Rachel Murnane

Rachel Murnane feels free. The June 2006 spine surgery at Mayo Clinic to correct Rachel's worsening scoliosis liberated the 15-year-old Sparta, Wis. resident from a steadily deforming and increasingly painful body.

"I'll have a normal back for my whole life now," Rachel says. "We definitely made the right choice for me."

While Rachel's scoliosis was manageable in her pre-teen years, she was developing such a pronounced curve in the spine — measured as a 59 degree curve on a scoliosis assessment scale known as the Cobb angle, in which 0 is a straight, normal spine — that her Mayo Clinic physicians knew a brace could not contain the spinal deformity. Rachel was referred to Mayo Clinic after a brace she received in Wisconsin failed to correct the curve. "Surgery is an extreme step and we try hard to work with teenagers and families to get them into proper braces at an early age to prevent abnormal growth pattern and to avoid the need for surgery," explains Rachel's Mayo Clinic physician, orthopedic surgeon William Shaughnessy, M.D. "But there are some cases, like Rachel's, that are too extreme for bracing."

Pre-operative X-ray

Pre-operative

Pre-operative

Spinal Fusion Surgery
Extreme cases require extreme measures: a six-hour-long surgery during which surgeons corrected the growing S-curve in Rachel's back, realigned the vertebrae and stabilized the new straight spine with two parallel rods.

While Rachel's nerves and brain registered pain immediately after the surgery, her bones waxed conversational; they sent messages of an altogether different tone. Cued by the presence of the bits of bone stock placed into her spine, her natural bone-healing response embraced the fractured pieces. Rachel's spinal vertebrae began to fuse together — to stabilize permanently, straight and strong.

A 'Snowball on a Hill'
No one knows exactly what causes scoliosis, or how to predict which patients will develop the worst deformities. The hope in scoliosis research is that a genetic test will one day be developed to assist with such predictions. But no such test is available. What is available is evidence showing that if a spinal curve continues beyond 50 degrees there is a high likelihood that it will continue to worsen for the remainder of a person's life. This was the path Rachel appeared to be on. Says Dr. Shaughnessy: "There is a certain size curve beyond which bracing doesn't work. A curve of 50 degrees is big enough to create problems. It's like a snowball on a hill — it has a risk of getting worse rapidly and just getting bigger and bigger, even after a child stops growing. Maybe they don't look bad or suffer much as teenagers, but by age 60 or 70, their lives may be severely restricted by this condition — and they may be too old to have the surgery that can fix it."

Post-operative X-ray

Post-operative

Post-operative

Rachel's Recovery
After five nights in the hospital recovering with the help of pain medication, Rachel returned home to Wisconsin. Her convalenscence consisted of no brace or cast, but rather a gauze bandage and caution. Her father moved her bed to the main floor of the house to eliminate the exertion of stairs, and together, the entire family set about healing. "We timed it for summer so we wouldn't have to keep much of a schedule, and that was a good move, it really went pretty well," says Rachel's father, Raymond. Adds Rachel: "I just lounged around the whole summer. Looking back, it was a little surprising how easy it was to get through."

By the summer following her June 2006 surgery, Rachel was running and swimming and playing softball again. She even entered a 2 mile race with her father — "and I placed," she says. "When she did that, I really knew she was all back, and everything was going to be just fine," Raymond says.

Rachel's advice for teens and their families managing scoliosis: "Try to stay positive, and if you feel worried or scared, always talk to people about it. There really is a light at the end of the tunnel. I know, because I went through it and the surgery really helped. It's given me a lot of confidence."