Second Opinion Means Second Chance for Young Athlete

Spondylolysis patient Neill

Name any sport, and Neill Raymond has probably given it a try. He’s one of those people who are blessed with natural athletic ability. Coming into high school, he was excelling at his favorite sports—wrestling, football, and golf—and he was looking forward to an illustrious high school sports career. Then, the unexpected happened. He started to experience intense, unexplained back pain.

“Sports were a core part of his identity and social life, so it was really hard to watch him go through losing that connection,” says his mom, Amy.

Neill can’t pinpoint an exact incident that caused a vertebra in his lower back to fracture. Yet by the middle of his sophomore year, he was regularly experiencing throbbing lower back pain and shooting nerve pain, which meant he was facing the potential end of high school sports. He even found it difficult to stand in line, sit during class, or ride in a car without constant pain.

“Neill had spondylolysis, a break in the spine that probably developed after trauma. Most of the time in kids and young adults the bone slowly knits itself back together, but other times there isn’t enough stability for it to heal naturally. That’s what happened with Neill,” says John Vorhies, MD, a pediatric orthopedic surgeon and spine specialist with Stanford Medicine Children’s Health.

A long road to the right treatment

The family lives in central Kansas, which Amy says is not near a major health care network with advanced or emerging treatments. They sought care from multiple local orthopedic doctors, who had Neill try a number of treatments to help heal his back. He wore a back brace most of his junior year, but it didn’t provide enough support to promote healing. He received multiple nerve block injections in the area, which brought limited pain relief but not improvement. The family even explored the possibility of stem cell treatments but was told that they would not likely be effective for this injury.

“We spent a lot of time going through different treatments without a lot of satisfaction or relief for him, and it was taking its toll,” Amy says.  

Ultimately, Neill’s local doctor concluded that the only option for him was a spinal fusion—a surgery where two of his vertebrae would essentially be welded together with rods and screws. This would stabilize the fracture, but it would limit his spinal mobility, something that might have long-term implications for the health of his back.

A second opinion brings a new option

Amy wasn’t ready to take that option. In her relentless quest to find a better option for her son, she came across Stanford Medicine Children’s Health’s Online Second Opinion Program. It’s especially helpful for people who live in more remote areas of the country or in other parts of the world who don’t have a lot of options for getting in-person second opinions.

“We filled out a form, the service compiles all the relevant medical records, and Dr. Vorhies evaluated his case. He gave us some new ideas to take back to our local doctor. It really changed the conversation,” Amy says.

Ultimately, the family decided to seek care from Dr. Vorhies. For the family, it meant traveling to Palo Alto and staying nearby before, during, and after the surgery (and during COVID), but the effort didn’t matter as long as it would provide the best solution for Neill.

“To finally connect with someone who had ample experience and a proven case history in spondylolysis felt immediately right,” Amy says. “Because of Stanford’s reputation, we had a strong element of trust, and we felt confident that we would get the best level of care.”  

Early in Neill’s senior year of high school, when he was 17 years old, Dr. Vorhies performed a pars repair to resolve his spondylolysis. Spondylolysis is a fracture in a small structure of bone called the pars interarticularis, or pars for short. It connects the facets, or joints, between the bones of the spine. Fusion is a reasonable option to treat this condition, but in Neill’s case, Dr. Vorhies offered a less invasive repair of the fracture that avoided altering the normal mobility of the spine.

“Stanford was great. It’s one of the best hospital experiences I’ve ever had. Everyone was very helpful and kind, and Dr. Vorhies was awesome,” says Neill. “He made us feel comfortable about the procedure and confident going in that it was the right option.”

Neill’s pars repair required making an incision in his lower back so that Dr. Vorhies could place titanium rods and screws with hooks to squeeze the bone fracture together. Dr. Vorhies also removed scar tissue and placed a bone graft to encourage healing.  

“Neill was the ideal patient. He was very calm and motivated. We want children to go back to being children again, rather than becoming spine patients for life,” Dr. Vorhies says. “Unlike a fusion, the pars repair doesn’t alter the mechanics of the spine, allowing for natural mobility.” 

Stanford’s Pediatric Spine Center has advanced surgical capabilities, including the latest surgical methods, navigation tools, and imaging techniques, such as O-Arm surgical navigation, which gives real-time detailed 3-D models of an individual’s spine—something used for Neill.

“I was pleased that Stanford offered the latest advances, and to hear Dr. Vorhies say that a team from Medtronic would be in the operating suite to make sure there would be monitoring to avoid nerve damage was added assurance,” Amy adds.

“Surgery is a tough choice for parents. When it comes to their child, they have to put all of their trust in us. Amy had the right instincts to seek a second opinion so she could know she was making the right decision,” Dr. Vorhies says. “She handled it with such grace.”

From pars repair to shooting for par

The surgery was a success. It’s providing pain relief and empowering Neill to get back to sports. He was determined to return to playing golf by spring of his senior year, and he made that goal.

“It felt great to get back to sports,” he said. “Golf is something I can now do seriously.”

Seeing Neill back to being active was incredibly satisfying for Amy. She is proud of Neill for making the most of his high school experience despite all that he went through with his spondylolysis. It would have been easy for him to get depressed and give up on not only sports, but academics as well, but he didn’t let that happen. Today, Neill is enjoying his freshman year of college at the University of Colorado in Boulder studying mechanical engineering.

“I went snowboarding for the first time recently, and I was pretty worried it might hurt my back. I was surprised at the end of the day that I was barely sore,” Neill says.

The family is grateful for the care that they received at Stanford Medicine Children’s Health. Amy’s determination to find the best solution, and do whatever it took to give Neill the best chance at healing, paid off.

“We would’ve gone to the moon to find a solution, but we just had to go to California,” Amy says.

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