Tuesday, September 23, 2014

Fwd: [The Hey Clinic for Scoliosis and Spine Surgery] New comment on 15 yo Britney from South Carolina w preop 77 degre....

From: britney 
Date: Tue, Sep 23, 2014 at 6:56 PM

Britney has left a new comment on your post "15 yo Britney from South Carolina w preop 77 degre...":

I'm still doing awesome after 2 years. I was thinking about this and I never actually looked at this or my xrays side by side. You did an awesome job Dr. Hey and I thank you dearly!

Friday, September 5, 2014

What could happen to a small thoracolumbar curve with trunk shift as adolescent/young adult 40-45 years later?

Pam, Age 20 on left in red with trunk shift to right.
Pam, Age 60, 1 year after scoliosis surgery
Yesterday we saw Pam and her husband Gerry for her 1 year postop follow-up at Hey Clinic for her thoracolumbar-iliac wing instrumentation and fusion with laminectomies and osteotomies.  She is doing really well, is active and really enjoys her new posture.  She shared a very interesting story, which she also shares on YouTube video below:  Recently she went home to the house where she grew up and found an old photograph of herself with her college roommate at age 20.  Pam studied the photograph and noted that the picture clearly shows that she had a slight trunk shift to the right, although she was never diagnosed with scoliosis.  For her wedding pictures a few years later, the photographer made her stand in a very awkward way, which he said made her look "straight" but to Pam made her feel wierd and unbalanced.  In the years to come, she noted increased back pain, loss of height, and worsening humps on her back with posture/appearance increasing difficulty.

This is really a wonderful "Time Machine" look at why it is important to screen and follow-up for scoliosis, not only in children and teen-agers but in young adults and older adults as well.  In this day and age, Pam could have had her scoliosis fixed at age 16 or possibly even up until her late 20's with a much smaller operation, which would have preserved a good portion of her lumbar mobility, while centering the loads to help prevent those lowest discs and facet joints from wearing out prematurely, causing back pain as well as possibly sciatica, spinal claudication and leg pain and trouble walking.  Increased awareness by not only pediatricians, but OB/GYN's , family practitioners, chiropractors, physical therapists and others can help ensure that patients like Pam are diagnosed early, and followed regularly, so they potentially can choose less invasive options that could prevent issues in years to come.

Fortunately there is also hope for the older adults who have progressive deformity, and/or increasing pain and problems with quality of life, as Pam can attest!

Thanks for being willing to share with others on the blog, Pam and Gerry!

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

Monday, September 1, 2014

Another interesting and busy week caring for kids, adolescents and adults with spinal deformity, spondylolysis, and spondlylolisthesis

All of us at Hey Clinic are catching our breath this holiday weekend after a good, but very busy weeek in the clinic and at the hospital caring for children as young as 4 years old, up through tons of teens with adolescent idiopathic scoliosis, and adults with old adolescent scoliosis deformity now concerned about increasing curves and/or quality of life issues.  Many folks got good news that their curves were small and / or have not progressed, while others learned that their curve had become quite large due to growth or degenerative collapse.  We heard from many of ALL ages worried about long-term consequences of their deformity on their posture, pain, quality of life, future pregnancies, need for future back surgery, and its affect on sports and exercise.

Mom of adolescent idiopathic scoliosis teenage girl shares before and after pictures from her surgery with us at Hey Clinic

16 yo young man 6 weeks postop from Scheuermmann's kyphosis surgery and his mom share their story on improved posture, quality of life and 2-3 inches of new height!!

Here's a sample of some of the folks we saw in last week or so back for follow-up telling their stories, which can be also found on our YouTube Hey Clinic channel, with their permission to share these stories with all of you!  

Our annual SRS meeeting (SRS.org) is coming up this coming month, and as Chairman of the Adult Deformity Committee, there is a bunch still to be done, working on some presentations, publications and reports.  I always enjoy this meeting though -- always plenty to learn and share with scoliosis colleagues from literally around the world!

14 yo returns to soccer during first few weeks and months after scoliosis surgery.  Patient and family share their thanksgivings, appreciating care at Hey Clinic and Duke Raleigh Hospital

When should I get a scoliosis evaluation as an adult? Should I get up the courage to go and talk to someone about my scoliosis concerns?

My PA Rachel and I spent a good hour with Diana, who is now 70, but looks and acts more like someone in her 30's or 40's!  Diana had adolescent idiopathic scoliosis, and had upper curve fixed with non-instrumentated fusion, and postop casting in 1957, before the Harrington rod instrumentation was done commonly.  She spent a month in the hospital, and a whole year recovering with a postop cast, then back brace, and lots of time in bed.

She is incredibly healthy, and does everything possible to maximize her spine health:  keeping her weight down, core strengthening, low impact aerobic exercise, and some physical therapy in the past.  We saw her back in 2007, and she came back for follow-up with concerns that her lower curve was collapsing, and some new symptoms.  This past week, she saw us back, and indeed her lower curve has progressed, and trunk shift has increased.

Here is email interchange with my PA Rachel responding to her email below.  It does take courage to go and see a scoliosis expert regarding your curve, but we do try very hard at Hey Clinic to use it as a time to educate, track the curves and quality of life and other factors carefully, and just let you know what your options are moving forward.  We also try to let you know what to look for as "warning signs", or "red flags" that might indicate when/if more serious trouble may be brewing due to severe spinal stenosis, disc herniations and/or cauda equina symptoms which may make surgical intervention more necessary and immediate.  From Diana's email below, you can tell that she was glad to make the trip and learn more about her current state, changes over time, and options moving forward.

In general, remember that it is good to have your scoliosis checked every year through age 25, and every 3-5 years thereafter on X-Ray, even if you have had a previous fusion, since there can be degenerative curve collapse, and this X-Ray measurement data over time can help you to know if you are dealing with a progression.  Carefully checking your height each year is also a good check --- any height losses more than an inch is worrisome sign of potential significant curve progression.

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


I'm glad you had a good visit yesterday.  We enjoy being able to take the time to educate patients and clearly convey all options.  The blog is an excellent resource for real life stories too, for patients who were once in your shoes.  We also have some patients who have said they would be happy to talk with anyone who is interested or considering he surgery.  If you would like to pursue this, let me know and we can arrange this.  Please let us know if we can help you with anything else.  We look forward to hearing about your therapy and following you.

Thanks for the encouragement and I will pass this along to Dr. Hey as well.


> On Aug 30, 2014, at 9:25 AM, "Diana> wrote:
> Rachel,
> It was a great pleasure to meet you yesterday, although we didn't talk much.  I appreciated your input into my reevaluation.
> Please let Dr.Hey know that although it's very hard for me before the fact to  think of talking to an orthopedic surgeon about my back, Dr. Hey makes it a very good experience when I actually have the appointment.
> I appreciate his sensitivity and understanding, and I am so grateful   he took the time to listen to me, reassure me, and give me hope.  I have been looking at his blog this morning, reading the stories and looking at the pictures and xrays.  When it comes to the scoliosis I have, I usually swing from keeping my head buried in the sand to feeling doomed.  I felt so much better about my future when I left your office yesterday.  I'll continue to do all the things which keep me healthy, but I am conforted to know that there is medical  help for me if I need it.
> Thanks Rachel, and please thank Dr. Hey for me, and for my husband.
> Diana
> PS
> ALL of the staff is wonderful!