Today in clinic I saw a delightful 42 yo woman, who actually was bringing her young adolescent daughter in for a scoliosis check.
The mom mentioned that she had scoliosis surgery done with a Harrington Rod by Dr. Ralph Coonrad when she was 13 years old, and has done great ever since.
She had not had an X-Ray in many years, so we offered to get her a screening X-Ray today.
Her fusion looks awesome, hardware is intact, and her 3 discs below the Harrington Rod fusion all are well preserved without flat back syndrome, or spondylolisthesis (slippage).
With her permission, I was able to forward her X-Rays to Dr. Coonrad, who seems to remember all 2,000 of the children he helped with scoliosis over the many years he worked out of Durham Regional Hospital. We have seen many of these adult patients back for follow-up, who all remember Dr. Coonrad with great warmth and thanksgiving.
It is important for scoliosis patients who have had fusions as a child or adolescent or young adult to get periodic checkups every 5 years or so to check for deformity or degeneration/slippaged below or above the old fusion. Finding a regional scoliosis center that can handle both children and adults is a good place to have this done.
It is great to see how well patients can do even decades after scoliosis fusion.
As mentioned in previous blog, trying to spare as many motion segments as possible is important to help maximize disc wear while also seeking to get best possible correction.
Lloyd A. Hey, MD MS
http://www.heyclinic.com
Hey Clinic for Scoliosis and Spine Surgery
Raleigh, NC USA
Three weeks ago today on my first day back from Haiti, we “straightened up” a 12 yo girl named Brittany @ WakeMed in Raleigh. She had a 48 degree upper curve and 58 degree lower curve, but fortunately had wonderful correction of her lower 3 disc spaces on bending films, so we were able to spare 3 discs below.
Brittany’s surgery took around three hours, and her evoked potential sensory and motor function was normal throughout surgery. Preoperatively, she had 2 very noticable humps on her back, both of which were down to almost nothing by the time I finished closing the skin.
She did not require any blood transfusions, but we did give her back blood from the cell saver.
Since she was only around 75 lbs, with a small thin frame, I used the pediatric low profile instrumentation, to lesson the chance of the hardware irritating her soft tissue, or being palpable / visible at the level of the skin.
Postoperatively, she did great in the hospital, not requiring an ICU stay, so her mom could stay with her in the hospital room both nights.
She is now recovering well at home, with a nice email from her mom and dad reminding me to post the X-Rays as I had promised.
Sorry for the delay, Brittany! It’s been way busy!. My scoliosis surgery and family life are interfering with my Blog and writing career!
:)
Maximizing preserved motion segments, while still maximizing curve correction is key to long-term success. In fact, today in clinic I saw a very pleasant 42 yo woman who had scoliosis surgery back in 1972 by Dr. Coonrad, who was here at Hey Clinic to have her young teenage daughter screened for scoliosis. Dr. Coonrad saved 3 of the lower discs below her double curve, and now 36 years later her discs below look just great, and she has no significant back pain. Historically, patients who had long Harrington Rod fusions with only one or two discs remaining preserved did not do as well as those who had 3 or more (3 doing better than 2, doing much better than just 1 disc remaining). Having more shock absorbers is better than fewer.
Lloyd A. Hey, MD MS
http://www.heyclinic.com
Hey Clinic for Scoliosis and Spine Surgery
Raleigh, NC USA
