Severe spinal deformity correction

As a major tertiary center for neurosurgery, Mayo Clinic is able to correct even the most severe spinal deformities. Procedures on complex deformities are undertaken in children and adults, and are available at all Mayo Clinic campuses.

Recently, neurosurgeons at Mayo Clinic in Jacksonville, Florida, performed a complex surgical correction of a double major curve in a young woman with scoliosis, with excellent results. The patient was diagnosed in childhood with scoliosis, which remained stable through adolescence. However, the scoliosis worsened in early adulthood, resulting in an increasingly noticeable hump on her back, pain that interfered with her functioning and quality of life, and shortness of breath. Her condition hindered her ability to work and to care for her young child.

The patient was evaluated by H. Gordon Deen Jr., M.D., and Mark A. Pichelmann, M.D., both consultants in Neurosurgery at Mayo Clinic in Jacksonville, Florida. The surgical team included both of the neurosurgeons as well as a neuroanesthesiologist, an intensive care specialist and nursing staff with experience in complex spinal surgeries.

The surgery was performed in two stages: a fusion of the anterior lumbar spine between L5 and S1, followed a few days later by a posterior decompression and fusion of the spine from T3 to the pelvis, including insertion of rods and screws, and bone grafting.

"We were able to completely straighten the patient's back, significantly relieve her back pain and help her breathing capacity as well," Dr. Deen says. "Our patients can have an excellent result, even with very complex surgery, because of our team approach. For a complex problem, it's important to have a team of experts helping to take care of the patient."

The procedures for the double major curve correction utilized intraoperative monitoring of the spinal cord to enhance the patient's safety as well as intraoperative CT image guidance. The enhanced image guidance available at Mayo Clinic facilitates placement of more-robust implants with novel trajectories to better stabilize complex spinal deformities.

"Image guiding also allows us to identify any issues and make modifications during the operation, as opposed to getting a CT two days after surgery and possibly having to return to the operating room to make corrections," Dr. Deen says.

These technologies, along with improvements in instrumentation and surgical techniques, enable Mayo Clinic neurosurgeons to treat more complex cases than was previously possible. "It is a real pleasure to see a young patient benefit from Mayo Clinic's expertise — to see how she was able to recover and return to her normal activities," Dr. Deen says.