Scoliosis: Surgery Corrects CJ Sultini's Curved Back

"My Back Is Finally Straight"

Discovered by a school physical therapist, CJ's scoliosis was monitored by her pediatrician. After a growth spurt at age 13, an orthopaedic surgeon near her home recommended a brace that encased most of CJ's torso to hold the spine in a straighter position. But this started to affect her breathing. 

A year later, CJ's spine was curving at an angle of 60 degrees and was causing discomfort. Today, after undergoing the VATS procedure (video-assisted thoracoscopic surgery) to straighten her spine, CJ looks forward to the day when she can return to varsity dancing and the soccer field. 

"If you want the best, go to Cincinnati."

Those words from their doctor in Michigan would prove to be valuable advice for Diana Sultini and her daughter CJ as they coped with CJ's steadily worsening curved spine. But for two years before heading down I-75, they explored their options closer to home.

Discovered by a school physical therapist, CJ's scoliosis was monitored by her pediatrician. After a growth spurt, the energetic cheerleader, then 13 years old, visited an orthopaedic surgeon near her home in Warren, Michigan, just outside Detroit.

To prevent the curve from becoming more severe, CJ's pediatrician recommended a brace that encased most of CJ's torso to hold the spine in a straighter position. Normally it's worn almost full time, until bone growth has stopped.

CJ wore the brace for three or four months, but then started resisting. "The brace wasn't working because it was affecting my breathing," she says.

Watching and Waiting

The Sultinis watched and waited. "A year later, she was in bad shape," Diana says. "We went back to the doctor, and we both left the office crying. We had read about the minimally invasive surgery called VATS, but this doctor told us that nobody does it because it takes too long." They would soon discover otherwise.

"I remembered that Cincinnati Children's had been recommended to us, so I researched it on the internet. CJ found another web site where girls with scoliosis discussed their treatment, and she became interested in the minimally invasive option," Diana explains. Because CJ was starting high school and worried about how major surgery would affect her schooling and her goal of becoming a varsity dancer, the Sultinis continued to watch and wait.

Finally they decided the time had come to relieve CJ's discomfort and straighten her spine, now curving at an angle of 60 degrees. Another visit to the orthopaedic surgeon ended in tears.

Next, the Sultinis contacted the University of Michigan, but would have to wait nearly three months to see a physician there. In the meantime, Diana called Cincinnati Children's in February -- and the Sultinis had an appointment within days with pediatric orthopaedic surgeon Alvin Crawford, MD, known worldwide for his work in scoliosis.

Answers at Last

"We both really liked him," Diana says. "CJ had two pages of questions for Dr. Crawford, and he answered every one of them. He talked directly to her, and left us with the task of deciding between traditional surgery, which requires six weeks of bracing afterward, and the VATS surgery, which requires three months of continuous bracing, followed by a weaning period."

In traditional scoliosis surgery, a large incision exposes the spine so the surgeon can attach the metal rod that straightens the curve. For the VATS procedure (video-assisted thoracoscopic surgery), only four small incisions are made for surgical instruments and to insert the metal rod.

Although the family had settled on traditional surgery, a call from Dr. Crawford's nurse changed their minds. "Darlene told us that Dr. Crawford had just done VATS on a boy with the same problem I had, and it went well, so he thought I could have it, too," CJ says. "I didn't want the surgery at all, so VATS was good news."

Successful Surgery

Diana, CJ, her dad Joe and her aunt Mary arrived in Cincinnati a day ahead of her June 8 surgery. "On the morning of the surgery, I was a wreck. I didn't want to do it," CJ says. "I didn't expect to see Dr. Crawford before surgery, but he came and talked to me and that really helped."

During the next 10 hours, regular updates from an operating room nurse eased the Sultinis' anxiety. Through four openings, each less than 2 inches long, Dr. Crawford removed seven discs in CJ's back and, with screws, attached a metal rod to the bone to straighten the curve. He also removed three of her ribs so he could fuse the vertebrae with the rib tissue. Her ribs will regrow.

CJ's sister Lindsay and some of her friends came down to visit her, and five days after surgery, CJ left the hospital with a brace to protect her spine as it heals and strengthens. With long-distance support from the staff at Cincinnati Children's, the Sultinis helped CJ get through a difficult summer of recovery.

"Dr. Crawford, the residents and all of the nurses were just wonderful," Diana says. As a participant in a research study comparing the results of three different surgical treatments to correct scoliosis, CJ will return to Cincinnati Children's for follow-up visits over the next five years.

CJ's back is finally straight. 

Tall, lithe, animated -- and now an inch taller -- 15-year-old CJ looks forward to the day when she sheds the brace for good and can return to varsity dancing and the soccer field.

"Dr. Crawford was a great choice. He and the nurses helped me so much with everything," she says. With a smile spreading across her face, she adds, "The best part of all of this is that my back is finally straight."

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