New way to treat Scoliosis in adults

March 18, 2010 3:27:03 PM PDT
Scoliosis, or a curvature of the spine, is typically a condition we associate with teenagers, but there are more than 800-thousand 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.

Chronic back pain pushed Kelly Heyler's cooking hobby to the back burner.

"I stopped giving dinner parties because I would be on my feet," Heyler said.

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

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

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

"We've denied surgery to patients. We just don't think they can take it," Dr. Neel Anand said. He is director of Minimally Invasive Spine Surgery at Cedars-Sinai Spine Center in Los Angeles.

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 one-inch path for surgeons to 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," Dr. Anand said.

In the first stage of two, surgeons operate through one inch incisions on the side of the abdomen to remove problematic discs and insert spacers to correct the curve of the spine. In a second procedure, two days later, surgeons place a screw or rod to stabilize the base of the spine at the L5-S1 level. They then operate through small incisions to insert screws and a rod that hold the corrected spine in place.

In his 92 cases so far, Dr. Anand has seen less blood loss -- as little as a cup. Patients don't go to the i-c-u, 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," Dr. Anand said.

Three months after surgery kelly'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, even 15 years after the operation.


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