Video · The Doctors segment
Published on YouTube Length 2:34
Kyle, 19, says he was born with a caved-in chest called pectus excavatum and had surgery for it, then noticed a small curve in his spine. Several doctors diagnosed scoliosis and recommended a spine fusion, but an MRI at Dr. Melamed's office found a tethered spinal cord. Kyle says Dr. Melamed told them that fusing his spine with the cord still tethered would leave him paralyzed. The segment walks through releasing the cord under the microscope, and Kyle says his curve kept progressing afterward despite bracing and physical therapy.
Medically reviewed byDr. Hooman Melamed, MD, FAAOS
From the video's automatic YouTube captions, edited for punctuation, capitalization and paragraph breaks. Filler sounds such as "um" are left out, and clearly misheard names and medical terms are corrected. Words that could not be made out are marked [inaudible].
My name is Kyle, and I’m 19 years old. I was born with a caved-in chest. It was called pectus excavatum. By the age of 12 it started getting pretty severe and was interfering with my heartbeat in my lungs. I have surgery to correct the deformity in my chest. When I was 16, I had a very significant growth spurt in a short amount of time, which caused me to have to do a second procedure on my chest.
It was shortly after that procedure where I started noticing it’s a small curve in my spine. I went to several doctors, and they all took X-rays of me and diagnosed me with scoliosis and recommended that I went through with the spine fusion. I decided that I wasn’t ready to do the fusion surgery. I paid a visit to Dr. Melamed, and he actually took an MRI instead of just an X-ray.
We discovered that he had a condition called tethered cord, where the spinal cord had not migrated up to where it’s supposed to go in the spinal column.
Dr. Melamed told us that if we went through with fusing my spine while that cord was still tethered in my spine, I would be paralyzed.
He needed an operation first to undo the tethering of the spinal cord.
We do the procedure under the microscope from the beginning to the end. We go down about four inches, get the muscle away from the bone, which is protecting our spinal cord. We actually drill a hole between L4-5, below where the spinal cord is. It allows us entrance into the canal where the nerves are sitting, but the nerves are inside what’s called the dura.
Now I’m going to release the ligament from around the bone. We lift the ligament up, and now we’re looking at the dura, this sac that surrounds the nerves and the spinal fluid. You open the door, basically, and microscopically you go down, you find what’s called a filum, which is the, a rope tethering the spinal cord. Use the little micro scissor and release the band, and that’s it. And we’ll just close the patient up.
Following the surgery, the curve actually continued to progress from 60% to 70, and during that time I was still against the idea of doing the fusion. I was wearing braces for 18 to 20 hours a day, two or three hours of physical therapy exercises. It just wasn’t enough to keep the spine from regressing.
Second opinions welcome
Send your imaging for a personal review with Dr. Melamed. Many patients learn a smaller, muscle-sparing option is on the table.