Quaile November 2006

I saw this pleasant lady today who now lives in Marbella. She had a scoliosis correction under Bob Jackson in Southampton some years ago. This was due to an idiopathic curve which had hit over 70 degrees by the time it was operated on. She appears to have got a very nice correction from x-rays taken today. I have been able to show her that in comparison with x-rays taken in the past this shows that this is not actually deteriorating. Unfortunately she still has symptoms of leg pain and some facet joint type symptoms which we discussed at length today.

I think the way forward is to look at doing an up to date MRI scan. This is particularly to investigate the leg symptoms. I explained to her that realistically we should be continuing to treat her non-operatively. This is to say we can usually deal with leg pain via a caudal epidural and facet joint symptoms by facte joint blocks. If the facet joint blocks in particular prove temporary then there are ways of making these permanent by radiofrequency lesioning.

I would not be keen on making her fusion any longer as this would inevitably have consequences in the long term. There are new technologies around, including disc replacement, but I am not sure that disc replacement is particularly appropriate for this case.

She is going back to Marbella to get an MRI scan performed and she will send it to me. Hopefully this would give us better diagnostic information in terms of her current symptomatology and certainly I think we should be looking at non-operative way of improving her symptoms.

I will keep you in touch with things as they progress. She is currently in a wheelchair having a great amount of difficulty mobilising. I cannot see that this situation in its own right will improve particularly rapidly and therefore she should be considered for a disabled sticker as her walking distance is a matter of yards.