Winter 2009 Issue

Preventing Paralysis
Young Teacher Undergoes Successful Spinal Tumor Surgery

The spinal tumor in the pre-op image on the left caused the spinal cord to thin down to the size of a shoelace. A post-op MRI found no signs of the tumor, and the fluid within her spinal cord was significantly reduced.
For more than a year, Shelby High School teacher Christie Hoyle suffered from extreme headaches, dehydration, and intense back pain that forced her to sleep in an upright position. When her condition began to rapidly decline over a three-week period, she finally scheduled an appointment with nurse practitioner
Lois Smith at Shelby Women’s Care in August of 2008.

By that time, Christie’s weight had dropped to 109 lbs. and she had numbness in her arms. An MRI revealed a large tumor on her thoracic spinal cord. Neurosurgeon Paul Kim, M.D., of Carolina Neurosurgery & Spine Associates was immediately contacted, and he saw Christie that same day.

“When I first examined Christie, it was evident howpoor her condition was in terms of spinal cord function. I was impressed with how tough she was despite her worsening condition,” said Dr. Kim.

Dr. Kim observed that Christie dragged her right leg when she tried to walk and she had lost sensation in her feet to the point that she couldn’t tell whether or not she was wearing shoes. The blockage of spinal fluid caused by the tumor resulted in a condition called syringomyelia. Christie’s entire spinal cord had stretched and thinned down to the size of a shoelace.

“In cases like Christie’s, one of the major goals is to intervene before the patient deteriorates to the point where recovery of neurologic function is not possible,” said Dr. Kim. “Surgery to remove large spinal cord tumors like hers presents a significant risk of neurological worsening, or even paralysis. However, in her case, without surgery, the chances of the tumor causing paralysis was a virtual certainty.”

Christie and Dr. Kim
In reviewing her imaging studies, Dr. Kim felt it was likely that she had a vascular tumor called a hemangioblastoma, which had little chance of recurrence if fully resected. In advance of the tumor removal, practice neurosurgeon Joe Bernard, M.D., performed an angiogram and embolization, which provided critical information about the blood vessels surrounding the tumor. This process allowed the surgical team to proceed with greater understanding and knowledge of Christie’s condition.

On September 4, Dr. Kim and practice neurosurgeon Dan Oberer, M.D., successfully removed the tumor. A postoperative MRI found no signs of the tumor, and the fluid within her spinal cord (syringomyelia) was significantly reduced.

So far, Christie is ahead of schedule for recovery. After the surgery in September, her goal was to be out of a wheelchair by December. She was actually walking without her cane by Thanksgiving and returned to work this January. She continues to go to therapy three days a week for almost three hours. In addition, she spends time on a treadmill two days a week to improve her walking skills.

“Christie has been blessed with the most heart, determination and family support of any patient that I’ve ever seen,” said Dr. Kim. “All of which have contributed to her remarkable recovery.”

For more information about the treatment of tumors and other spine disorders offered by Carolina Neurosurgery & Spine Associates, call 800-344-6716.
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