On Wednesday this past week, we helped Lindsay, who is a delightful 18 yo young lady with Down’s Syndrome and a history of severe scoliosis.
Lindsay had scoliosis surgery performed elsewhere, corrected using Leuke Rods and Sublaminar Wires and Galvaston technique fusing into the pelvis
Both of her rods broke through, and she developed severe pain and recurrent deformity.
Her surgery was revised, but it broke again, and her quality of life has gone steadily down hill, with inability to to much of anything. Even sitting in a chair was painful for her.
Wednesday, we did a complex reconstruction, taking out all of the old hardware (which took over 3 hours to remove!), and then reconstructed her spine with strong pedicle screw instrumentation. I clearly identified the “crack” in the fusion mass, which is called a pseudarthrosis, and took out the tissue around that area, also performing an osteotomy at that level to help straighten her up a little more to help decrease the loads at that spot. I then performed a complex reconstruction using our new “quad rod” technique (closely coupled rod) on the R side, and a new parallel rod technique on the concave side on the L, which also dramatically improves the strength of the construct. Several pedicle screws were placed right around the area of highest load, using laminectomy at that level to help direct screw placement.
What is very cool is that some of the instrumentation techniques we used for Lindsay have been developed with our biomechanical research we are performing with NC State’s Department of Mechanical Engineering, where we are developing computer models and testing systems for figuring out the best spinal reconstruction techniques.
Bone Morphogenic Protein (BMP) as well as copious amounts of bone graft taken off of her posterior fusion mass was used to help improve the biological healing rate as well.
Lindsay is recovering very well in the hospital. Her surgery was one of the longest I have had to do during past 3 years or so, taking almost 9 hours to finish, in large part due to the time required to remove all of the old hardware with sublaminar wires.
She spent a couple days in ICU, but is now out on the orthopaedic floor ready to go home soon.
I think Brittany and I and the rest of the surgical team are still recovering too!
It’s worth it, however, to get Lindsay back on her feet, and back bowling again!
Some of our most thankful patients have been our revision scoliosis/kyphosis patients and their families.
Lloyd A. Hey, MD MS
http://www.heyclinic.com
Hey Clinic for Scoliosis and Spine Surgery
Raleigh, NC USA