Suzanne Sullivan, a 21-year old New Yorker, can finally stand up straight - thanks to a specialized surgical procedure by Keith Bridwell, MD, a Washington Univeristy orthopedic surgeon at Barnes-Jewish Hospital.
When Jack Engsberg, PhD, director of the BJC Human Performance Lab, was told of Sullivan''s outcome after spine surgery, his reaction was ""If they were able to help her, it''s a miracle." And he should know - he sees patients on a regular basis who struggle with everything from lost limbs to cerebral palsy and has learned to never be too optimistic.
Sullivan came to Barnes-Jewish Hospital suffering from a painful spinal deformity called a fixed sagittal imbalance, a condition that leaves a person bent over at the waist and unable to stand upright. The deformity is something Keith Bridwell, MD, chief of pediatric and adult spinal surgery at Washington University School of Medicine, has treated many times at Barnes-Jewish Hospital and St. Louis Children''s Hospital. In this case, though, things were very different.
She was so pitched over and so young," Dr. Bridwell says. "Normally, the people we see with this are 40-75, not 21 years old."
And Sullivan''s case was severe. Picture an elderly woman with slumped shoulders, and one can visualize a slight example of the deformity. Sullivan, however, was bent over at the waist to the point where she was bent practically in an "L."
"I walked like a duck, bent over with my head up. That''s the best way to describe it," Sullivan says.
Sullivan had dealt with the problem since her early teens. The deformity appeared after a ballet accident at age 14. Subsequent back pain led to her first surgery at age 16 in New York, with a procedure called an anterior lumbar interbody fusion with cages. The intended outcome was for the cages to fuse with her spine. The fusing wasn''t complete, however, and a second surgery was performed two years later.
Unfortunately, the surgeries weren''t successful. In fact, Sullivan''s condition worsened. "Prior to that, it was just pain," she says. "After the surgeries, I noticed I couldn''t sit up straight." The cages had actually begun to rub away at her spine and sent her from mere back pain to a life-changing deformity.
"You try to define yourself as what you are," Sullivan explains. "For me, I was a dancer, but then I couldn''t dance … then I''m a high school student, but then I''m a home-schooled high school student. It changed me."
After consulting with top spinal experts on the East Coast, the recommendation was that Sullivan undergo a procedure called a pedical subtraction osteotomy. However, many of those experts were nervous about operating on someone as young as Sullivan and said there was only one person in the United States they trusted for her case. Among her physicians was Thomas Haher, MD, of St. Vincent''s Hospital in New York. "He said there were six doctors in the world he called ''Wizards'' who docs like him went to with questions, and the only one in the United States was Dr. Bridwell," Sullivan says.
Sullivan flew to St. Louis to meet with Dr. Bridwell at Barnes-Jewish Hospital. "We saw so many doctors who were unsure of themselves about my case," she says. "He was the one guy who didn''t see this as a problem and offered us a solution - and said that I had a chance to be fixed."
Other surgeons in the United States perform pedical subtraction osteotomies, but Dr. Bridwell is recognized as one of the world''s leaders in treating the deformity. He and his colleague, Lawrence Lenke, MD, professor of orthopedic surgery at Washington University, have now done more than 60 of these procedures, considered one of the highest totals in the world.
The objective of the surgery is to restore erect posture, which further enables a patient to walk upright, normalizes appearance and generally makes everyday life more normal. This is done by carving a V-shaped wedge out of the bony spine (an osteotomy is surgical removal of bone). If successful, normal lumbar (lower back) lordosis (backward curvature) is restored, allowing a patient to stand up straight.
Dr. Bridwell conducted the surgery on Sullivan May 7, and thus far, results have been phenomenal. "Before, when I would lie down, my chest was down here," Sullivan says, pointing at her waist. "When I woke up from surgery and my back was flat for the first time in memory, I was like, ''Where did my chest go?''"
Sullivan will have to wear a protective brace for the next four months, but is walking pain free for the first time since that ballet accident seven years ago. Amazingly, she stood and walked the day after surgery.
Prior to surgery, Sullivan was sent to Dr. Engsberg''s Human Performance Lab for a gait analysis, where her condition remains one of the more severe he''s seen. "I''ve never seen someone so young pitched over like she was," Dr. Engsberg says. The computerized images of Sullivan''s gait (stride and balance) after the surgery show an almost normal pattern.
Sullivan and her family credit prayer right along with surgical expertise. A website created to update those back in New York on her progress is a testament to her friends and supporters. Set up through Yahoo!''s free Geocities Web domain, Yahoo! asked Sullivan to purchase a domain name because the free site had suffered too many hits. "It had more than 900 hits, so they made me pay for it," she says. "Can you believe that?"
Despite her problems, Sullivan began pursing a career in nursing school at Seton Hall University in New Jersey three years ago. She''ll be going back to New York in a few weeks, but now that she''s seen Barnes-Jewish and the Washington University Medical Center campus up close, she''s toying with the idea of finishing nursing school in St. Louis. "You take all of the hospitals in New York, push them together, and maybe they''re the size of this place (Barnes-Jewish)," Sullivan says. "I''ve just been amazed by all of the stuff going on here."
There are many amazing stories, but few as interesting as this 21-year-old "miracle" who describes life after seven years in agony in simple terms: "It''s good to be back."
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