Last summer, Faber had surgery to straighten her severely curved spine. Her mother, Melonie, vividly remembers Megan's first words after waking up from surgery: "Is my back straight now?" Megan asked to look at the X-rays to see for herself that the years of doctor exams, back braces and hoping for results was over.

When Faber was 11 years old, her doctor noticed the curve in her spine while he was listening to her lungs. He was surprised she didn't have pain, considering the severity of the curve, but Faber was healthy, strong and active, and the symptoms of scoliosis hadn't caught up with her yet.

Megan had adolescent idiopathic scoliosis (AIS). The curved and twisted spine appears for no known reason, usually in young girls.  It is the most common type of scoliosis, but the problem also can be due to a birth defect or as a complication of diseases such as cerebral palsy, muscular dystrophy or spina bifida. Scoliosis also is seen in older people with degenerative arthritis.

Faber wore a back brace nearly 24 hours per day throughout her sixth grade year. In seventh grade, she wore a brace for 12 hours per day. Unfortunately, all that time in a brace did not keep her spine from curving more. Her parents started investigating surgery. They chose Julie York, M.D., a neurosurgeon at Loyola University Health System, because of her expertise in scoliosis surgery.

When York examined Faber, she observed a 57-degree structural curve in Faber's lower back and a 37-degree compensatory curve higher up the spine. The compensatory curve was the body's way of keeping Faber's shoulders and head upright in spite of the scoliosis.

The degree of curve is figured by imagining lines along the bottoms of the vertebrae (the cylindrical shaped bones of the spine). In a healthy back, the lines would remain parallel and never intersect. If the spine curves, the lines would eventually cross at some point out to the side. The angle they form is the degree of curve. Scoliosis is defined by a 10-degree or greater curve. Most cases of AIS with less than a 20-degree curve are monitored but not treated. Bracing often is warranted for a curve of 25 to 30 degrees. A curve of more than 40 degrees usually requires surgery.

York noted that, along with the degree of curve, skeletal maturity is an important factor in determining the best treatment approach. Curves often worsen prior to puberty, until the skeleton becomes more mature and stable. So a small curve in a girl of 10 or 11 years old would be more serious than in a girl of 16 since it may worsen as she matures.

Bracing is generally the right first step for AIS and can prevent the need for surgery in some cases, York said. The object of bracing is not to correct the curve, but rather to keep the curve from worsening during the growth spurt of puberty.

Without surgery, a big curve in the spine could eventually cause breathing and heart problems, back pain, a visible deformity like a hump, leg pain and weakness. If a severe case of scoliosis is not treated in adolescence, it might eventually require a more extensive operation.

York operated on Faber in the summer before she would start eighth grade. York approached the spine from an incision in Faber's side. She started by removing one of Faber's ribs. Then she removed four vertebral discs (the cartilaginous pads between the vertebrae) to loosen up the spine in the curved section. She then used tiny pieces of the rib to fuse the vertebrae together. She placed 10 screws and a rod at that section of the back to hold it together while the bones healed and fused, and contoured the rod to recreate the natural curve of the lower back. All the while, York was assisted by high-tech monitoring equipment that would warn her if she operated too close to a nerve.

During the five-hour surgery, Faber's family waited anxiously for the results. "All the doctors were wonderful," Melonie Faber said. "They kept us informed every half hour or hour throughout the surgery."

Since Loyola is about three hours from their home, the Faber family stayed at the Ronald McDonald House near Loyola University Medical Center. "It was wonderful. I was looking for a hotel. I thought we would have to eat out every night," Melonie said.  Instead, they enjoyed three meals a day and snacks provided by volunteers. They had use of a library, a TV room and a children's playroom, and enjoyed the comfort of being close to Megan during her recovery. "It was a godsend," she said.

After surgery, Faber had three more months in a back brace while her bones healed. A small section of her spine is now immobile, but it is not visibly stiff and will not limit her activities. She can continue to pursue all her favorite activities - swimming, soccer and dance - with no more worries about a crooked back.

To make an appointment with York, call (708) 216-8563.

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