12 yo Emily goes home from hospital today after scoliosis surgery for Double Curve June 11

This past couple of weeks has been very busy caring for many of our younger scoliosis patients who have just recently gotten out of school.
This past Wednesday, we cared for 12 yo Emily and her family.
Emily had a 47 degree thoracolumbar curve, and got an excellent correction of her curve.
Preop she had quite a crew here, including her parents, grandparents, pastor and his wife.
The pastor led all of us in a wonderful prayer before surgery.
Emily’s surgery went very smoothly, completing a T5-L3 instrumentation and fusion with thoracic and lumbar pedicle screw instrumentation.
Her surgery took a little over three hours, and we were able to spare 3 discs below her fusion, based on preop bending films and intraoperative findings.
As shown in X-Rays above, her correction is close to 100 percent, with the lower discs also leveling off nicely.
Her estimated blood loss (EBL) was 1100 cc, and 500 cc was returned to her with the cell saver machine.
She did not require blood transfusion.
Her mom and dad and family were totally psyched to see her preop/postop X-Ray comparison right after surgery.
They greeted Emily a couple hours after surgery up in their large private room, where the family stayed with her for the 3 nights in the hospital.
Emily’s posture is excellent, with complete removal of the thoracic and lumbar “humps”.  Her torso is in excellent balance, and she looks about 2 inches taller!
Emily went home this morning with her parents, doing very well.

Best wishes, Emily for a speedy recovery!

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery
Raleigh, NC  USA
http://www.heyclinic.com

Note: At Hey Clinic, we respect our guest’s privacy, but also allow sharing to encourage others, and allow others in the greater community to learn.
Emily’s parents gladly share this Blog entry with attached photos with friends and family and others who visit our Hey Clinic Blog, as confirmed with them June 13 2008 9pm.  

FW: Four Years!!! Adult Scoliosis follow-up email

From: Lynn

Sent: Thursday, June 12, 2008 11:06 AM
To: Dr. Lloyd Hey
Subject: Four Years!!!

 

 

Hi Dr. Hey!

 

Well, can you believe I am going to be celebrating my “Hey Day” number four this Sunday? My back is doing wonderfully well, allowing me to walk and workout and do yoga and just about every thing this 55 year old body wants to – without any pain. And every single day for the last four years I think of you at least once, and how very lucky I am to have found you. I’ve decided I’m going to have a bumper sticker made for myself that says “I Love Lloyd!”.

 

Hope all is well in your world. Please know how much I appreciate you Dr. Hey.

 

All the best,

Lynn W_________________

Answering question regarding 14 yo runner having scoliosis surgery

I received this comment/question this evening on my Blog:

“I just received information regarding my 14-yo child's scoliosis.  She is possibly facing surgery for a 53-degree curve. She is an avid runner, logging almost 30 miles per week.  She is highly concerned that if she goes through with the surgical intervention that her running will be over.”  Is this true? I anxiously await your response.Jeanene

Dr. Hey’s answer:  Jeanene, it should be quite possible for your girl to return to a very active lifestyle, including running, although there may be some “down time” during the healing process while the fusion heals, depending on the length of the fusion, and the type of surgical technique used.  I would be happy to take a look at her X-Rays for you, and do a phone consultation if that would help.  Web requests can be sent through my website at http://www.heyclinic.com.

Take care,

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery
Raleigh, NC  USA

History of Scoliosis Treatment 3000 BC until now. Katie O'Kelly, Hey Clinic Summer Intern

Yesterday at our weekly Hey Clinic Quality Conference with the Duke Raleigh Hospital staff, Katie O’Kelly gave a great talk on the history of scoliosis treatment.  Below she gives a summary of her talk, with some of her slides also shown.
Great job, Katie!

Lloyd A. Hey, MD MS
http://www.heyclinic.com
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History of Scoliosis Treatment:  3000 BC to Present.  Katie K O’Kelly, Penn State University

            To many, scoliosis treatment may seem like a rather recent development.  However, this type of treatment dates back over 5000 years.  Ancient Hindu texts describe a type of scoliosis care that involved pressing down on the feet and pulling up on the chin.  Very positive post-treatment results were reported as well.  In 400 BC, Greek physician Hippocrates, well known as the “Father of Medicine,” writes that “there are many varieties of curvature of the spine even in persons who are in good health; for it takes place from natural conformation and from habit."  He treated scoliosis in a few ways.  The more conservative approach involved spinal manipulation and traction on a table called a scamnum.  To this day, many physical therapists use similar ways of relieving neck and back pain.  Hippocrates used another mode of treatment that involved strapping the patient to a ladder, hoisting the ladder and the attached patient into the air, and then dropping the patient from that large height.  Interestingly enough, there is also a Biblical story in Luke 13 in which Jesus heals a woman who was “bent over and could not straighten up at all,” an obvious case of kyphosis (humpback).  
            Treatment continued to improve in days of the Renaissance when Ambroise Pare became the first to treat scoliosis with a brace. In 1741, pediatrician Nicholas Andry published Orthopaedia, a medical handbook for raising healthy children, a type of Correcting and Preventing Deformities in Children for Dummies or something. In this book, he described his methods of scoliosis treatment which included rest, suspension, postural approaches, and padded corsets.  It was in 1839 that Jules Guerin became the first to use subcutaneous tenotomy and myotomy as a way to surgically treat scoliosis.  The use of the plaster jacket was popularized by Lewis Sayre in the mid-1800s.
            Entering the 20th century, we saw the advent of the first spinal fusion in 1911 by Fred Albee and the first surgical scoliosis technique involving metal implants in 1920 by Wreden. Scoliosis surgery became more and more popular over the next decades.  In 1931, Russel Hibbs published the results of over 300 scoliosis operations he performed.  Twenty years later, Küntscher nails were first surgically implanted as a way to stabilize the spine.
            Surgery’s popularity resulted in a demand for safer and more effective instrumentation.  Paul R. Harrington developed the Harrington rod system in 1962.  Many people today still have these Harrington rods in their backs. (For those who do, make sure you watch out for flatback syndrome!)  The Cotrel-Dubousset  (CD) segmental hook instrumentation was developed from 1982-1984 while lumbar screws were used for scoliosis beginning in late 1980’s.  Then, in the mid-1990s, the thorascopic technique was developed, and, during the past 5-10 years, posterior thoracic and lumbar pedicle screw instrumentation has become the gold standard for spinal deformity treatment, both in children and adults.  To this day, researchers, engineers, and doctors like Dr. Hey continue to develop and test even better instrumentation and surgical techniques. Who knows what the future will hold for scoliosis patients?

30 years ago today my world changed. Thanks be to God, and Dr. Mark and Charles Pitman, Barbara Bader, PT and many others

June 5, 1978  A clear, sunny day just like today.
A day I will never forget.
From a care free teenager one minute, to a teenager bleeding severely on the street, clenching my left leg crushed beyond recognition.
I cried out to God like never before: “HELP!”
Help came with a sense of peace, and then a nurse who put a tourniquet on my leg.
The ambulance showed up soon after, with my best friend Terry, an EMT, who held my hand, which I crushed all the way to the hospital at Glen Cove.
The pastor from my church, Pastor Brown, and Lisa from youth group happened to be there at the hospital, and stayed there until my parents arrived.
Dr. Mark Pitman, on his way out to his car, walking out through the Emergency Department happened to see my X-Ray of my shattered tibia and fibula on the board, and asked the nurse if he could help, even though the initial evaluation looked like my leg was not salvagable.
Dr. Pitman came into my room, and in my pain and fear gave me some hope for healing.
Dr. Mark Pitman and his brother Charles had experience piecing together people who had stepped on landmines during the Israeli War years before.
Dr. Pitman told me my leg looked like I had stepped on a land mine, and that there was a slim hope of saving it.

I spent that whole summer at Glen Cove Hospital, with MANY caring nurses, nurses aids, and physical therapists who helped keep me sane with much compassionate care.  Barbara Bader, a physical therapist, helped me get through the painful Hubbard tank hot betadine treatments to try to treat my large open wound.  Dr. Pitman took me back for a total of 11 surgeries over several months, including several debridements for sepsis, and for bone grafts that wouldn’t heal, and skin grafts that would not heal.  My family went through hell and back that summer, including my mom and dad and brother and sister, and many other family members who faithfully visited me regularly and made me appreciate family at a whole new level.  The pastor from my church, Pastor Brown, came to visit me every single day in the hospital except just one, and encouraged me to read the Bible for myself to figure out who God is, and who I was, which I did do with the large amount of time I had on my hands.  I discovered God’s great love for me and for us, and how He desires to pour His love through us to others as His loving hands and feet.  Transforming time.

Dr. Mark Pitman months later listened to me when I proposed a new design for the Hoffman external fixator which did not seem stable enough to hold my bones in my leg, causing pain and delayed healing.  His gentle smile, and willingness to try the new design led not only to immediate relief of the severe pain in my leg but eventually helped lead to permanent bone healing and a functional leg which has worked great for the past 30 years, including many long days in the operating room.

As I prayed on the night in the hospital before my last leg surgery in December 1978, I had great peace that God was going to use this very bad thing that happened to me for a greater good.  I caught a glance of a vision that my experience as a patient, combined with my “tinkering” skills could be used by God to bring healing.

Since that accident 30 years ago today, I do believe that God has put many caring people in my life to help bring healing and encouragement, and direction.
I thank God for every one of them.
I also thank God for sparing my life 30 years ago today, and healing my leg, and giving me a passion to serve Him with great energy He provides every day to bring glory to Him in humble service as a father, husband, neighbor, and surgeon.

Thank you, Dr. Mark and Charles Pitman for taking on my case 30 years ago today, and sticking with me through it all, even when it was rough.
Thanks for also being mentors and encouragers to apply my “tinkering” to help patients.  For the past 14 years of practice, and many more years of training before it, this combination of “tinkering” innovation, with compassionate care has continued to grow and develop.

Thank you Barbara Bader, Physical Therapist, and the many other caring nurses and other caregivers who cared for me through that very dark valley.
Thanks to the nurses who pushed my head and chest on the stretcher out the emergency exit so I could get a breath of fresh air that summer, while obeying the doctor’s order that my leg with the open wound “did not go outside the hospital.” :)

Thank you Mom, Dad, Ken, Kris for sticking with me, and loving me during that rough time and through the long journey of training.

Thank you Jeff and my other friends who even jumped on the back of trains on a regular basis to come and see me.

Thank you God, for sending me a wonderful wife and best friend, and also wonderful children which are a gift from you.

Thank you God, for the wonderful staff you have blessed me with at Hey Clinic, and at Duke Raleigh Hospital and WakeMed Hospital, and not so long ago at Duke Medical Center.

Thank you God, for the thousands of patients and families who have touched my life, prayed with and for me and my staff and other patients, and who have been a great encouragement to me.

30 years ago today, at this time, I was in the operating room as a patient, with the Pitman brothers washing out my shredded leg, and applying the external fixator.
26 years ago today I graduated from MIT in Electrical Engineering, minoring in bioelectrical engineering, after doing bone/tissue healing research for 3 years.
22 years ago today I graduated from Harvard Medical School, staying on at Harvard for Internship and then Residency in Orthopaedic Surgery.

Every year when June 5 rolls around, I always pause to give thanks to God, and to the wonderful caring people He has put in my path.
In my past 14 years of practice and almost 5,000 surgeries, there have many times where God has been able to use my own story of suffering through 11 surgeries and 2 plus years of recovery to encourage some of my patients and families that faced similar trials.  

In some small way, I hope the daily life I live out for God would be a thankful Gift that I can live out of the love and healing I have received.

June 5 2008
Today, unlike having surgery, I did surgery on 2 people who were in severe pain and disability with crushed nerves.  On rounds this evening, both of these patients had excellent relief of the pain that was there in the morning.  I also rounded in the hospital, and saw many patients in clinic who did not have Hoffman external fixators like I had, but who had “internal fixators” made out of titanium, which I molded and fashioned and inserted to help straighten up crooked spines in children, adolescents, and adults.  On hospital rounds I saw a 13 yo who had a corrected kyphoscoliosis, as well as a 20 yo young man with Scheuermann’s Kyphosis, and a 20 yo woman with a thoracolumbar scoliosis, as well as a 66 yo woman with a severe degenerative scoliosis with stenosis.  

Over at Hey Clinic this afternoon, I saw several postoperative follow-ups who were a big encouragement  I saw today, was “JJ”, an athletic young man, around the same age I was when I had my accident, just a few months out from his scoliosis surgery looking great, and back playing basketball wide open.  I also saw “Judy”, who had several previous scoliosis surgeries elsewhere, who came back today just a few months out from my complex revision scoliosis surgery now standing up straight and tall, well-dressed, and sharing what an encouragement her story of healing has been in her church.

Meanwhile today, I was followed around all day by my two pre-med “shadow” guests named Katie and Chris.  Katie is my niece from Pennsylvania, who goes to Penn State and is studying engineering and pre-med.  Chris is an engineer, already graduated from NC State, but feels led to go to medical school, but in the meantime is helping out with some biomechanical research we are doing with the Department of Engineering at NC State to develop better scoliosis instrumentation techniques and equipment.  Sharing life, and inspiring the next generation continues to be a wonderful part of my life of service.  Meanwhile, when I came home, my son showed me his progress on an engineering project of his own, with a unique new mount for a scoliosis hardware testing system he is helping to design and construct.  David is right around same age I was when I began to innovate and create new constructs.

Tonight, my son prayed a prayer of thanksgiving that my life was spared 30 yrs ago, and what God has done through my life since then.

I wouldn’t be here today if it wasn’t for God, and the countless people that he worked through to make this day possible.

If God grants me another healthy 30 years on this earth, perhaps I can still be serving Him as a scoliosis surgeon, as my mentor Dr. John Hall did through his 70’s.

Thank you, God, for the way you can turn bad things into good (Romans 8: 28), and who brings healing and encouragement and purpose in all sorts of ways.

Lloyd A. Hey, MD MS
http://www.heyclinic.com
Hey Clinic for Scoliosis and Spine Surgery