Amazing surgery helps Thomas walk tall
PUBLISHED: 08:48 02 June 2006 | UPDATED: 10:56 22 October 2010
Scoliosis - curvature of the spine - is a condition that can leave children crippled for life, but revolutionary surgery at Norfolk's flagship hospital is offering hope to families across East Anglia that their children grow up straight and tall.
Scoliosis - curvature of the spine - is a condition that can leave children crippled for life, but revolutionary surgery at Norfolk's flagship hospital is offering hope to families across East Anglia that their children grow up straight and tall. Health Correspondent MARK NICHOLLS reports.
To see three-year-old Thomas Smith running around his garden kicking a football, it is hard to believe this is a child who will need two operations a year until he is a teenager.
Thomas was born with scoliosis - curvature of the spine - and the diagnosis was that it would get progressively worse, leaving him crippled by the time he reached his late teens.
But a revolutionary operation using hi-tech instrumentation will mean that Thomas will grow into a strong, tall and straight-backed young man, able to enjoy life to the full.
At the beginning of April, he underwent six hours of surgery at the Norfolk and Norwich University Hospital to straighten his spine with screws and “growing rods” beside it.
Consultant orthopaedic and spinal surgeon Am Rai says the reason Thomas will need two operations a year until his teens is that every six months the rods will be extended.
“Effectively, the instrumentation will grow as Thomas grows,” said Mr Rai.
More than a dozen children are seen at the N&N's spinal clinic each week with the condition and three major operations on the scale of the surgery Thomas had are carried out each month to straighten curved spines.
His parents Iain and Lorna from Hemsby noticed that Thomas was not standing up straight just before Christmas 2004. But it was only later, when his mother took him to the doctors with a cough, that suspicions were aroused.
Mrs Smith said: “The doctor asked me to take his top off and he saw straight away that his shoulders were not correct.”
The GP, it emerged, had seen cases of scoliosis before and made arrangements that eventually led to a referral to the N&N to see Mr Rai.
“It was awful for us when he said it was his spine,” said Mrs Smith. “We thought that perhaps he would have a brace on for a year or two, we did not know anything about scoliosis. But then we were told that Thomas would have to have an operation because it was so severe, we were devastated.
“We were told that if he did not have it done, by the time he was eight he would be leaning right over and it could affect his lungs.”
His parents are pleased the major operation is over, though realise that he will need two hour-long ops a year for a decade.
“We feel as though we have got over the biggest hurdle and we were glad to have it done and are now just looking forward to the time when it is all over.”
Speaking to a family in a similar position offered them support at a difficult time in the process, and that is a factor in Mr and Mrs Smith, who have a daughter Natalie, 6, deciding to speak about the operation that will help Thomas lead a normal life.
Like many parents faced with such a major operation, the Smith family had doubts over whether they could or should put their son through such a trauma.
“I kept thinking what if anything went wrong, but if we hadn't had it done he would perhaps blame us for not having the operation,” said Mrs Smith.
But Mr Smith added: “We always knew that we would have it done. We are just taking it six months at a time, but looking forward to the time when he comes through it, but I think we are now through the worst of it. We are very grateful to Mr Rai for what he did.”
Surgeon Mr Rai concedes it was one of the more difficult operations he has carried out, for a number of reasons.
“He is about the same age as my son and it was very difficult for me to detach from the patient. His parents were extremely anxious, which is what is to be expected and as he was about to go down to surgery his mother said to me 'he is my only son, his life is in your hands, please take care of him.”
During Thomas' operation an incision was made along his back to expose the vertebrae and screws inserted as anchor points above and below the curve to which rods were attached to straighten the spine.
During the operation nerves on his legs and arms were monitored to ensure the neurology of the spinal cord was not affected.
“One of the dangers is that this can cause paralysis which would be a disaster in anyone, but especially a child. There is an inherent risk of this between 1-500 and 1-1000,” said Mr Rai. “We monitor to see if we cause nerve damage, particularly when straightening the spine.
“As Thomas grows the instrumentation will grow with him. At the end of his treatment, which may be another 10 years, hopefully he will have a normal trunk length and be a normal individual.”
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