"Wheelchair Girl" Unfortunately Suffers from Lateral Bending Xiangya experts helped her regain her life

During the re-examination 4 months after the operation, XiaoYi and his parents took a group photo with the team Professor Zhang Hongqi and Professor Liu Jinyang.

Red Net Moment March 7 (Correspondent Tan Zezhao) Paraplegia, scoliosis, pressure sores, urinary and urinary incontinence, body deformation, breathing difficulties... Even if ordinary people suffer from one of them, it is a disaster, and the girl Xiao Yin has persisted in the face of these sufferings for 20 years. Along the way, she fought against fate, not only completed her studies, but also passed the CPA certificate and participated in the work; at the same time, she did not give up the hope of treatment, and the family traveled around to seek the opportunity of new life - finally, with the help of professor Zhang Hongqi's team of spine surgery department of Xiangya Hospital of Central South University, this wheelchair girl with paraplegia complicated by scoliosis once again overcame the pain and won the miracle of life.

Paraplegia complicated by lateral bending, tough "wheelchair girl" fights against fate

20 years ago, while practicing dance, Xiao Yin suddenly appeared weakness in both lower limbs after "lowering his waist" and his feelings disappeared; he was subsequently diagnosed with paraplegia and identified as a first-degree disability, which meant that Xiao Yi would have to spend the rest of his life in a wheelchair and bed.

The sudden bad news cast a shadow on the family, but the roof leaked overnight, and 2 years later, Xiaoyi's spine began to bend to the left, and was diagnosed with scoliosis, and as she grew, the curvature of the spine to the left gradually increased, and the pelvis also began to tilt to the left with the left bend of the spine, making the lower limbs look long and short. The left sloping pelvis caused Xiao Yi to be unable to sit on her right hip when she sat upright, the pressure on her left hip was too great, and her entire lower body had no feeling, resulting in repeated ulceration of the left hip and pressure sores not healing for many years. Even though Xiaoyi's parents have taken good care of them, Xiaoyi still often suffers from pressure sores.

In addition, due to the aggravation of scoliosis, sitting tall and short, chest and abdominal organs are compressed, resulting in Xiaoyi's breathing often has a sense of distress and decreased appetite, reduced eating or difficulty, etc.; the tilted spine makes her have to use her hands to assist to maintain the sitting posture, which brings great trouble to learning and work, and even eating such simple life self-care actions are very difficult; long-term paralysis makes Xiaoyi's sacral bone upturned, and the sacral tail can be seen with obvious bulges.

But the strong Xiaoyi did not bow to fate, she overcame the unimaginable difficulties of ordinary people, she was admitted to college, and admitted to the certified public accountant, so that she had a decent job; at the same time, her perseverance and unremitting enterprising spirit has also touched countless people.

Self-helpers help, Xiangya experts are willing to help

In the face of their daughter's condition, Xiaoyi's parents have never given up, they have visited major hospitals, but they have received negative answers. Until the recommendation of many doctors, it was learned that Professor Zhang Hongqi of the Department of Spine Surgery of Xiangya Hospital of Central South University is an authoritative expert in spinal orthopedics, and has high achievements and rich experience in the treatment of scoliosis. One morning in May 2021, Xiaoyi's parents brought Xiaoyi to Professor Zhang's clinic with hope.

After Zhang Hongqi learned about Xiaoyi's experience and condition, while sympathizing with her, he also realized that this was a tricky case. This is a case of neuromuscular scoliosis that occurs after paraplegia, not only the scoliosis angle is large and very stiff, but also the trunk is unbalanced, the center of gravity is shifted, the pelvic tilt is serious, and the conventional scoliosis treatment plan cannot be copied. Because XiaoYi's paraplegia is irreversible, Zhang Hongqi even doubts whether surgery is necessary; but if the lateral bend is not corrected, allowing it to develop will cause pressure on his heart, lungs and other organs, which will cause Xiaoyi to breathe more and more difficult, so that it is life-threatening.

In the end, he was touched by Xiaoyi's optimistic attitude and her parents' unrelenting love for Xiaoyi for more than 20 years, and decided to face the difficulties and perform orthopedic surgery for scoliosis for this inspirational girl.

Point directly to the focus of the operation and write down the optimal solution in the "Xiangya way"

Even patients who are already paraplegic should proceed with caution. Zhang Hongqi thought very carefully about Xiao Yi's situation: "This patient has a very small age of onset, the progression of lateral bending runs through the entire growth cycle, the deformity is very stiff, the flexibility is poor, if the nail surgery is carried out directly, not only the orthopedic effect is not good, but also increases the risk of surgery." After careful evaluation by the team, he decided to use the "Xiangya step progressive halo-femoral large-weight traction method" to let Xiaoyi first traction treatment, and review the imaging to evaluate the traction effect.

After more than 1 month of heavy weight traction, the angle of Xiaoyi's lateral bend has been significantly improved compared with before traction, and the surgical conditions have been initially reached.

However, the formulation of the surgical plan is not simple, and the ordinary lateral bending patients take into account and focus on the pursuit of aesthetic differences, so that Xiaoyi can sit upright in a wheelchair, free his hands, while restoring the balance of the pelvis, both hips at the same time, the force is balanced, no longer have pressure sores, is the real meaning and purpose of the operation.

Zhang Hongqi repeatedly studied the imaging data and believed that the key to surgery was to correct pelvic tilt while orthopedic. "The patient sat upright with his entire upper body pressed against the left pelvis, and if he ignored this and simply orthopedic, the operation may be more inclined to the trunk." He had repeated discussions with the doctors at all levels of the medical team, and came to the bedside many times to carefully examine XiaoYi. He found that Xiaoyi's coccyx was softened due to abnormal development, so that the problem of new pressure ulcers forming in the coccyx during postoperative sitting was also solved. In the end, Professor Zhang developed an individualized treatment strategy and a rigorous and thoughtful surgical plan.

Professional treatment + nursing, wheelchair girls regained their lives

On August 27, 2021, with the assistance of Professor Wang Yanqing of the Department of Anesthesiology, Dr. Ding Zhuofeng, and nurses such as Guo Jing and He Qingqing, the head of the spine specialist group and the nurse in charge of the operating room, and with the cooperation of Zhang Hongqi, Associate Professor Liu Jinyang, Associate Professor Deng Ang and Dr. Sun Yang, the operation was carried out in an orderly manner. Due to the serious development of Xiaoyi's pelvis, the obvious osteoporosis of the iliac bone and the obvious atrophy of the bone bed in the proposed nail area of the iliac bone, the holding force and strength after the nail are difficult to meet the biomechanical requirements required to maintain the upright posture of the spine after surgery, Zhang Hongqi cleverly used multiple rods and other techniques, placed after the orthopedic rod, and at the same time placed multiple satellite rods to support the internal fixation structure, avoiding the rupture of the orthopedic rod due to excessive force on the concave side of the thoracolumbar spine. With Zhang Hongqi's exquisite technology and rich experience, as well as the skillful cooperation of the team, after 10 hours of concerted cooperation, the operation was finally completed smoothly.

After professional treatment and meticulous care, Xiao Yi recovered well after surgery. Thanks to the efforts of the spine surgery nursing team and Xiaoyi's parents, she never had pressure sores during her hospitalization. The imaging results of postoperative review showed that the orthopedic effect was satisfactory, the internal fixation was stable, and there was no case of nail pulling or orthopedic rod breaking.

In the 4th week after the operation, Xiao Yi tried to sit up for the first time after the operation, and she was pleasantly surprised to find that she could not only sit up straight, but also significantly increased her sitting height, the legs that used to look long and short were now as long as they were now, the previously deformed torso became like a normal person, the problems of respiratory distress and food intake were significantly improved, and she no longer needed two-hand support to maintain sitting, so that her hands were completely liberated.

With the success of orthopedics and the correction of pelvic tilt, the quality of Xiaoyi's life and work has been greatly improved. Xiao Yi's parents were full of emotions: "Thank you Professor Zhang and his team for their noble medical ethics and superb medical skills!" Our whole family will always remember this kindness. ”

Xiangya experts remind that children need to be cautious when learning to dance "lower waist"

Zhang Hongqi introduced that when XiaoYi learned to dance when he was a child, the paraplegia caused by the "lower back" is also called "spinal cord iniurywithout radiographic abnormal, SCIWORA)", which refers to the exclusion of penetrating injuries, electric shocks, birth injuries and congenital spinal deformities, and external forces lead to spinal cord injury and radiography does not find obvious abnormal signs such as fractures and dislocations. Studies have found that SCIWORA is concentrated in children aged 4-7 years with a history of minor trauma, and dance training "lower back" movement is the main cause, of which thoracic cord injury is the most common, which may be related to the anatomical and physiological characteristics of the spinal cord in children: children under 10 years of age have not yet formed a hook process that can limit the lateral and rotational movement of the vertebral body, the joint mobility is large, and the movement of the coronal surface is prone to hyperextension; the thoracic spine is less resistant to axial traction and torsion; the spinal cord is small in compliance, and the spinal cord can tolerate far less traction than the spine The sagittal diameter and transverse diameter of the thoracic 4-thoracic 9 spinal canal are the narrowest, and the external and internal arteries of the spinal cord have the fewest anastomosis branches, which is prone to spinal cord vascular injury. When the child practices the lower back, the thoracic spine is extremely hyperextended, and the two ends of the spinal cord are relatively fixed to the position of the spine, and the spinal cord is stretched accordingly, because the child's spinal cord compliance is much smaller than that of the spine, when the critical value is reached, it can cause damage to the supply vessels of the spinal cord.

At present, more and more children are learning dance, but dance training institutions are uneven, and some children do not have professional teachers to practice dance, especially "lower back" and other movements, which will significantly increase the risk of spinal cord injury. He reminded that for children to learn dance, teachers and parents should pay great attention to it, and the society should strengthen the supervision of dance training institutions and let children practice dance under professional guidance.