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Spinal Fusion Corrects Painful Kyphoscoliosis in Carol Stream Boy

While other boys his age were anxious to get the latest video game or a cool new pair of tennis shoes, last winter, Brian Melko, a 15-year-old from Carol Stream, was hoping for less back pain and better posture as he awaited spinal fusion surgery.

Brian's mother, Jamie, was optimistic as well: "I just hope that surgery gives Brian the opportunity to do the things he wants to do, like going to an amusement park. Right now he needs to sit down every 15 minutes because of the intense pain."

A normal spine appears straight when viewed from behind, but a malformation in which the spine forms an s-shaped or c-shaped curve is called scoliosis. The most common type of scoliosis, known as adolescent idiopathic scoliosis, appears for no known reason, usually in young girls. In Brian's case, scoliosis was associated with Marfan's syndrome, a genetic disease that affects connective tissue.

Since connective tissue provides a framework for many of the body's systems, Marfans syndrome can cause disorders of the skeleton, eyes, blood vessels, nervous system, lungs or heart. Brian's 17-year-old brother also has Marfans syndrome, and his mother was unaware she had the condition until Brian was diagnosed at age 6.

In addition to scoliosis, Brian's spine bulged out to form a hump in the middle of his back. The combination of problems was diagnosed as kyphoscoliosis.

To find help for Brian, the Melko's talked to three different surgeons who all were reluctant to tackle such a complex spinal fusion procedure. Some said they would need to perform more than one operation to straighten Brian's spine. The Melko's eventually found Anthony Rinella, MD , who had the experience, expertise and confidence to treat Brian and promised to do the procedure in only one operation. Dr. Rinella is an orthopaedic surgeon who specializes in spine surgery at Loyola University Health System.

"Brian's case was much more complex than the average scoliosis surgery because he required fusion of 15 of his 17 thoracic/lumbar vertebra and a number of osteotomies (bones cut) to straighten the kyphosis," said Dr. Rinella.

The 11-hour operation was performed this year on Jan. 31. Dr. Rinella straightened Brian's spine using two metal rods that extended from his shoulder to hip and 21 screws. Small pieces of bone were taken from Brian's hip to fuse the spinal column into the proper position. With a straightened spine, Brian grew to about 6 feet 4 inches - approximately five inches taller than he was previously.

Spinal fusion has limited Brian's mobility to some extent. His back does not bend where the rods are in place, and he has limited torso rotation. However, his spine now will remain straight and he does not suffer the back pain that was once a constant aggravation and kept him from either sitting or standing for extended amounts of time.

"Dr. Rinella did an amazing job of straightening Brian's back," said Jamie Melko. "The hump on Brian's back is gone and his posture looks better. He is still restricted in his activities, but he goes to the internet café with his friends and sits for hours with no back pain. We found the right guy in Dr. Rinella."

For more information or to make an appointment with an orthopaedic surgeon at Loyola,
call (708) 216-8563.