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| SPINE ASSOCIATES
Houston Beaumont |
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New & Notable |
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STRAIGHT & PAIN FREETechnique fixes spine curvature more effectively Author: Deborah Mann Lake; Special to the Houston Chronical A surgical procedure that straightens individual vertebrae, not just the spine, shows promise for being more effective at straightening the spine of people suffering from scoliosis. Called "translation and segmental derotation," the procedure has been used for the past three years by Dr. Richard Francis, assistant professor of orthopedic surgery at the University of Texas Medical School at Houston. "The traditional surgery is to lengthen the spine by stretching it at the ends. It's like looking at a twisted rubber band. You can either pull it to untwist it or you can untwist it and lengthen it at the same time," said Francis, who said translation and derotation can result in a correction of 75 percent instead of the average 50 percent achieved with traditional surgery. The spine normally forms a straight vertical line when viewed from the back. Scoliosis is an abnormal sideways curvature of the spine and most often affects the spine in the chest area and lower back. Idiopathic (of unknown cause) scoliosis, is the most common form of this debilitating condition and is usually diagnosed in children after the age of 10. Scoliosis affects approximately 2 percent of the population. According to the National Institutes of Health, of every 1,000 children three to five will have enough of a curve to require treatment, which can range from a brace to surgery. Symptoms of the disease develop gradually and may include: • Visible curving of the spine • One shoulder that is higher than the other • Abnormal gait • Back pain • And in severe cases, the rib cage may become deformed, leading to heart and lung problems. In some scoliosis cases, individual vertebrae will rotate. Francis' technique corrects the rotation of key vertebrae at the apex and ends of the curve, as well as in-between. After the correction, the bone is held in place with rods and screws and fused with the patient's own bone, usually taken from the hip. The traditional surgery, called compression and distraction, also uses rods, screws and fusion, but treats just the ends of the curve. While mild curvature may not progress with age, a curve of 45 degrees or more will generally continue to progress and require surgery, Francis said. Surgeons prefer to wait until the spine stops growing, at approximately age 14 for girls and 16 for boys. Josh Deitel, 17, had a curvature that doctors expected would get worse. Diagnosed at 11, the senior at Cypress Springs High School was experiencing daily pain. "Over time, I felt it get worse and worse as far as pain, especially in my lower back and neck," Deitel said. "Even walking upstairs became painful and I was starting to hunch over a little bit." He underwent surgery June 5 and could tell the difference the first time he got out of bed. "The pain is much better now, and I can tell I'm getting straighter every day," he said. In some cases, adults whose scoliosis was not corrected earlier will turn to surgery when they begin experiencing more debilitating problems. Freida Shepard, 54, who lives on Lake Sam Rayburn, always thought her back problems were due to a school bus accident when she was 7 years old. But the pain began to escalate when she was in her late 30s and she eventually started limping. "My right leg felt like it was getting shorter," she said. "I also noticed that my left shoulder was becoming more rounded and I was becoming less flexible." Shepard underwent surgery on two discs in her neck, which corrected the shoulder pain, but Francis was hesitant to operate on her back because he assumed the pain was caused by nerve damage from the bus accident. Shepard felt her pain was getting worse, and Francis suggested doing a magnetic resonance image (MRI), which revealed for the first time the scoliosis that had gone undiagnosed for decades. She underwent surgery Sept. 4 and, like Deitel, could tell the difference immediately. The drawback to the surgery, both patients said, was the amount of post-surgical pain. Deitel spent five days in the hospital and said he felt back to normal in six weeks. Shepard was in the hospital six days, including two in intensive care, and said she was "still pretty miserable" the first week at home. But both said it was worth it. "The first day I got up, I didn't limp," Shepard said. "Now I can drive and walk a mile and I feel much better."
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