Resource Newsletter Archive
Donated Bone Helps Spinal Patient
At
16, Melissa Meyers considers herself a normal teenager. Lively and
outgoing, she loves playing basketball, racing, and dancing. Of
course, since she was born with spina bifida, she's learned to make
accommodations. But if other people see only her wheelchair, she doesn't.
“Throughout our daughter's life we have had to look at creative ways that things could be accomplished,” said her mother Jennifer. “She taught us an important lesson. If we always look at the half empty glass we will overlook the fact that it's really half full.”
Last year Melissa's condition suddenly deteriorated. When Melissa came to Dr. Howard King, an orthopaedic surgeon in Seattle, she had a scoliosis and kyphosis. She had already undergone several revisions of earlier spinal fusions and new tests showed that her spinal cord had atrophied. After the instrumentation in her back was removed during a required procedure last summer, her spine had severely collapsed.
Dr. King recommended she undergo an anterior and posterior spinal fusion. But unlike many patients who can provide their own bone graft, Melissa required donated bone for this procedure.
“Typically we would take bone from the back of the patient's pelvis. But because of Melissa's medical condition she doesn't have a large pelvis. You often find that with children born with this condition there isn't a lot of patient bone you can use,” said Dr. King.
A history of spinal surgeries Melissa's first surgery occurred within hours of her birth, when doctors repaired a myelomeningocele in her lumbosacral region. Over the next 16 years, 29 major surgeries would follow. When Melissa was eight, she suddenly lost all function in her legs. She underwent two laminectomies and had pediatric Harrington rods placed in her back. After the surgery, she was permanently confined to a wheelchair.
At 13 she underwent a spinal fusion. At the same time doctors removed the pediatric rods and replaced them with Isola rods. A year later she underwent a lumbar-sacral spinal fusion. During this surgery, her doctors extended the rods in her back and untethered her spinal cord. Although her right leg remained paralyzed, she eventually regained some function in her left leg.
Then, last August, Melissa suddenly lost all function and sensation in her left leg. In order to do an MRI, doctors first had to remove the instrumentation in her back. The MRI revealed that Melissa's spinal cord had atrophied and was completely gone below the T8 area.
Three weeks after the surgery, Melissa appeared hunched over. Suffering from severe pain in her left ribs, Melissa could “not only feel but sometimes hear” her ribs crunching into her pelvis. Even breathing became difficult. Although she was given a temporary brace for support, she was in constant pain.
In February Melissa underwent the six-hour anterior and posterior spinal fusion at Swedish Medical Center. During the anterior approach, Dr. King entered on the side near Melissa's rib cage. He removed several discs from her spinal column and placed morselized bone from the Northwest Tissue Services to fill in the spaces that were left. After closing the front incision, he went in from the back and placed more bone in the areas that had not fused properly.
Melissa will wear a brace for six months to help with the fusion stabilization. After that, she's expected to make a good recovery. “For a lot of the complicated spine surgeries we perform we rely on the bone bank. We wouldn't be able to perform these surgeries without the tissue and bone that we get from the Tissue Services,” said Dr. King.
As for Melissa, she already knows what she wants to do after college. She'd like to become a counselor so she can help other people who are facing health problems. Meeting the needs of Northwest patients like Melissa for transplant tissue is a key element of Northwest Tissue Services's mission. A convenient ordering system gives surgeons and hospitals access to quality tissues, recovered and processed according to the highest standards of the American Association of Tissue Banks. Our Product Services Coordinators (PCS) are responsible for filling the orders and providing excellent service to Tissue Services customers.
When the PCS receives a request for tissues, the order is documented with hospital, name of person placing the order, patient, surgeon, surgery date and time, procedure, specific type of tissue needed, sizing requirements (if applicable), and purchase order number. The order information is entered into a computer and assigned a number. Specific tissues are selected, assigned, and held until ship date.
A barcoded transplant record is generated for each graft and sealed in a plastic pouch with instructions for reconstituting or thawing. Shipping boxes are labeled as “Fragile, Human Tissue for Transplant”, and for frozen tissues, they are validated to hold temperatures of -40C for a least 24 hours. Heart valve shippers hold ultralow temperatures for ten or more days. The order processing and shipping procedures provide the quality control and tracking necessary for each tissue and for every patient.
When tissue ordered is not readily available or requires special size matching, our PCS obtains all the information needed and may request a patient x-ray to assist in finding the best graft. If a patient's need doesn't allow time for a custom tissue order, the Tissue Services will make every effort to locate the tissue at another AATB accredited tissue bank and will arrange for shipment.