Teens walking tall after surgery

EIGHTEEN-YEAR-OLD Adanna Boris and 12-year-old Kim Capiatha are walking tall and proud these days. Gone are the days when their shoulders drooped, and walking and sitting caused them pain. Their height has even increased a few inches since they had surgery in January to correct  scoliosis — curvature and twisting of the spine. They were among 38 patients who got free surgery from a team of US specialist surgeons brought to TT to do orthopaedic surgeries through a collaboration among the Health Ministry, Operation Rainbow and Missions International. The recuperation of local patients was described as “amazing” by the US doctors. Recovery usually takes six to eight weeks but Adanna and Kim were on their feet and able to walk after a few days.

Dr Taylor Smith, a member of the Operation Rainbow team which was in TT last week to perform more orthopaedic surgery, reviewed their cases and said there has been excellent progress. He said the treatment of scoliosis was very difficult and required a team effort. He said “hardware” — metal rods/pins — was inserted to rotate the spine. Then the vertebrae were fused. Adanna’s seven and a half  hour surgery was painless because she was under anaesthetic but she realised something was different when she awoke. “I could walk. I feel confident. Thank God. I am feeling straight, it is a beautiful feeling.” 

There was one adverse reaction to the surgery — one of her lungs collapsed. This was remedied with the use of a spirometer — used to help exercise the lungs and prevent them from collapsing. Dr Smith told Sunday Newsday scoliosis was eight times more likely to occur in girls than boys. The type of scoliosis seen in Adanna and Kim was idiopathic scoliosis which is of unknown cause and develops as the child gets older. Dr Smith said this type starts at the age of ten or 11 with the onset of puberty and the consequent growth spurt. Orthopaedic surgeon Dr Richard Gosselin said there are congenital (present at birth) cases of scoliosis in which the vertebrae do not fuse completely. He said it can take years for the disease to become visible and it can occur anywhere along the spine.

There is a simple test to determine changes in the spine. The child should remove his or her top and bend forward at a 90-degree angle. The parent then stands behind the child and looks at the shoulders. “The two shoulders should be at the same level. If one is higher or crooked it should be checked.” Dr Gosselin said screening is done in US schools and this assisted with early detection. “They send patients to the orthopaedist and seven out of ten times they were right. It is better to send three patients for nothing than have surgery later.” Adanna and Kim’s parents said there should be more public education about the disease. “This is a serious problem, they blame the school bags but the main thing is that it is detected as soon as possible. It can be difficult for them to do sports, exams,” said Rhett Boris, Adanna’s father.  She was diagnosed with scoliosis four years earlier after an X-ray was done. Prior to this she visited eight doctors who could not make a diagnosis.

However, the impact of the disease was evident: She could not sit up straight, walking was painful, she had to stop playing badminton, she often fell down because one leg was longer than the other, and one breast protruded more than the other.  Kim also had signs of scoliosis. When she stood up or walked she always leaned to one side, her right hip, breast and right shoulder protruded. Concerned with these changes, her father Mclean took her to a doctor two years ago. She was referred to the orthopaedic clinic at (EWMSC) Eric Williams Medaical Sciencees Complex and from there sent to a private specialist. 

Donna Capiatha, Kim’s mother, decided that a back brace should be used because she was afraid of the risks with surgery. Kim said it was very painful and she had to stop participating in sports — swimming and marital arts. She sat the Secondary Entrance Assessment last year and passed for St Francois Girls’ College. But the brace was not able to do much since the curve was already too severe. Surgery was the only alternative and Kim was willing. The seven-hour procedure was done on January 24. Kim spent most of the new school term recuperating.

Capiatha called for the Ministry of Education to assist with educating parents about scoliosis. She said someone knowledgeable about the disease should visit schools to talk to parents. One of the things she did to educate others was to take literature on the condition to Kim’s school. The principal posted it on the school’s notice board. “Parents out there are not aware unless it is too late. We were not aware, we did not know.” Capiatha said with early detection there is the possibility that the child can use a brace to correct the curve “before it reaches critical and surgery is required.” Although she was initially reluctant about surgery she now understands the benefits. Left untreated, scoliosis affects the heart and lungs.

The severe twisting of the spine can cause breathing problems because the ribs press against the lungs. It can also cause spondylosis — an arthritic condition of the spine. Boris is spearheading the formation of an association of parents of children with scoliosis. The aim is to educate parents so they can recognise the early signs of the disease.