Dreams and Dramas

A teenage girl was referred to one of our doctors for some serious correction of her back problem - a dextro-scoliosis of T4 to T11 with an 80 degree Cobb angle of the curve. This is my first time to assist a spine surgery and yes, it was a heck of an experience with continuous shots of C-arm fluoroscope. 

Patient’s X-Ray result before the surgery.

Exposure had to be done such that all the intrinsic muscles were stripped off the thoracic vertebrae & posterior-most proximal rib surfaces.

Pedicle screws were used for moving & correcting the curved thoracic segments particularly in T3, T5, T9, T10, T11, L1 and L2. The surgeon later removed the L2 pedicle screw & simply shortened the left rod to match the right. The really tricky thing was the fact that the sizes of the pedicles of the thoracic & lumbar vertebrae were sub-normal & assymetric, making pedicle screw fixation a real pain in the neck.

The former 80-degree thoarcic curve is now nearly straight. The surgeon did a wake-up test before finalizing the correction - the anesthesiologist cuts down on the anesthetic gas, wakes the patient up & asks the patient to move both lower extremities in order to assess whether the spinal cord inside the bony vertebral column has not been over-distracted (& thus rendered partially or fully paralyzed). In this case, patient was able to move both lower limbs with vigor, so the surgeon accepted the correction. Closed the incision and was transferred to recovery room.

It was an 8-hour long surgery. Both my feet and eyes ached after the whole thing but I left my mind in the operating table wondering how did the team managed to deal with this case. Thus, Orthopedics is not for the weak-willed individuals. I see myself performing such surgeries in the near future.