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Like most boys his age, Adam Peak loves music, sports and hanging out with
friends. At his home in the northwest Arkansas town of Farmington, where basketball
is king, Adam has spent many afternoon hours polishing his moves to the basket
- "Michael Jordan moves," as his father likes to call them.
But unlike his buddies, 16-year-old Adam struggled with a severe curvature
of his spine. The scoliosis, diagnosed four years ago during a school screening,
had been treated with an orthotic brace intended to stop the progression of
the deformity.
But the curvature continued to worsen, at one point reaching 60 degrees, and
had increasingly robbed Adam of lung capacity. Before spine surgery in January,
at the Shriners Hospital in St. Louis, capacity in one of Adam's lungs had dropped
to only 48 percent.
It was then that doctors in Arkansas told the family that bracing was no longer
adequate treatment - surgery was a necessity.
"I had anterior spine surgery myself in 1996, and I was scared to death for
Adam," recalled the boy's father, Richard Peak. "I just couldn't picture my
son laid open on the operating table, with his spine exposed."
So when Lawrence Lenke, M.D., a spine surgeon at the St. Louis Shriners Hospital,
suggested use of a new procedure, Richard Peak said he was immediately interested.
The technique, known as video-assisted thoracoscopy, is a far less invasive
method for accessing the anterior (front) spine.
Adam was the second patient to receive thoracoscopy at the St. Louis Shriners
Hospital. Spine surgeons at the Philadelphia, Erie and Mexico City, Shriners
Hospitals also have performed the procedure, while surgeons at the Chicago Hospital
plan to do so in the near future.
During thoracoscopy, surgeons view the spine with the assistance of a video
imaging scope and work with instruments inserted through four small incisions.
"We place the thoracoscope - basically a miniature camera - through one of
the holes and that's what we use to see what we're doing," said David Clements,
M.D., of the Philadelphia Shriners Hospital. "When the surgery is over, we cover
the incisions with small Band-Aids."
Lenke agrees with his Shriners colleague that the less invasive thoracoscopic
approach is an important advance in patient treatment.
"The advantage of this approach is that instead of having one large incision
with a lot of muscle dissection and chest cage soreness, we do it through a
series of one-inch incisions with much less morbidity to the patient's muscle
tissues and respiratory function" Lenke explained.
John Lubicky, M.D., chief of staff at the Chicago Shriners Hospital, said,
"The number of appropriate cases that thoracoscopy could be used for is somewhat
limited, but there are cases in which it could be of help. The procedure doesn't
change what is done on the inside; just the approach is different."
During Adam's thoracoscopic procedure, Lenke removed disc material from the
boys spine to make it more flexible during the posterior spinal fusion that
immediately followed.
Four weeks after his surgery, Adam returned to the St. Louis Hospital to meet
with Lenke and spine case manager Joetta Whorton. The boy was cleared to return
to school, and from all indications he is now on the road to recovery.
"I was scared, but I trusted the doctors. I knew them, knew what they were
doing," Adam said. "I've been doing a lot better and I've noticed that I can
breathe better."
For his part, Richard Peak commented he is grateful for Shriners Hospitals.
"This surgery has been a godsend," the father related with a smile. "Before
we were referred here I had no idea what the Shriners represented, but then
we got here and saw all these children with such major problems. All the things
that Shriners Hospitals do for families . . . . There's no way, a blue-collar
family like ours could have afforded this. I just thank God for Shriners Hospitals."
Material Provided by Shriners Hospitals for Children, St. Louis
You may visit their website at www.shriners.com
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