Straightening spines, shortening recoveries

 

April 12, 2010 9:52:23 AM PDT
Scoliosis -- or a curvature of the spine -- is typically a condition associated with teenagers, but there are more than 800,000 adults living with the problem. Severe cases cause chronic back pain and force people to hunch over. Traditional surgery is a major undertaking, often including days in intensive care. Surgeons are taking a new approach by making a grueling surgery a little easier on the patient.

If you step into her kitchen, step out of her way -- but chronic back pain pushed Kelly Heyler's hobby to the back burner.

"I stopped giving dinner parties because I would be on my feet," Heyler told Ivanhoe. "It got too painful."

Heyler has scoliosis. Exercise and physical therapy helped for years, but gradually, the pain and her curve got worse.

"I was feeling like an accordion," Heyler said. "It would just take a lot of mental energy to get myself pulled up."

Surgery is the last resort because it's so extreme -- an up to 10-hour procedure that involves a six-inch incision, three liters of blood loss and stripping back muscles to reach bones.

"We've denied surgery to patients because we just don't think they can take it," Neel Anand, M.D., director of Minimally Invasive Spine Surgery at Cedars-Sinai Medical Center in Los Angeles, Calif., told Ivanhoe.

Dr. Anand is taking a new approach: the same surgery, but done through tiny tubes. Instead of stripping muscles from the vertebrae, the tubes open a 1-inch path through which surgeons can place screws and rods that realign and stabilize the spine.

"So we would drop a tube down and essentially work through that tube and do the same exact procedure -- relieve the disk, put in the spacer, realign the spine disk by disk," Dr. Anand explained.

The surgery is split into two procedures, two days apart to make recovery easier. In his 92 cases so far, Dr. Anand says he has seen less blood loss -- as little as a cup. Patients don't go to the ICU, and recovery speeds up from months to weeks.

"I had patients coming in two weeks to the office with literally no pain and very little requirements for pain in terms of medications, and that was really exciting," Dr. Anand added.

"Honestly, one of the things that I'm most excited about is I get up out of bed every morning, and I don't feel pain," Heyler said.

Three months after surgery, Heyler's curve went from 60 degrees to 15 degrees. She walks two miles a day and is back in her element.

"I made a rack of lamb and a lot of dishes, and that was my first full meal, and it was great," Heyler said.

Dr. Anand's studies show patients who are one to three years post-surgery are seeing the same results as those who had traditional surgery. Doctors say the true measure of success will come when they can compare the two procedures 10 to 15 years after the operation.


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