Surgery Dec. 22 and No Neurologist Scheduled

[timalosa]

My 12 year old daughter is scheduled for surgery on December 22nd. She is healthy with the exception of having scoliosis (T45/L40 and probably fusing T5-L1). We have visited three surgeons and have settled on the second one since he and the third pretty much said the same thing. However, I just discovered that he is not scheduling a neurologist for the surgery. He performs hundreds of spinal surgeries per year and has not had any neurological complications from damaging a spinal cord. This was his response when I asked about spinal cord monitoring:

"With modern instrumentation techniques that do not use distraction, (rather translation and derotation) I only find monitoring useful for the very large scoliosis corrections and some congenital scoliosis corrections and have never had a neurologic complication. Years ago when most of the correction was done with Harrington rod distraction, the cord could potentially get stretched. The monitoring wires attached on the face and scalp do tend to cause the adolescent a lot of stress just before surgery. Sometimes you do get confusing data from the monitoring intra-op that can slow the progress of the surgery, resulting in prolonged "open wound" time. For these reasons, I do not routinely use the monitoring for routine adolescent and adult scoliosis."

Is spinal cord monitoring not a part of standard operating procedure for spinal fusion? Would I be crazy not to insist on it? Should I just TRUST the doctor?

[LindaRacine]

Hi...

First, having a neurologist (or neurosurgeon) present is a separate issue from spinal cord monitoring, which is performed by a non-MD.

To be honest, I don't think I've heard of present day scoliosis surgery being performed without spinal cord monitoring, but if you trust the surgeon, and have talked to at least a few of his patient references, I guess I personally wouldn't let this get in the way.

Who is the surgeon?

Regards,
Linda

[Laura P]

Linda,
We are scheduled for Dec. 16 and that was one of the questions I asked our surgeon last week during our preop visit. He said absolutely she would be monitored with the neuro wires during the entire surgery. I don't know what I would do as it is a tough decision. We are leaving our home town, where there are a couple of surgeons here that do this, but our doctor was recommended by two outside sources one of which is from Vandy. I know it is hard but I would go with my mothers instinct. Good luck.

Laura P.

[timalosa]

The doctor's name is Lloyd Hey in Raleigh, NC. He was at Duke, but opened a private practice in Raleigh. I've talked to a parent of one of his patients and honestly, she wasn't sure which vertebrae were fused in her daughter, didn't get a second opinion and doesn't know whether spinal cord monitoring was performed during her child's surgery. She just felt comfortable with him and because he recommended the surgery and said he'd do it if it were his daughter, she went ahead with it and was pleased with the result/decision. Her daughter was even back to doing back handsprings after 2 1/2 months (not okayed by dr. of course).

I trust the dr's instincts. I just don't want anything to go wrong (child paralyzed for life) and then blame myself later for not insisting on the monitoring.

[Cheryl M]

We just had spinal fusion surgery in Charlotte with Dr. M. Wattenbarger with OrthoCarolina. Along with Shriners in Greenville, SC, I think he is considered one of the best in our area. My daughter's curves were similar to your daughters and DR. W recommended we at least try the brace. A lot depends on the risser signs for growth. Of course, the brace didn't work and we ended up with surgery. Just wanted to give you another Dr. in case you wanted another opinion in the NC area. The spinal monitors were used during my daughters surgery and the anesthesiologist was available in case they saw signs of needing to do a wake-up test. They didn't need to do this.

Hope this helps.

Cheryl

[Sheena]

with my operation, they connect me to a spinal monitor, and if somewhere something went wrong, they would have stopped the procedure.
hope your op goes well!!!!!
wishes
sheena xxxxxxx