Estephan Zuniga

No more pain

Estephan Zuniga is enjoying being a teenager. He smiles broadly as he talks about hanging out with his friends and what he might do for a career some day. But until he recently received specialized pediatric neurosurgery and orthopaedic surgery at Children’s Hospital, what he wanted most was to breathe normally, walk without slumping over and not be in constant pain.

“I just wanted to be like other kids,” explains Estephan, recalling life before medical treatment.

Diagnosed with mild scoliosis in junior high school that progressed rapidly, Estephan soon suffered from a debilitating 100-degree curvature of the spine. Hunched forward, with a large prominence on his back and his right shoulder significantly higher than his left, he had trouble walking and tired easily. Scoliosis this severe puts extreme pressure on the heart and lungs, and can become life-threatening if untreated. Estephan also experienced ongoing headaches and muscle weakness due to other medical complications, including structural defects in the cerebellum that affected the normal flow of spinal fluid to and from his brain.

As his health declined, Estephan became more socially withdrawn. “He stayed in his room a lot,” says his mother, Llane Zuniga, glancing sadly at her son in their Fresno home. “It was very difficult for him – and for us.”

Not any more.

Thanks to Dr. Meredith Woodward, a neurosurgeon, and Dr. Michael Elliott, an orthopaedic surgeon, at Children’s Hospital, Estephan, now 17, has a new life. Surgeries with each physician resolved his spinal fluid issue and, using a new, safer technique to improve spinal deformity, reduced his curvature by an impressive 80 degrees. “I don’t know where I’d be without both doctors,” says Estephan.

The diagnoses

Estephan’s first experience with Children’s Hospital began when he was a baby. Dr. Woodward surgically removed a cyst on the back of his head, with a root that extended deep into his brain. Estephan didn’t experience any health issues until years later when he learned he had scoliosis and was referred to Children’s for further evaluation. Dr. Woodward diagnosed Estephan with Chiari malformation type 1. The congenital disorder – in which part of the cerebellum is located below the opening at the base of the skull – affects the natural flow of cerebrospinal fluid, the clear liquid that cushions the brain and spinal cord. The condition can cause headaches, fatigue, muscle weakness and sometimes paralysis.

“Essentially the brain gets pushed into the cervical spine because there’s not enough room in the head for the brain, and this puts pressure on the brainstem,” says Dr. Woodward.

Life-changing surgery

To correct the issue, Dr. Woodward performed decompression surgery. She removed a small portion of bone from the back of Estephan’s skull and upper cervical spine and created a “patch,” thereby reducing the pressure and making more space for the brain tissue.

“If done incorrectly, the brain procedures could have hurt Estephan’s ability to function,” says Zuniga. “Dr. Woodward took care of Estephan very well, just like when he was a baby.”

To improve Estephan’s severe curve, Dr. Elliott turned to a cutting-edge technique. Used for curves of 100 degrees or more, Internal Traction is performed in two stages. The first surgery implants a rod that partially straightens the spine. A second operation a week later inserts double rods allowing further improvement. This gradual approach is safer for the patient and results in shorter hospitalization.

“Like with Dr. Woodward, I knew how risky a spinal surgery can be,” says Zuniga, tears in her eyes. “But Dr. Elliott didn’t let us down – he gave us back our son.”

Dr. Elliott emphasized these complex procedures should be done at a pediatric hospital such as Children’s that specializes in spinal surgery: “We have the best options available with modern technology that we can tailor to each patient.”

Today, Estephan stands taller and breathes easier – literally. No longer wishing he could be like “the other kids,” he enjoys socializing and school. “I can run now and lift weights,” he says. “I’m not in pain any more.”