dan, a very athletic guy in his 50's with a severe multilevel cervical spinal stenosis.  I performed a C34, C45, C56 and C67 anterior cervical discectomy and fusion (ACDF) using innovative PEEK cage technology to correct an issue he had with previous collapsing allograft bone plugs.  His wife Rachel and I had a good chat about how to tie Dan down a little bit after surgery so he gives himself a chance to heal!

My In-Laws are up visiting from Florida, and they brought a gift from one of my patients who is their next door neighbor there:  home made cranberry scones!  That was our dessert after lasagna tonight.  Awesome.  This is actually the second batch we've enjoyed -- the last batch was this past winter when our family visited them at their home in Florida.  Dear people.  My in-laws have both had successful lumbar spondylolisthesis and stenosis surgery done years ago, and are both extremely active with dance, tennis, jogging, swimming, travel, gardening and the like.   My In-Laws are still thankful, for their improved quality of life even more than 12 and 7 years ago since their spine surgeries.

And finallly, here's a note I received this evening from Neal, one of our lumbo-sacral spondylolisthesis postop patients:

Dr. Hey,

Needless to say, you and my new back are on my Thanksgiving list!  I am so grateful to you and your “second opinion.”

I’m still amazed at all the “coincidences” that put me in your office:  the referral by my nephew, that my daughter and Brittany were on a medical mission trip together,  your last-minute cancelled trip to Chicago last November that allowed you to spend so much time with me on a day you had not scheduled appointments, that I was able to see you with a few hours notice because a friend had delivered the MRI results to me the same day I requested it……amazing.

I hope Thanksgiving Day’s  a good one for you. Thank you!


Thanks for taking the time to send a note, Neal.  
Thanksgiving is definitely a good and healthy thing.  

Wishing all of you and your families a very Happy Thanksgiving.

Dr. Lloyd Hey 
Hey Clinic for Scoliosis and Spine Surgery 
"Experience.  Compassion.  Service.  Results"

Friday, November 16, 2012

Little Quinna w/ Rett's Syndrome Postop from Scoliosis Instrumentation and Fusion

Quinna Preop
Quinna X-Ray Today at Hey Clinic
I just left the exam room with little Quinna, who is growing like a weed!  Her surgery blog entry can be found by clicking here, and her 3 month Postop Blog can be found by clicking here.  We did scoliosis surgery for her a few months ago, and she is doing just great.  She now can sit up straight in her wheelchair,  is smiling widely, and does not appear to be having any back pain.  Her postop X-Rays look quite good.  This is  good example of a younger child, even with neurologic involvement, can sometimes be treated with definitive instrumentation and fusion rather than growing rods or Shilla.

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery

Laney 6 weeks postop from Adolescent Idiopathic Scoliosis Surgery Doing Well

 I just saw Laney and her mom and dad back for 6 week follow-up doing really well.  Check out the scoliosis surgery journey story her dad wrote, and I shared a few weeks ago.   She went back to school a little more than 2 weeks, and is all caught up on her school work.  She is an inch or two taller, and very happy with her new posture. She can return to sports as soon as she would like now.  Her X-Rays from today look really good, and you can see how her "hour glass" figure has been returned to normal (trunk shift), which now decreases the loads on the lower back.  On physical examination, her right rib hump is gone, and incision looks great.

Her family brought us wonderful cookies x 2 boxes - one box for us, and one box for the nurses and staff over at Duke Raleigh Hospital they are heading over to visit right now.  Their family also made a donation to the Inter-Faith Food Shuttle, and gave us the nice card below:  "Thank you so much for the hope and healing for Laney - as well as our family!"

This looks like a good non-profit to support.  They work with local restaurants to take leftover food to the hungry, and actually have a "back pack program" to help provide weekend meals to needy kids in school to bring home for food over the weekend.  Will check this out.

How do Early Onset Scoliosis Patients do in first few days and weeks after surgery? Saw Cayleigh, our 11 yo back for f/u today

Cayleigh had just turned 11 a few days before we did her very large Early Onset Scoliosis (EOS) double curve scoliosis last week, which can be found on my blog.   I got a chance to see her just now for a brief postop visit today in the clinic, and she looks great!  She's excited that she is 2 inches taller, and loves her new posture.  She is off all pain meds, and says she really is not having any significant pain.  Go Cayleigh!

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery

Postop Scoliosis Patient, Retired Nurse Practitioner Gives Thanks 1 Year after Scoliosis Surgery

I just saw Nancy back for follow-up after her revision thoracolumbar sacral iliac wing revision extension instrumentation and fusion now one year postop doing extremely well.  She had a small lumbar fusion done years ago, but then had degenerative scoliosis collapse above that with severe pain, trouble walking and severe spinal stenosis.  She is now doing great, and brought me a wonderful gift bag filled with home made jams, pickles and much more -- perfect timing for our family guests coming in for Thanksgiving!

Nancy shares a word of thanks to all of the caring nurses, physical therapists, surgical techs and others over at Duke Raleigh Hospital who cared for her with her surgery.  She also expressed her thanks also to the Hey Clinic staff as well.

Take care Nancy!    Dr. Lloyd Hey -- Hey Clinic for Scoliosis and Spine Surgery

Thanksgivings from adolescent with multiple congenital spine abnormalities now doing well 1 year postop.

On Nov 16, 2012, at 10:02 AM, Emory wrote:
Dear friends and family,
I am happy to announce that today, November 16th, is officially one whole year after my scoliosis surgery in 2011! I am doing great and am basically pain free! Thank you to all who prayed for me and all you did while I was recovering! What a blessing! Thank you again. God bless.

Just got this nice note from Emory, a 13 yo who had a very complex congenital upper thoracic scoliosis and lumbar scoliosis with severe preoperative pain, and large shoulder obliquity.  Thanks Emory for taking the time to send out your thanksgiving to everyone!

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery

Thursday, November 15, 2012

Can Scoliosis be fixed with minimally invasive microsurgery?

Here's a real short video on YouTube I shot yesterday with a 29 yo woman who has a 19 degree scoliosis with severe radiating left leg pain, secondary to large L45 disc herniation on the left.  In response to the pain, she's developed a significant scoliosis and lean to the right. (She was psyched to be on YouTube and Blog --- received her permission to post)

We'll be fixing her sciatica and scoliosis soon with minimally invasive microdiscectomy surgery!

Meanwhile, our 18 yo who had the revision scoliosis surgery is recovering well upstairs, except for some nausea and borderline ileus, which he had with his last surgery done elsewhere.  He is psyched about his new posture and chest shape, which he can tell is significantly better, both front and back.

Did a huge revision scoliosis surgery today on a lady from Florida, who had a Harrington Rod fusion years ago now with adjacent level failure, kyphosis and severe pain.  Her surgery went well.

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery

Monday, November 12, 2012

Getting ready for the big game: Complex Revision Deformity Surgery Planning.

Today I completed two complex deformity surgeries, did two surgery consults, picked up vegetarian Thai food on the way home for my daughter and I, and then sat down to get ready for the "Big Game" for tomorrow: a revision double curve scoliosis surgery for an adolescent who had surgery 8 months ago elsewhere, with painful, inadequate correction.

I just spent the last hour studying his spine from top of thoracic to bottom of lumbar planning out each level of the surgery, with angular measurements, and which screws need to be added, and which screws need to be replaced and / or redirected.

Now I can get to bed early, and sleep on this surgical plan, then get up and make it happen tomorrow!

I'll have 3D imaging technology in the operating room tomorrow with my ace surgery team, including Nurse Kelly Hohman coming in on her day off to help out.

The 11 yo girl who had scoliosis surgery this past Wednesday went home from the hospital this past weekend doing great.  Mom and dad very happy with her rapid recovery, posture, and the care they received at WakeMed Children's Hospital, Raleigh Campus.  Many thanks for everyone who helped little Cayleigh and her family.

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery

Wednesday, November 7, 2012

11 yo young lady we straightened up today

This morning we straightened up this 11 yo girl, who just turned 11 within the past week!  Her double curve has been rapidly progressing, and she is in the midst of a very big growth spurt.  Fortunately she has gained enough trunk length that we were able to fix her with a definitive instrumentation and fusion, rather than having to use the growing rods or Shilla technique.   We did a special technique that allows us to get a really nice correction gently and safely.

Her surgery took about 3.5 hours, with a 300 cc blood loss, no blood transfused.  Her two "humps" are gone, and her X-Ray shows a very nice correction.  When I showed mom and dad the X-Ray after surgery, mom gave me a big hug, and dad a nice handshake.  A nice end to a great morning.  Patient was able to go to a regular pediatric bed tonight with her parents in the room with her.  No PICU needed!

In the afternoon, I did a revision scoliosis surgery on a 43 yo woman, who did very well.  Whew, now I am tired and ready for bed.  Two big surgeries for tomorrow including a cervical-thoracic kyphosis surgery.

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery

Second Opinions for Scoliosis Bracing, and Including Your Child / Adolescent In The Decision Process.

We do quite a few second opinions for scoliosis and other spine surgeries at Hey Clinic, many of whom travel from out of state to come in for a visit.  It makes sense -- scoliosis surgery is a big deal, and can be helpful to learn more, and consider whether surgery is really best option, and/or what techniques and surgical team's approach and experience might be best fit for you or your loved one.

7:30 yesterday morning,  my nurse practitioner Brittaney and I  did a second opinion for a very nice family whose 14 yo daughter has adolescent idiopathic scoliosis (AIS) measuring about 38 degrees.

The family had seen a pediatric orthopaedic surgeon just recently for a few minutes, who quickly wrote a prescription for a scoliosis brace, and sent them down the hall to get the brace made.

The mom described how they were in a state of shock, and did as they were told, and ordered the brace.

After going home, they started to think about it a bit more, and decided to come in to see us for another opinion, and a friend recommended coming in to see us at Hey Clinic.

When we saw this young lady, we took a careful history, remeasured all her films, and then spent some time exploring the benefits vs. the "costs" of bracing.   We actually took out a Boston Brace and showed it to the patient and family ---- this was the first time they actually saw a real brace!  Yikes!  How can you expect a young lady to decide whether she is willing to wear the brace if she's never even seen one!  The young lady's eyes got quite wide.  We drilled down on specific growth parameters for this young lady that allowed us to risk stratify the potential benefit of bracing and risk of progression for her.  We explained the prospective bracing literature which has shown that bracing may decrease the rate of scoliosis surgery by as much as 50% at the time of skeletal maturity.  We also explained, however, that the brace does not straighten the curve, or improve her posture / appearance, and it is no guarantee that she will not need surgery in the future.   We explained that bracing for scoliosis was different than bracing for your teeth, where you don't have the option of taking your braces off, and braces typically make your teeth straight!  (This young lady messed up my story though.... because she told me that her teeth went crooked when her braces came off!  :)  )

Not unlike surgery, scoliosis bracing is a big commitment, and there is usually no medical emergency to get your child or adolescent in a brace within the next week or two.  Take your time, collect information, feel out your child a bit, and then decide.  Bracing in some ways is a  BIGGER commitment because it requires the compliance of the teenager to wear the brace for at least 18 hours a day, usually over several years.  At Hey Clinic, we spend time, quite a bit of time, engaging the teen as well as his or her parents in the decision-making process, pulling up special growth remaining and other tables and literature to help families make an educated decision.  For the younger children we see with Early Onset Scoliosis (EOS), the issue of bracing is not as traumatic --- the younger kids actually don't mind the brace as much, and actually like to decorate it with stickers, etc.  Bracing in the EOS group also has some big advantages as we seek to at least slow the curve while their bodies are gaining crucial size.

We do brace quite a few children and adolescents at Hey Clinic, but always have a good dialogue first and let the patient and the parents make the final decision on an individualized basis.    Let's face it: as a parent, you have to pick your battles when you are trying to mold a teen into a successful, independent adult!

So, if you feel like you just got whisked down the hall to the brace shop with your son or daughter's new scoliosis diagnosis, it may make sense to slow the doctor or other provider down and ask some more questions, and then, most importantly, talk to your son or daughter about the decision and include them in the process.  This can make it a very positive journey, and build trust.

This particular family left my office yesterday morning really glad that they made the trip, and were going to go home as a family and have that dialogue!  That is time well spent.  An extra hour for a second opinion, or going back to see your pediatric orthopedic surgeon before having your son or daughter wear a brace for 6,500 hours per year for 2-5 years is probably a good investment!  In general, a more holistic, developmental approach that fully engages the adolescent or child in the process is the way to go. That is what I would want for my teen, which is why that's the way we do it this way at Hey Clinic.

If you are looking for a good place to get a second opinion for scoliosis bracing, the Scoliosis Research Society ( is a great resource.  They also have all sorts of great references online, including their new eText site which you can sign up for....

Dr. Lloyd Hey

Sunday, November 4, 2012

Hannah smiling after revision scoliosis surgery

I rounded at Duke Raleigh Hospital around 7 am this Sunday morning on our four inpatients up on the Orthopaedic Floor, including Hannah, who is the 23 yo featured in the short video posted yesterday.

Hannah stood up and was thrilled with her new posture after I performed revision deformity surgery for her.  She had scoliosis surgery back when she was 13 done at a Shriner's Hospital.  She had difficulty with pain, and just under a year ago, her spinal hardware was removed to try to help her with the pain.  However, instead of the hardware removal helping, she actually got a lot worse, and her curves progressed over this year significantly.

On Monday this week, I performed a complex revision deformity surgery with 3D Brainlab Navigation, and multiple spinal osteotomies, and used segmental instrumentation with pedicle screws and 2 cobalt chrome rods.  Hannah says that her back already feels significantly better, in that the deep pain she used to have is gone, and now she has a less significant surgical incisional pain which is being well controlled.  She also notices that her humps are significantly smaller, which even makes it more comfortable for her to lie down and stand up.  She also has gotten her "hour glass" posture back.

In the photo below, her mom took a picture of me showing Hannah her new X-Ray.  You can tell that she is smiling, even though you are looking over her shoulder.  She told me that the new correction is actually even better than the original one done 10 years ago.   Her mom is smiling too.  They have both been very happy with the nursing and physical and occupational therapy care at Duke Raleigh Hospital as well.

Hannah and her mom checked out Sarah's mini video and really liked it as well...

Get well soon Hannah!

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery

Saturday, November 3, 2012

Mini Video Portrait of Dr. Hey done this week!

This has been just a great week.

It all started off bright and early Monday morning when my daughter Sarah came in early with me to shoot some video for a video project she needed to do for school:  a 2 and a half minute "mini-portrait" of me at work.  We received permission from each of the families she ended up video-taping, and I actually got a chance to share her final product with Hannah, the 23 yo woman that I did the revision scoliosis surgery for that morning.  She smiled from ear to ear as she watched it, and wanted me to post it as soon as possible, so she could share it with her friends.

Sarah only had about 3 hours total to shoot the whole video, then edited it this week, and showed it to her professor today, who loved it!

Let's see what you think.  Welcome to a snippet of my world, seeing a new adolescent scoliosis patient, and then getting ready for surgery, and doing surgery!

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery