Scoliosis is an abnormal curvature and rotation of the spine and is one of the longest and most complicated orthopedic surgical procedures performed on children. It generally occurs during the growing years, especially during the growth spurt from 10 to 17 years of age and is more frequently noted in females.  Doctor’s don’t know what causes the most common type of Scoliosis, although it appears to involve hereditary factors because the disorder tends to run in families.

    School screenings consist of examining children while standing upright and during a “Forward Bending Test,” which requires the child to bend over at the waist, parallel to the floor, while the school nurse or doctor checks for visible signs of uneven shoulders, protruding shoulder blades, uneven arm positioning, or bulges in the back. A doctor may order an initial X-ray to confirm the diagnosis and determine the spinal curvature.  Treatments depend on the child’s age, stage of growth, and the degree and pattern of the curve.  Spinal curves of 25 to 40 degrees typically respond well to bracing technology and spinal curves greater than 40 to 50 degrees generally require surgery. 

    Vertebral body stapling has been proposed as an alternative to bracing in the treatment of scoliosis.  Staples are surgically inserted into the vertebrae and are designed to prevent further curvature of the spine.  Spinal fusion is surgery to permanently connect two or more vertebrae in your spine, eliminating motion between them. It involves placing extra bones to fill the space between two spinal vertebrae.  The bone graft material used in spinal fusion may be in a preformed shape where plates, screws, or rods are placed to hold the vertebrae and graft in place to promote healing after surgery. Once the bone grafts heals, the vertebrae are permanently connected. 

Nester Story –

It was December of 2007 when we gave Abby a hug of encouragement for her voice/piano recital and realized that one of her shoulder blades was protruding, not wanting to draw attention before the recital; we waited till afterwards to look at her back to realize that we were dealing with a curved spine.  We then made an appointment with our local pediatrician who performed an x-ray to confirm what we feared.  We were then referred to Dr. John Purvis with the Pediatric Orthopaedic Specialists of MS in Jackson.  Abby’s x-ray determined her curve to measure 25 degrees.  It was then decided that we would have her fitted for a TLSO brace.  This brace was made out of plastic and was custom molded to fit closely under her arms and around the rib cage, lower back and hips.  This brace was to be worn 23 hours a day, only to be taken off to get a bath.  Needless to say after the newness wore off and it became summer time it was harder to get 23 hours wear.  During the months and year to follow we had several office visits and x-rays to see whether or not the brace was being effective.  With much disappointment the curve was still advancing to the point where we knew surgery was the only option.  In was then in April of 2009 when we met with Dr. Purvis concerning the procedure of surgery which would involve a spinal fusion.  Our next step was to set a date for surgery and speaking with Dr. Purvis it would be late July (2009) before he had an open date.  We looked at Abby during this discussion to see the tears in her eyes.  Not so much tears for the surgery, tears for the fact that she had just made the Clarkdale High School Cheer Squad and this would mean that she would not be able to cheer for the upcoming football games.  With much discussion with the doctor we were opt to set her surgery date for October.  This would allow Abby to cheer for seven games and taking the chance that her curve would not get much worse.  During our discussion Dr. Purvis informed us that he and his staff were relocating from the Baptist Hospital to the Blair E. Batson Hospital after July and would not be equipped to perform any surgeries till after the first of the year 2010. 

    Dr. Purvis then referred us to Dr. Lawrence Haber, whom he was joining at the University of MS Medical Center.  It was late July (2009) when we were able to see Dr. Haber, and needless to say we were all impressed with his personality and medical reputation.  It was no question about Abby needing surgery, her curve by now had progressed to 68 degrees and the first opening he had was in mid October (2009) which coincided with the time we had originally planned.  The preparation for surgery involved Abby having a MRI, taking iron tablets daily and donating 2 units of her own blood a few weeks before surgery, so if additional blood was needed, she would have her own.  Due to Abby’s age and weight, she was only able to give one unit and her Dad gave the 2nd unit. On October 12, 2009, we arrived at 6:00 a.m. at the Blair E. Batson Hospital and were told that surgery would take 5 to 6 hours.  Finally after 5 ? hours Dr. Haber met with Bryce and I to tell us that he was very pleased with the process; later x-rays showed that he was able to correct Abby’s curve from 68 to 27 degrees.  The surgery involved installing two stainless steel rods each being 16 inches long, secured by 18 screws and 2 hooks into her spine.  After surgery, Abby spent 24 hours in ICU before being placed in a regular room. The next 4 days in the hospital Bryce and I were filled with such emotions to see the pain that Abby was enduring.  She was on morphine for the pain and needed to be turned often, which required both of us to move and position her so as to lessen any additional pain.  It was on the 3rd day when “Lucy” our physical therapist arrived with instructions to have Abby up and beginning to walk.  Needless to say her mother had to leave the room during such sessions.  We were able to bring Abby home late on the 5th day after surgery.  We were blessed with neighbors who loaned us a hospital bed to use during her recovery at home. Abby’s recovery was slow; she missed 5 weeks of school and was limited to lifting no more than 10 pounds thereafter for several months. 

    During this process of Abby’s treatment we became aware that Emily was showing signs of Scoliosis, also.  For months before we were constantly advising Emily to keep her shoulders back and stand-up straight, thinking that Emily was not using good posture and not realizing that she too was a victim of scoliosis.  During one of Abby’s appointments with Dr. Purvis, Emily was also examined and x-ray showed a spinal curve of 34 degrees. Now that it was obvious Abby’s brace was not controlling the curve movement we all decided that most likely it would not be effective for Emily either.  As the months progressed and we were anticipating Abby’s surgery as well as keeping a check Emily’s curvature, it became apparent to us that she would need surgery also, even though she stated it would not be.  The girl’s personalities are totally different; Abby being the more daring and happy go lucky type and Emily the more reserved and sensitive type.  So it worked out for the best that younger sister experience the ordeal first, and as Emily witnessed the Lord blessing her sister throughout the process, she gained the confidence to undergo it as well.  We all had become very confident of Dr. Haber, so it was no question who we would want to perform her surgery.

    Emily’s surgery was scheduled during the summer of 2010 in order to prevent her from missing school, however as the time drew close, schedule complications and other issues arose.  Just a week before her surgery, we were notified that Emily’s blood test showed a false-positive reading for Hepatitis C, indicating possible liver damage.  We rushed to have more blood tests done to determine if this was true or not, with results not back in time to continue with surgery as planned it now looked as though all would have to be postponed until sometime in the fall.  However, after much worry, prayer, phone calls back and forth to doctors and labs, we received a call late one evening from Dr. Haber’s nurse that he had a surgical cancellation plus a postponement of a seminar he was to attend and therefore we had a surgery date of July 19th 2010, just a week after the original date. 

    Emily’s surgery and recovery went much smoother than Abby’s due to at least a couple of reasons: we all knew what to expect and Emily had such peace and confidence.  She was a great patient, always expressing thanks, even to the nurses when drawing blood or “Ms Lucy” when administering her PT.  Her curvature was a bit different than her sister’s, and the spinal fusion only required 12 to 14 inch rods secured by 15 screws and a few hooks.  She got out of the hospital a day earlier than her sister and was up and going within 4 weeks after surgery.

    We are glad to say that Abby was back on the cheer squad for this school year and even though she has restrictions from performing stunts or tumbling she was able to cheer at the football games.  Emily only missed a portion of the first week of school and is enjoying her junior year with her school activities and musicals.

    We have truly been blessed with two daughters who have both shown such Christian faith in their time of surgery and recovery, and as we look back at the times of changing of doctors, hospitals and rescheduling surgery dates we know that it was always in the Lord’s timing.  To our family, friends and church family, we can not thank you enough for all of your thoughts, prayers, calls, cards and visits.