Amanda Anderson — Neurosurgeons use procedures developed at Barrow to save Queen Creek child’s life
-by Catherine Menor
Amanda Anderson seemed to be on the mend, and her parents, Dave and Shanna, were confident that the 18-month-old Queen Creek girl would be well enough to wear her new pink kitty costume for Halloween 2007.
Amanda was in her fourth day at an East Valley hospital, where she was receiving care for a case of suspected viral meningitis. “Doctors told us that if she didn’t have any high fevers and was stable, we could go home the next day,” says Shanna.
|
“All through the night, she couldn’t communicate at all. She couldn’t look you in the eye, and she was making these really strange movements. I don’t think she would have lasted much longer.”
|
The next morning, Amanda’s doctor ordered a CT scan and discovered the cause of her symptoms. The child had severe bleeding and swelling in her brain. Worried that child abuse might be the cause, the hospital alerted Child Protective Services and transferred Amanda to St. Joseph’s Hospital and Medical Center.
And that’s when the Andersons’ fortunes took a definite turn for the better.
Finally, a diagnosis Within a few hours of Amanda’s arrival at St. Joseph’s, the Barrow Neurological Institute team had found the cause of the bleeding—an aneurysm behind Amanda’s eyes. “The doctors explained that she would need surgery as soon as possible to stop the bleeding,” Shanna says.“This was not caused by an accident, and we were told she likely had the aneurysm from birth.”
Dr. Robert Spetzler, director of Barrow, explains, “The aneurysm involved very small blood vessels deep in her brain, a very unusual condition in a child so young. The aneurysm had ruptured, causing a life-and-death situation.”
Fortunately, a surgery scheduled for the next morning had been cancelled, and Dr. Sptetzler would be able to operate on Amanda.
“All through the night, she couldn’t communicate at all,” Shanna says of the agonizing hours before the Oct. 26 surgery. “She couldn’t look you in the eye, and she was making these really strange movements. I don’t think she would have lasted much longer.”
 |
|
Neurosurgical research conducted at Barrow—and supported by the Barrow Women’s Board, other benefactors and the Health & Wealth Raffle— enabled surgeons to successfully eliminate an aneurysm that ruptured when Amanda Anderson was just 18 months old. |
Dr. Joseph Zabramski is one of the neurosurgeons who developed the modified OZ approach. He says it was critical to the success of Amanda’s operation. “In young children, the skull is small and there’s not much extra room around the brain. Retracting the brain can put pressure on it and damage it. With the modified OZ approach, the Barrow team was able to reach the aneurysm without retracting Amanda’s brain.”
Once he reached the aneurysm, Dr. Spetzler removed it, leaving a hole in the artery where the aneurysm had arisen. He then did a very unusual bypass to repair the opening in the artery. Maneuvering a tiny nearby vessel over the opening, Dr. Spetzler secured the vessel in place with microscopic sutures to prevent future bleeding.
Dr. Spetzler credits the Barrow team’s ability to successfully perform the unique operation to the neurosurgical research conducted at Barrow.
“Through research, we were able to develop the modified OZ approach and conduct anatomical studies that demonstrated the feasibility of the bypass,” he says.
During the long hours of Amanda’s surgery, Dave and Shanna received regular updates from the Barrow staff. Finally, an anesthesiologist came out to tell the couple that the surgery was over.
The child recovered beautifully, her mother says, surprising even her doctors. A week after surgery, Amanda went home and within two weeks, she was attending church with her parents, visiting her grandparents and going to the zoo. Today, the long scar that runs from the top of her head down to her right ear is hardly visible beneath her blond ringlets.
“Amanda has been truly blessed and healed by some very skilled people and has been in the hands of our Father in heaven,” Shanna says. “It was not her time to go, and for that we are very thankful.” ■
Tyler Button — Barrow surgeons use latest techniques to remove tumor from young teacher’s spine
-by Melissa Morrison
 |
|
Tyler Button is back in his classroom after a spine-tumor scare
|
History teach Tyler Button was playing basketball with some of his high school students when an overzealous opponent hit him from behind. When Button’s neck was still aching a few days later, he went to the emergency room for a muscle relaxant.
Turns out, he had a tumor the size of a racquetball imbedded in his spine.
“They said they were surprised my spine was able to hold my head up,” Button says. “It was eating my spine away. I should have been paralyzed
or dead.”
Several hours of surgery, a bout of high-tech radiation, and a year later, Button, who is 25 and engaged to be married, is tumor-free.
Had he not discovered the mass in time, his neurosurgeon says, it would have further eroded the bones of his cervical vertebrae to the point where
a similar accident would likely have rendered Button quadraplegic, or worse.
“I hate to wax philosophic, but if this tiny incident hadn’t happened, dramatic things would have,” says Button, who teaches at the Peoria campus of the Austin Center for Exceptional Students, whose student body is learning disabled and emotionally handicapped.
“It kind of makes you question the idea of fate and whether this was meant to happen.”
‘High-priced real estate’
The tumor was located in the junction where the spinal cord meets the brain stem and is fed by two vertebral arteries, which were tangled in the tumor. “We were working in a very small area with a lot of high-priced real estate,” says neurosurgeon Dr. Nicholas Theodore.Removing the tumor took the latest in neurosurgical techniques.
Button lay face down, so the surgeons—Dr. Theodore and his partner Dr. William L. White—could reach around the spinal cord to access the
tumor.
|
“They said they were surprised my spine was able to hold my head up. It [the tumor] was eating my spine away. I should have been paralyzed or dead.” |
“The approach that we used was going from behind to take this tumor out in a fairly radical way,” says Dr. Theodore, who is director of trauma service at Barrow Neurological Institute. “A lot of people probably wouldn’t have done it two years ago. Our surgery techniques are on the cutting edge, especially in difficult cases like Tyler’s.”
During the operation, the surgeons referred to a real-time CT scan to guide them. Such navigational techniques have long been used for brain
surgery, but only recently have they been perfected for the spine.
After the surgeons removed the tumor, along with parts of Button’s spine, they replaced the missing bone with a piece from the young man’s hip, fusing together three of his cervical vertebrae.
Radiation via robotic arm
The surgery was followed by radiation treatment using a CyberKnife, which directs a convergence of more than 100 beams of radiation on a tightly focused spot, thus sparing most healthy tissue. The machine allowed neurosurgeon Dr. Randall Porter to program it to deliver its potent radiation via robotic arm to Button’s lesion. As a result, the patient suffered few side effects.
“It looks like a giant projector and a giant arm thing similar to the arm of a space shuttle,” Button says. “It’s so accurate, it’s able to miss nerves and arteries.
“I thought it was going to be cool till I actually went through it.” Button had to wear a mesh mask—”very medieval”—that was fixed in place, immobilizing him for each hour-plus session of the weeklong treatment.
Drs. Theodore, White and Porter’s combined effort is a prime example of the team approach Barrow takes toward tumor cases. “Just taking the tumor out is not enough,” Dr. Theodore says. “Even if the patient doesn’t need radiation, they do need close follow-up to make sure the tumor doesn’t recur.”
As for Button, he and his longtime girlfriend, Melissa Austin, made it official over the holidays. They plan to marry next spring.
He has reminders from the experience in his classroom. He’s hung the CyberKnife face mask on the wall there. And the student who was responsible for the fateful neck injury frequently stops in.
“He comes by all the time saying he saved my life,” Button says. “He honestly did save my life, but I don’t let his head get too big.” ■
Renee DeSalvo — Woman placed in hospice gets second chance at Barrow
-by Catherine Menor
 |
|
Renee DeSalvo is enjoying life again after a frightening encounter with an arteriovenous malformation. |
Cindy and Steve Crandall, DeSalvo’s sister and brother-in-law, were in shock. DeSalvo had seemed perfectly healthy until that Wednesday when she’d suffered a severe pain in her right eye and passed out at work. Doctors at the hospital where she was taken told the family that an arteriovenous malformation—an abnormal tangle of blood vessels on the left side of her brain—had ruptured, causing a massive hemorrhage and leaving the 53-year-old woman paralyzed and blind on her right side.
“They said that if they operated, she’d probably be a vegetable and need a feeding tube,” recalls Steve.
The doctors recommended hospice, and, knowing DeSalvo’s independent streak, the family reluctantly agreed. DeSalvo received last rites and was transferred to a nearby hospice. It was Wednesday evening.
Second thoughts
As DeSalvo lay in her hospice bed, still unconscious, her family gathered to say their goodbyes. DeSalvo’s long-time friends “The Crazy Eights” caught a red-eye from Chicago to be with her one last time.
But late that night, DeSalvo suddenly reached over to one of her two grown sons, and said, “Why are you crying?”
The next day, she was moving her affected right side some, and she seemed to recognize people. That’s when Steve decided the family needed a second opinion. Steve, who was well acquainted with Barrow, drove DeSalvo’s scans to St. Joseph’s late Thursday night in hopes that he could get Dr. Robert Spetzler, director of Barrow, to take a look at them.|
“Life is so beautiful. Every day is a good day.” |
Early the next morning, Steve called Barrow and reached a doctor. Ten minutes later, he had an answer— Dr. Spetzler would do the operation that day.
Things happened rapidly after that. DeSalvo arrived at Barrow by ambulance, and the Barrow team quickly obtained new CT scans. Then, Dr. Spetzler met with the family to map out his treatment plan, and the family agreed to surgery.
A team of neurosurgeons, led by Dr. Spetzler, removed the blood clot and the AVM from DeSalvo’s left temporal lobe. At 6:30 Friday evening, the family received the news they’d been praying for—the surgery had been successful.
“There are no words to explain how this feels,” says Cindy. “It’s that big of a miracle.”
Long road back
DeSalvo spent a rocky week in ICU, a few days in a regular patient room, and nearly three weeks in the Deborah and Bruce Downey Neuro Rehabilitation Center. There, she learned how to sit in a chair, walk with a walker and feed herself. She also worked on improving her memory and ability to communicate. DeSalvo left the hospital in late January and continued outpatient rehabilitation until December 2007.
Today, DeSalvo, who has no memory of her hospital stay, lives independently. She reads and does puzzles daily to improve her cognitive skills, attends Brain Tumor Support Group meetings at Barrow, and volunteers at a school and hospital near her home.
Although she still has language and thinking deficits and peripheral vision loss, DeSalvo is grateful for the second chance she’s been given. And her attitude is much better now than it was before her ordeal, she says. “Life is so beautiful. Every day is a good day.”
DeSalvo hopes someday to work as a volunteer at Barrow, helping other patients achieve a more positive outlook after surgery.
In February, DeSalvo flew back to Chicago for a 40th school reunion. She couldn’t wait to see all her old friends. ■
Wendell Brown — Sales executive is first at Barrow to receive FDA-approved artificial cervical disc for neck pain
-by Sally J. Clasen
 |
|
Wendell Brown |
In July 2007, Brown was lifting barbells over his head when he felt a twinge on the left side of his neck and shoulder. “I assumed I pulled a muscle, so I stopped working out. I waited a couple of days, but the pain did not stop. It was an excruciating, sharp pain in my neck, arm, through the upper back and down my leg.”
Brown first went to an urgent care facility, where he was prescribed pain medications, and then followed up with his general doctor, who ordered x-rays and more pain meds. When the x-rays didn’t reveal anything significant, Brown had an MRI done. In the meantime, he did physical therapy to alleviate the symptoms but continued to have problems.
Two months after the injury occurred, MRI results revealed that Brown had damaged the cervical disc between his fifth and sixth vertebrae, which was pressing on his nerves. Brown’s primary physician then referred him to Barrow neurosurgeon Dr. Nicholas Bambakidis, who suggested that
Brown undergo a new technique in which an artificial cervical disc is used to replace the damaged one.
Novel technique
Brown decided to take his doctor ’s advice, and six months after injuring his neck, became the first Barrow patient to have the Prestige artificial cervical disc, a product of Medtronic, inserted into his neck. It is the first artificial cervical disc to receive FDA approval.
The most common treatment for cervical degenerative disease is an anterior cervical discetomy and fusion to relieve compression on the spinal cord or nerve roots. While more than 200,000 fusion surgeries are performed each year, the surgery has some limitations, according to Dr. Bambakidis, who does two to three fusion surgeries a week.
“With fusion surgery, the goal is to remove the disc causing pressure on the nerves and replace it with nothing, or replace it with a piece of bone and metal plate to create the fusion. The problem is that it ‘freezes’ the joint, and since the diseased disc isn’t replaced with something that physiologically resembles the original, the person’s mobility is decreased.”
Benefits of artificial disc surgery
|
“Patients who’ve had artificial disc surgery... seem to do better than those who have traditional fusion surgery.” |
Surgeons insert the artificial cervical disc, a stainless steel device with a ball-in-trough design, through the front of the neck in a procedure that takes about an hour to perform.
“In clinical studies in the United States and Europe, patients who’ve had artificial disc surgery return to work quicker, have less pain and generally seem to do better than those who have traditional fusion surgery,” Dr. Bambakidis says. He says an added benefit of the artificial cervical disc is that it may decrease the risk of arthritis above and below the area affected because it allows patients to maintain better motion.
While those who have had prior fusion surgery to the affected area are not candidates for artificial cervical disc surgery, it shows particular promise for those with degenerative disease and injury to one cervical disc. “All patients with degenerative cervical disease can be considered for artificial disc surgery, but, in particular, younger people limited to one level of disease are the best candidates,” Dr. Bambakidis says.
Brown stayed one night in the hospital after surgery. He immediately felt better and has no pain or discomfort. He is participating in physical therapy and “working his way back” to his regular exercise regimen.
“As far as I’m concerned, I have no limitations,” Brown says of his post-surgery condition. “I’m thoroughly pleased with the implant.” ■
