ORTHO SPINE news NEWS AND UPDATES • WINTER 2014
Woman Stands Tall After Bent Spine Surgery Thanks to spine surgery in September, Deborah Defer can now hang up clothes in her closet. For someone who spent two years in a wheelchair, bent over at a 90-degree angle, that is a very big and welcome change. Deborah says she can’t wait for the day she’ll be able to get behind the wheel of her 2010 Chrysler Sebring and edge it into traffic. “Just to have the freedom to say I think I’ll go to the store,” she says, with no pre-planning and no previous arrangements with a driver. “Those little things that you take for granted, I couldn’t do it.” The 62-year-old Algonac mother, a former legal assistant and office manager, has had more than her share of spine problems. She had polio as a child, has mild scoliosis, and has been in two car crashes – one of them quite serious: The car rolled over. All of those traumas eventually took a heavy toll: Three years ago Deborah's body slowly started bending over from the hips due to flatback deformity, forcing Deborah into a wheelchair. A surgeon did multiple operations and ended up fusing her spine from between the shoulder blades to the tailbone. But Defer’s body outwitted the doctor; she was still in pain and bent over, so the surgeon recommended she see David Montgomery, M.D., one of many Beaumont doctors with the know-how to perform complex surgeries. Dr. Montgomery (see related story), an orthopedic surgeon who specializes in spine deformity surgery at Beaumont Hospital, Royal Oak, performed a six-hour surgery. He revised all of Deborah’s spinal fusions, rotated her pelvis bones that were out of line due to the spine deformity, and fixed her broken tailbone. continued on back
Dr. Montgomery and Deborah Defer.
Focus on Spine Deformities Earns Doctor Prestigious Membership David Montgomery, M.D., is the only orthopedic spine surgeon at Beaumont with active membership in the prestigious Scoliosis Research Society, which has strict standards for who may belong. This spine surgeon restricts his practice to treating adults with spinal deformities. Dr. Montgomery grew up in East Detroit, now called Eastpointe. He earned his medical degree at Wayne State University School of Medicine, where he graduated in the top 5 percent of his class. He also did his general surgery and orthopedic residencies at WSU, after an internal medicine residency at the University of Michigan. To become a specialist in spine surgery, Dr. Montgomery completed a fellowship at the University of Rochester-affiliated Strong Memorial Hospital in Rochester, N.Y. continued on back
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New Research Tool Helps Explain Disc Degeneration In a group of 10 people age 60 and older, nine will have degenerative disc disease. “Most people may not even be aware their discs are becoming less spongy and poorer at their job as shock absorbers for the spine,” says Kevin Baker, Ph.D., director of the Orthopedic Research Laboratories at Beaumont Hospital in Royal Oak. “The condition can lead to severe pain and decrease a person’s quality of life, making normal activities such as playing with a grandchild or lugging a sack of groceries difficult or impossible.” The diseased disc may cause pain to shoot down a leg or arm – called radiculopathy. And, depending where the problem is in the spine, symptoms may include muscle weakness, numbness, or – in the worst cases – complete loss of motor control. Several imaging tests, including X-ray and MRI, are helpful to see if a patient has a bad disc, but neither of these techniques gives information about why the condition occurs. To help answer the “why” question, Beaumont researchers teamed up with biomedical engineering students at Lawrence Technological University in Southfield to develop a novel way to use very high-resolution CT with injection of a contrast agent to image the discs. By using this process in animals, they were able to measure the amounts of a molecule that helps discs retain water to keep their sponginess. The team found that EPIC-mCT was useful to measure very small changes in amounts of the molecule, showing that it is an effective tool to begin to understand the process of disc degeneration. The researchers are in the process of sharing their results with spine surgeons, both at professional meetings and in medical journals. They’ve also purchased a very highresolution CT scanner, and hired one of the LTU students to work with Dr. Baker to continue the research.
Former Protegee Takes Chairman’s Place After the untimely 2013 death of Harry N. Herkowitz, M.D., chairman of the Orthopedic Surgery department at Beaumont Hospital, Royal Oak and the Oakland University William Beaumont School of Medicine, Jeffrey Fischgrund, M.D., has been appointed to replace him in both positions. Dr. Fischgrund has been part of the Beaumont system since 1993, when he came to the hospital to complete a spine fellowship under Dr. Herkowitz’s guidance.
Woman Stands Tall
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Deborah says of her first words after she was able to stand upright post-surgery: “I just kept saying it’s a miracle, it’s a miracle.” Dr. Montgomery explains that he had to cut Deborah’s vertebrae in several places, re-contour her spine to a normal posture, and then hold the bones in place with screws and rods. “He said it was like screwing into butter,” Deborah says. She’s now graduated from a wheelchair to a walker, is dealing with other health-related problems, and has an implanted pump that delivers medication for pain that’s usually a “5,” with “10” being the worst. But Deborah spent Christmas with her family, including 6-month-old grandson Cameron, and is upbeat about her future. “I think the reason for that is that I have family and friends to help me pull through this,” she says.
Orthopedic Spine Surgeons at Beaumont Bradley D. Ahlgren, M.D. Richard W. Easton, M.D. Jeffrey S. Fischgrund, M.D. Christopher Hulen, M.D. Jad Khalil, M.D. Lawrence T. Kurz, M.D. David M. Montgomery, M.D. Daniel K. Park, M.D. Brady T. Vibert, M.D. For an appointment with one of these specialists, please call the Beaumont Orthopedic Center of Excellence at 855-220-2663.
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“The spine is one of the most complex areas of the body to do surgery on, and its function is one of the most important in the body,” says Dr. Montgomery. “That’s why it’s extremely gratifying to me when I can help a patient achieve a healthier spine and a better quality of life after spinal surgery (see related story).” He performs surgeries at Beaumont Hospital, Royal Oak, where he also teaches orthopedic surgeons who are in training. Dr. Montgomery is also assistant professor of orthopedics at the Oakland University William Beaumont School of Medicine. A frequent lecturer at professional meetings and publisher of medical articles, Dr. Montgomery recently co-authored an article about spine fusion, which is to be published in the Spine Journal, and a chapter about adult degenerative spondylolisthesis, to be published in the textbook Operative Spine Surgery. He is an avid runner, and has run multiple 5K, 10K and half-marathon events. Dr. Montgomery is also a member of MENSA, an organization for individuals with an I.Q. in the top 2 percent of the population.