July 7, 2011 -- Just a year ago, severe pain and schoolyard bullying were a daily reality for Joshua Stewart, a U.K. teen afflicted with severe scoliosis that twisted his spine and left him with a hunchback. Now, thanks to a surgery that implanted two metal rods in his back, Joshua is not only up and running again, he's biking several sections of the Tour de France.
"Before the surgery, my whole back was curved, my hip was out of place, and breathing was difficult at times. It was quite painful…and there was quite frequent teasing. I didn't want to live like that for the rest of my life," Joshua, who lives in Hampshire, U.K. says. Just a year after his surgery, Joshua is biking about 40 miles a day of different stages of the Tour de France with his father this week, often hitting the trails the day before the official race does.
"I'm in no pain anymore -- it's brilliant!" Joshua says.
"This is his first big cycling trip ever, so it's a great accomplishment," says Joshua's father, Paul Stewart, who is riding with him. "Before the operation we were concerned he may not be able to ride his bike like before, but he's doing great."
The Tour de France is considered the most prestigious cycling race in the world. This year it will cover over 2,000 miles of terrain throughout France and last from July 2 to July 24.
Though Joshua had had pain, muscle tightness and a "twisted figure" a couple years back, it wasn't until he got injured in a rugby game a year and a half ago that he and his family began to realize that something was seriously wrong with his spine. The doctors thought he had broken a rib because of the way his chest was warped, but after getting a second opinion, Joshua and his parents found out he had severe scoliosis.
"Joshua came in with a significant curve to his spine, but it was his rotation that was monstrous," says Evan Davies, Joshua's orthopedic surgeon at Spire Southampton Hospital, U.K. Davies says that Joshua's spine was twisted about 45 degrees off from where it should be, causing his rib cage and back to look disfigured.
"We operated from the back of the spine and put in rods that screwed into his bones to shape his spine and rotate it back around. They will stay there forever, since he's not going to grow anymore," Davies says.
The surgery, which once left patients on bed rest for weeks afterward, now has a much shorter recovery period and doesn't require any follow up physical therapy. "We told Joshua to get on with it and go back to his normal sports activities. The bike is the best thing he could do because it's not high impact, it's aerobic, and being in bike position offloads strain from your back," says Davies.
Scoliosis affects 1 in 2,000 people in the western population, but very few of these require surgical interventions like Joshua's, Davies adds.
Surgery For Scoliosis
Before the 1990s, scoliosis surgery involved wearing a cast for nine months afterward and a great deal more bed rest and recovery than is experience by kids today, says Dr. Andrew Casden, associate director of the Spine Institute of New York at Beth Israel Medical Center. "Now, there's no cast or brace post-op and with adolescents. The recovery can be quick. Kids are usually up walking the next day," he says.
While the rods used in scoliosis surgery are completely immobile titanium, the patient's movement is not really restricted if the surgery only deals with the thoracic, or upper spine. "These kids have pretty much a normal life after surgery," Casden says. When the curve of the scoliosis takes up the upper and lower portions of the spine however, the rods implanted can limit motion a bit and recovery can be longer.
In Joshua's case, the rods affected only his upper back and he has negligible limitation in his motion. He still suffers some aches and pains because of his condition, but otherwise he says he feels "fantastic."
"Before I was quite self conscious -- people would not know what to do when they saw my hump. It feels really good knowing that I look and feel normal. And the cycling is great fun. I've always liked cycling and now I get to experience one of the biggest races … the Tour de France."