AIS: Thoracolumbar curve in a golfer who is still highly competitive post-operatively

Description

In 2006, a 14-year-old male from Mississippi came to see Dr. Bridwell. He had a fairly large, stiff, and progressive thoracolumbar curve. The curve was at 75º. He and his family were interested in substantial correction, but they didn’t want a long fusion. The patient has aspirations to be a Division I golfer, so he was concerned about losing his ability to play well.

Treatment

Dr. Bridwell used an anterior approach—that means he approached the spine from the front of the body. Specifically, he performed a thoracoabdominal approach. This kind of approach is well tolerated in teenagers and young adults. Dr. Bridwell used an anterior approach—that means he approached the spine from the front of the body. Specifically, he performed a thoracoabdominal approach. This kind of approach is well tolerated in teenagers and young adults.
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Dr. Bridwell chose not to perform the surgery posteriorly because, even with pedicle screw implants, he would have had to fuse more vertebrae in order to get the same amount of curve correction he achieved with the anterior approach.

Dr. Bridwell used a 2-screw/2-rod construct for this patient.
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Result

After surgery, the patient’s curve was reduced to 12º. At two years after surgery, he’s doing well, and his golf score is better than it was before he had surgery. Post-operatively, he has returned to being a scratch golfer and is currently highly recruited for Division I college golf schools.
Patient's Comments: 

In 2001 I was diagnosed with scoliosis at age ten.  I was young, hence they were not sure if it would progress or not.  I was able to continue playing baseball and golf.  They did make me stop racing dirt bikes, but that did not slow me down.  By the time I was in middle school I had stopped playing baseball and was playing only golf and serving as a camera man for the football team. 

In 2003, after football season, I went in for another check-up, and in two years my scoliosis had progressed from a 30 degree curve to 60 degrees.  My body was beginning to look deformed, such as my shoulders were crooked, my hips were out of line, and the  right side of my back was higher than the left.  It was evident that surgery was necessary at this point.  My parents then began to search for just the right surgeon to perform the necessary operation, and after nearly two months we decided on Dr. Keith Bridwell.  He was located at Washington University Hospital in St. Louis, MO.

The surgery was eventually scheduled for November 4, 2004.  My curve had progressed up to 75 degrees by then.  I can remember having to pick out the flavor of anesthesia I wanted to smell before falling asleep.  Lying on the cold metal operating table did not help me already being extremely nervous, but the nurse came and held my hand until I counted backwards from ten to one and fell asleep.  After the five hour long surgery, and having removed half a rib, inserted two stainless steel rods, and twelve screws, the doctor woke me up enough to tell me to move my toes.  Then he got on the phone and called my parents and told them the surgery had gone very well and I was doing great.  I was then transferred to recovery for a few hours, and then moved to the Intensive Care Unit for a couple of days.  While in Intensive Care, I had my headphones on listening to one song “over and over again” by Nelly and Tim McGraw.  I was surrounded by many other children who were screaming and crying, and I could not hear them with my headphones on.  The headphones helped me to keep my mind off of all the pain I was in.  Four days after the surgery, I received a call from my eighth grade principal.  He was calling to tell me they were praying for me, and how I was voted Mr. Madison Middle School.  This brought an enormous amount of happiness to me during a time while I was in excruciating pain. They encouraged me more than they could ever imagine. 

When I was finally well enough to get out of bed, I realized I was three inches taller than I was before I went in for surgery.  Before surgery, I was shorter than my mom, and after they put all of the implants in my back, I was immediately looking down on her.  That was probably one of the coolest things I could think about at the time.  It was hard to imagine how much they actually moved my spine, and how it affected me so immediately.  After spending a little over a week in the hospital, I was released, but I could not go home until I got my weight up.  I went into surgery weighing 98 pounds and afterwards I weighed 87 pounds.  I was to get to 100 pounds before I could make the long trip home.  Luckily I had an aunt who lived in St. Louis, so we stayed there for about a week and a half, and I was confined to lying in bed, going on walks, having milkshakes, and eating meals. 

When I finally got home, I was so excited to be back with my friends and family.  It had been almost a solid month since I had seen any of them.  While I was home recuperating, I was fortunate enough to have a teacher willing to spend her spare time at my house tutoring me on what I had missed.  Mrs. Matthews was the teacher, she was also my eighth grade algebra teacher, and spent countless hours helping me learn while I was not in the mood and I was in an immense amount of pain.  After battling pain all throughout Christmas break, I returned to school to finish out my eighth grade year, and to this day is my most memorable. 

The following summer I began to play golf again competitively around Mississippi.  I was limited to which clubs I could use because of the doctor’s orders.  This put me at a disadvantage compared to the other players, but I did not let that bother me at all.  I was just thankful I could even play again, and to be able to compete with my friends the following summer, that was just something to endure.  When the summer season ended, it was time for the Cup Teams to be announced, along with an awards ceremony.  I was invited to the ceremony not knowing I had been awarded the Sportsmanship Award.  When they called my name, I was at a loss for words; I did not know what to say except for thank you to everybody for all of the support.

Now it was time for football season to start again, and I was in charge of the camera.  I enjoyed being the cameraman because I got to ride the bus with the team and hang out with a number of my friends.  I remained cameraman for the High School team all throughout my tenure at Madison Central.  I was also back on the golf team, and doing really well in that matter.  In 2008 I had what I would consider my most successful season with golf.  I won three tournaments, including the 5A state championship, and also received the Pop Star Award for being the No. 1 golfer in the state of Mississippi that year.  I also qualified for the National Big “I” Championship, which was played in Boise, Idaho.  Then in September of my senior year, I was traveling with the football team to Lafayette County, and called Coach Ernest Ross (Ole Miss Men’s Golf Coach) to check in with him and ask about the team.  Well during the conversation, Coach Ross offered me a scholarship to play golf for the University of Mississippi.  I was not hesitant to say yes.  That was one of the greatest days of my life, and we would end up winning that football game later that night.  After that game, I did away with the camera and focused primarily on my golf game.  I would end up winning two events as a senior, including a District Championship, and finishing fourth place at the State Championship.  I would have a strong summer to follow the fourth place finish.

I finished third in a tournament in Alabama, and competed in the Mississippi State Amateur for the first time.  The night prior to the first round of the tournament, the tournament director, Margo Coleman, was having a glass of wine with my mom at our room, and she asked me if I was trying to win the tournament.  I just laughed and said “naw, I just want to make the cut.”  However, I would end up leading the field after the first two rounds.  After the third round I had the lead taken from me by rising Ole Miss Star, Jonathan Randolph.  He had played really well Saturday, and had a five shot advantage going into Sunday.  Halfway through the final round, Jonathan still had a five shot advantage, and when we made the turn to No. 10 it was like I flipped a switch.  I birdied numbers thirteen and seventeen to tie it up, after he made some mistakes.  Although on the final hole, with an extremely large crowd, I would miss my birdie putt and he made his for him to take the title.  Even though I did not win, after all I had been through with my surgeries, not knowing if I was ever going to play golf again, I was proud of all I had accomplished and I was just happy to be playing the game I loved most.

If you have any questions or would like someone to walk you through this case, please call Dr. Bridwell's office at (314) 747-2526 or (314) 747-2560 and ask to speak to either Bernie or Jackie and they or one of his staff will be happy to explain the case in greater detail to you. To learn more about how to understand SRS and Oswestry Scores, please click here.