Jeni's Scoliosis Links	Jeni Bartleman has cheer for results of scoliosis surgery	Write to Jeni
by Donna Raines © Paducah Sun Newspaper March 2, 1986

Like cheerleaders throughout the region, Jeni Bartleman is practicing her back handsprings and other gymnastic stunts in preparation for competition March 15.

Unlike the others, she was flat on her back last June after surgery to put two rods in her spine.

Watching her flip backward, jump skyward, and roll forward, an observer would never guess what the 14 year old freshman went through last summer.

She was in surgery 6 hours; in intensive 1 and 1/2 days.

"I was in bed for a week and in the hospital 11 days," she said. "Then it was hard to walk and I couldn't sit."

Her problem? Not a spine injury from a car accident or a dive. She had scoliosis, a side to side curvature of the spine.

She didn't feel sick. She was doing her flips and jumps as an eighth grade cheerleader when the curvature was discovered.

And she didn't look sick- except to her family doctor who noticed the curvature when she came in complaining of an allergy.

With Jeni's curvature progressing quickly, doctors warned her that it could cause serious problems later - not so much in appearance, but in internal problems, such as heart and lung restriction.

After lengthy discussions with her doctor and her parents, Paducah Sun reporter Bill Bartleman and wife Carla, Jeni agreed to have corrective surgery.

"That was the hardest thing I ever had to do," said her mother, "to put a well child in the hospital, knowing it was going to make her feel a lot worse before she got better."

As soon as she could stand after the surgery, Jeni discovered that she had "grown" two inches from having the curve in her back straightened.

Scoliosis occurs in varying degrees in one out of ten children - mostly adolescent girls.

Kentucky is one of 19 states that requires scoliosis screening in the schools. A health department said 88 out of 885 youngsters screened in Paducah and McCracken County last year were referred to doctors for further examination.

According to local orthopedist Dr. Frank Kolb III, most of them don't need any treatment, just observation.

Laura Gowen, president of the National Scoliosis Federation, said just two or three out of 1000 need some treatment. Most common is physical therapy, next is the use of a brace.

Depending on the degree of curvature, the rate at which it is worsening and the number of growing years the child has left, the treatment may be surgical.

"We are dedicated to stopping needless surgery," Gowen said. She estimates that one in 1000 needs surgery. Kolb, who conducts a monthly scoliosis clinic, said he has referred only two patients in nine years for surgery.

He saw Jeni in October 1994 after her family doctor discovered the curve. No problem had been detected when she was screened in school in the fifth grade. But in the eighth grade, she went to her doctor with an allergic reaction to her cat, he referred her to Kolb for a scoliosis examination.

Jeni's curvature went from 25 degrees in October to 31 degrees in December. Kolb suggested a brace.

Jeni balked at the idea of wearing a brace, so her parents sought a second opinion. By February 1985, the second time she saw Dr. John Johnson of the Leatherman Spine Center in Louisville, the curvature had progressed to 41 degrees.

Johnson told the Bartlemans about a new procedure, Cotrel-Dubousset Instrumentation, originated in France and first performed in the U.S. in Louisville in October 1984. About 200 patients have had it.

Doctors from all over the world have visited Louisville to learn the procedure, Gowen said. It is being performed now in Miami, Minneapolis and Boston as well as in France.

Surgeons connect two stainless steel rods in the upper spine with hooks during a lengthy operation. The rods actually straighten the spine and keep it straight because they stay in the body. They may be removed in adulthood, after growth is completed if they cause problems.

Unlike most other surgical procedures, it does not involve a brace or cast during recuperation.

Those were the magical words for Jeni.

"I missed a lot (of summer activities) during surgery," Jeni said, "but when school started I was back in cheerleading. I didn't miss any games."

Leatherman clinic charge nurse, Nancy Spencer, said Jeni's recovery is not unusual. "That's one of the reasons this procedure is so exciting. People usually return to normal pretty quickly."

Although Jeni can feel the rods, they don't hurt or restrict her movement in any way. Her gymnastics instructor, Reidland Middle School teacher Steve Martin, and her cheerleading sponsor, Reidland High School teacher Jane Bolinger, said she is just as skilled on he gym floor as she was before surgery.

"She's even picked up some new things," Martin said. "She has done extremely well since her surgery."

Bolinger said she can do all the stunts the other members of the Junior Varsity squad can. "She was back doing everything by December."

RHS Varsity cheerleading sponsor, Vicki Burnette said she has been impressed with Jeni's grit. "She came to our mini-clinic last summer on her way home from the hospital...when she couldn't even sit up," she said. "More than anything it's her attitude."

Jeni said she was determined throughout the ordeal to bounce back. "At first, my friends didn't want me to do anything (in cheerleading). They were afraid, but I knew I had to."

The prospect of major, incapacitating surgery to a 13-year-old was scary, Jeni said. "I'd never even been in a hospital before."

But she never doubted her decision, even in the days of the greatest pain and restricted movement. "I never wished I'd chosen the brace."

She would have had to wear a brace, likely one from her waist to just below her chin, until she stopped growing - perhaps to age 16 or 18.

For a teenage girl whose heart is set on cheerleading, the emotional scar from a visible brace would have been great, her mother said. And after the curvature progressed so quickly, doctors felt surgery would be more effective.

Johnson, the surgeon, said a brace probably would not have corrected her curve permanently. "If she wore a brace for a year, the curve might have been better when she first came out of it. But 98 percent of the cases (with curvatures 35 percent or greater) will revert to their original state within five years. It still could have required surgery in adulthood."

He said scoliosis treatment has to be tailored to the patient. For example, for a patient willing to try any treatment to avoid surgery, he would have recommended a brace.

But for Jeni, the brace was the menace. "You know, sometimes the (mental) scar on the brain can be as a scar on the back. If we had braced her and then she had later needed surgery, she could have had a double scar from the whole ordeal."

With the Cotrel-Dubousset surgery has revolutionized spine surgery, it has not replaced other forms of scoliosis treatment, Johnson said. "It has simply added a new dimension." Other surgical procedures, such as in the front of the spine, are still more effective for some patients.

And, Johnson said, other new procedures, some even to come out later this year, will expand the scope of treatment even greater.

We will be glad to share our experiences with you if you would like to contact us. Jeni's Scoliosis Links

Jeni Bartleman Drake Carla and Bill Bartleman