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Don't ignore your child's back pain, it could be scoliosis.

Summary: Bana underwent a seven-and-a-half-hour surgery to fix 24 screws in 12 places - two screws along each of the bent vertebrae - along her back on June 29

With 24 screws to hold her spine together in 12 places, a little bend in the back is not the end of the road for this youngster.

Thirteen-year-old Jordanian, Bana Qubain, until last year, was growing at the rate a normal teenager does until she started complaining of persistent back pain. Her parents, naturally, didn't give much thought to the complaints thinking they were 'growing up pains'.

"She complained but we thought that she had recently been through an intense play routine and was feeling sore because of that," Marwan Qubain, Bana's father, told Khaleej Times. "We travelled soon after but her complaining didn't stop. Later she showed us her swollen shoulder."

The worried parents rushed Bana to a hospital thinking she had dislocated her shoulder. But they were in for a huge shock when doctors, after taking x-rays of Bana's back, told them that their daughter had developed idiopathic scoliosis, a deformity of the spine that occurs in children and adolescents aged between nine to 12 years. Idiopathic medically means 'without any particular reason'.

"We don't know how and when this happened ... we had never heard of this problem before and we blamed ourselves for not paying enough attention," said the father.

Movement had become painful and bending over was already difficult for Bana as her spine had taken a C-shape and was now curved at a 60-degree angle. The only solution, doctors said, was surgery, or else the crooked spine would soon start crushing her internal organs. After research and weighing their travel options, the family chose Burjeel Hospital in Abu Dhabi.


Another case

While Bana was recovering from the surgery, another young girl, Layla Chamiloris, was also being treated at the hospital's award-winning spine unit for a much serious form of scoliosis.

Sixteen-year-old Layla was undergoing a posterior fusion surgery targeting thoracic and lumbar vertebrae (T3-L3), a procedure very similar to Bana's surgery.

"Layla's case was more complicated and also required an osteotomy (the surgical removal of a part of bone), facetectomy (where a part of the vertebral joint is removed to alleviate nerve compression) and spine correction to ease the extreme curvature in her spine," explained Dr Firas M. Husban, consultant orthopedic surgeon, who performed the surgeries on both the girls along with Dr Sebouh Z. Kassis, specialist neurosurgeon.

Both patients were scrutinised and it was determined that corrective spine surgery with posterior spinal fusion was required for both the girls, said Dr Firas.

Bana needed a T4-L3 posterior fusion which was performed under general anesthesia and spinal cord monitoring device. A posterior spinal fusion procedure was performed to create spinal balance in both the side and frontal planes of the body, which meant the patient's head would balance over the hips when viewed from the front and side.

"After Bana was prepped and positioned for surgery, an incision was carefully made over the affected vertebra. The back muscle, which was neither cut nor pierced, was gently separated off the bone at its attachment, exposing the spine," he explained.

"This allowed us to address the compression of nerves; we could also reach the facet joints and mobilise them to induce the flexibility of the spine and ultimately, the correction achieved during the standard open procedure," said Dr Firas. Bana was discharged from hospital just six days after the surgery.

Recovering and thankful

Today, Bana is thankful for the surgery and is recovering fast. She, however, has to take precautions for the next two months at least until the metal screws fuse into her bones.

"Bana cannot sit at a 90 degree angle ... she either has to keep walking or lie down straight," said Marwan. She cannot exercise as well and has to undergo intensive physiotherapy for the next six to eight months.

"We are trying to make suitable arrangements for school so that she doesn't miss out on her studies," said her father.

"The doctor says that the chance is that Bana will be up to 98 per cent normal and will also get her flexibility back," he added. Already, she has grown three and half centimetres since the surgery.

Similarly, the procedure has been instrumental in helping Layla correct her posture, get better spinal alignment, breathe better and get more flexibility in movement.

"Their lives have changed for the better," said Dr Firas.

What is scoliosis?

Scoliosis is a musculoskeletal condition due to which a sideways curvature of the spine occurs. This abnormality, in which the spine appears S-shaped or C-shaped, can be caused by a variety of factors ranging from congenital spine deformities and genetic conditions to neuromuscular issues and infections.

However, majority of scoliosis cases have no known cause and are termed as idiopathic scoliosis.

The condition usually occurs in children and adolescents after the age of 10.

"Juvenile idiopathic scoliosis, on the other hand, occurs in children between the ages of three and 10. The incidence of scoliosis is higher in girls than it is in boys," explained Dr Firas M. Husban, consultant orthopedic surgeon.

Mild cases of scoliosis don't hamper life or the regular activities of a person. However, more serious cases can limit functioning, cause pain, hamper breathing and even have a psychological impact on children

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Publication:Khaleej Times (Dubai, United Arab Emirates)
Date:Aug 14, 2016
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