St. Louis Children’s Hospital

I’ll Walk You Down the Aisle Mummy
The Sun reports about Tracey, who used her family's life savings to fly from the UK with her son Lewis to St. Louis Children's Hospital after hearing about Dr. T.S. Park and a procedure called selective dorsal rhizotomy.  After a successful surgery, Lewis plans to step down the aisle with his mom on her wedding day next year.

September 2009 - Read the story in The Sun

T.S. Park, MD, Neurosurgeon-In-Chief at St. Louis Children’s Hospital and Shi H. Huang Professor Neurological Surgery at Washington University School of Medicine received the Winn Prize from the Society of Neurological Surgeons in recognition of his accomplishments in laboratory and clinical investigations. The international award recognizes outstanding continuous commitment to research in the neurosciences by a neurological surgeon, and it is regarded as the most prestigious research award in neurosurgery.

With his long-time collaborator, Jeffrey M. Gidday, PhD, associate professor of Neurological Surgery, Park studied the role of adenosine in regulation of neonatal cerebral blood flow, and chemical and molecular mechanisms of neutrophil-mediated microvascular injury of the neonatal brain. His laboratory research was funded by NIH for 22 years, including the Javits Neuroscience Investigator Award. Additionally, Park developed new selective dorsal rhizotomy technique for treatment of spastic cerebral palsy and demonstrated safety of the operation on over 1700 children and young adults from 38 countries. In collaboration with Jack Engsberg, PhD. who was associate professor of Neurological surgery, Park studied outcome of selective dorsal rhizotomy with funding from NIH. He contributed to worldwide acceptance of the selective dorsal rhizotomy as a treatment option for spastic cerebral palsy.

Park has authored over 170 journal articles. He serves as a director of the American Board of Medical Specialties; and American Board of Neurological Surgery; and American Board of Pediatric Neurosurgery. He is an editorial board member of Journal of Neurosurgery: pediatrics, and Child’s Nervous System.

• Making A Difference: Cerebral Palsy Miracle Surgery Helps Boy Walk - Nov. 14, 2006
• Cerebral Palsy Miracle Surgery Helps Boy Walk - Nov. 15, 2005
• Surgery Brings Miracles To Families - Apr. 29, 2005
  

March 18, 2003
"Momma, when am I going to get fixed?" Pat Lynn's five-year-old son, Isaac, asked as she knelt in front of him, snapping braces on his little legs.

"Someday, sweetie,'' the Springfield, Georgia, single mom answered.

"I hope I get fixed soon, Isaac sighed.

"So do I, honey." Pat whispered, hugging him. You've been through so much, she thought sadly. You were my little miracle. Now if you could only have just one more… Pat had always dreamed of being a mom. But in her 20s, after a series of medical problems, a doctor told her, "You'll never be able to give birth."

It's not fair! Pat wept. And as the years passed, her longing for a child never subsided.

Then, when she was 33, Pat found herself pregnant. And though her romance with the baby's father had fizzled, Pat was overjoyed. I'll be the best mommy she thought happily. But when Pat was only in her 27th week, her water broke. It's much too soon! she panicked. Yet incredibly, though Isaac weighed just over three pounds, doctors pronounced him healthy. "He just might lag a little in his physical development," they told her.

Over the next months, Isaac grew into a happy baby. Oh, he didn't sit up when Pat's friends' babies had, and he scooted rather than crawled, "But that's okay," Pat cooed, "you'll catch up."

But at Isaacs one-year check-up, the doctor ran tests and …

"I'm sorry, but your son has cerebral palsy," the doctor said.

"Dear God!" Pat gasped. "What will that mean for him?"

Cerebral palsy, the doctor explained, causes the nerves in the brain to misfire, resulting in loss of muscle control. "In Isaac's case, it's mostly the legs that are affected,'' he said, adding gently, "He may never be able to walk."

"Isn't there anything you can do?" Pat asked, tears in her eyes.

Physical therapy might offer slim hope for Isaac to walk, the doctor suggested.

So day after day, Pat took Isaac to a rehabilitation center where therapists exercised his body to strengthen his legs and back. But as months passed, progress was excruciatingly slow—and the exercises made Isaac achy, turning his usual giggles into whimpers.

What if he goes through all this and still can't walk? Pat agonized. By three years old, Isaac could finally sit up straight and even take a few steps with help. Doctors began a more aggressive treatment: giving him shots of Botox to paralyze the muscles, then placing casts on his legs to keep the muscles in place. The process, which involved as many as 26 shots in each leg, had to be repeated every six months. Looking on as Isaac flinched in pain, Pat wept: I'd do anything to take this agony from him! Yet, Isaac, rarely complained.

"It's okay, Momma," he'd say, watching other children romp in the park "It hurts now, but someday, I'll be able to play baseball like the other kids."

My amazing little boy! Pat marveled, He's consoling me!

Now, here he was at five -- and the Botox treatments were having less and less effect. On good days, Isaac could get around with a walker, but more often, he needed a wheelchair. One afternoon at Wal-Mart, Pat, as always, pulled into the parking space identified by the blue sign with the symbol of a white wheelchair.

Suddenly Isaac made the connection. "Is that why we get to park here?" he asked softly. "'Cause I'm 'candicapped?"

How do I answer? Pat agonized. "No, honey"she said. "It's because you're special."

"I don't wanna be special," he sniffed. "I just wanna be like everyone else!"

It's such a simple wish, Pat's heart squeezed. Please, Lord, help my baby! she pleaded.

That day, in the store, Pat bumped into a mom whose son also had cerebral palsy. When the woman mentioned a new surgery that could offer dramatic improvement, Pat rushed home to find "Selective Dorsal Rhizotomy"on the Internet. She phoned the hospital in St. Louis where the surgery was done,

"I have to warn you, there are no guarantees," the nurse told her.

"Isaac doesn't need a guarantee," Pat said. "All he wants is a chance."

And there was another problem: Pat's insurance wouldn't cover the procedure because it was still experimental. I can't let money stand in the way of a chance for my son! Pat vowed. And she wouldn't have to. Isaac's principal started a penny drive -- and Isaac's little friends were happy to help. And as soon as the media spread the word about Isaac's plight, every school in the county pitched in. So did Pat's church and local merchants. And within six weeks, they'd raised $30,000!

One month later, Pat and Isaac were in St. Louis. As he was prepped for surgery, Isaac seemed to read the worry in his mother's eyes. "I'm going to walk, Momma," he soothed, patting her hand, "you'll see."

"I know you will my brave boy," Pat told him. "I love you."

In the operating room, Dr. T. S. Park, the neurosurgeon who had devised the procedure, delicately isolated the nerves along Isaac's spine that relayed messages between his brain and legs. Then he separated and tested each rootlet for normal activity. Finally, he snipped the abnormal nerves.

It was a painstaking, four-hour procedure, but when he met Pat in the waiting room…

"Everything went well," Dr. Park told her. "Still, we won't know for five weeks whether Isaac will be able to walk."

But just five days later, on St Patrick's Day -- Pat's 38th birthday -- she entered Isaac's hospital room to find him standing beside his bed.

"Isaac!"she gasped. "What are you doing?"

"Just watch, Momma,"he said -- and began toddling toward her!

"You can walk," Pat shrieked in amazement, opening her arms wide. Slowly, he wobbled one step closer, two, three, four … and finally, fell into her arms!

"Happy birthday!" he cried.

Doctors were stunned. "Super Rhizo Kid" they nicknamed -- and sent him home earlier than anyone could have imagined.

Today, after two years of therapy, Isaac not only walks -- he plays basketball and rides his bike, too!

"I don't hurt anymore 'cause I'm fixed," Isaac beams. "Everything's okay, just like I said it would be, right, Momma?"

"Yes, it is, Isaac,"Pat smiles. "You always believed. And God provided the fantastic doctor who delivered a miracle -- and the best birthday present ever!

— Dana Hood

The following article featuring Dr. T.S. Park and the Hickman triplets was featured on CNN Your Health and appeared in Time Magazine in February 2002. The article describes premature triplets, all with cerebral palsy, who underwent the selective dorsal rhizotomy surgery at our Center.

February 25, 2002
A TIME columnist bears witness to an operation to help triplets with cerebral palsy walk like other boys

by Sanjay Gupta, MD

Cindy Hickman nearly bled to death the day she gave birth -- three months prematurely -- to her triplet sons. Weighing less than 2 lbs. each, her babies were alive, but barely. They clung so tenuously to life that her doctors recommended she name them A, B and C. Then, after a year of heroic interventions--brain shunts, tracheotomies, skull remodeling--often requiring emergency helicopter rides to the hospital nearest their rural Tennessee home, the Hickmans learned that their triplets had cerebral palsy.

Fifteen years ago there wasn't much that could be done about cerebral palsy, a disorder caused by damage to the motor centers of the brain. But pediatric medicine has come a long way since then, both in intervention before birth, with better prenatal care and various techniques to postpone delivery, and surgical interventions after birth to correct physical deficiencies. So although the incidence of cerebral palsy seems to be increasing (because the odds of preemies surviving are so much better), so too are the number of success stories.

This is one of them. Lane, Codie and Wyatt (as the Hickman boys are called) have spastic cerebral palsy, the most common form, accounting for nearly 80% of cases. "We first noticed that they weren't walking when they should,"Cindy recalls. "Instead they were only doing the combat crawl."Their brains seemed to be developing age appropriately, but their muscles were unnaturally stiff, making walking difficult if not impossible.

Happily, spastic cerebral palsy is also the most treatable form of CP, largely thanks to a procedure known as selective dorsal rhizotomy, in which the nerve roots that are causing the problem are isolated and severed. Among the first to champion SDR in the U.S. in the late 1980s was Dr. T.S. Park, a Korean-born pediatric neurosurgeon at Washington University in St. Louis, Mo., who has performed more than 800 of these operations and hopes to do an additional 1,000 before he retires.

Having performed the operation myself as a resident in neurosurgery, I was eager to see how the country's most prolific SDR surgeon does it. Last month I got an opportunity to stand by his side as he operated on 3-year-old Lane Hickman.

Peering through a microscope and guided by an electric probe, we were able to distinguish between the two groups of nerve roots leaving the spinal cord. The ventral roots send information to the muscle; the dorsal roots send information back to the spinal cord. The dorsal roots cause spasticity, and if just the right ones are severed, the symptoms can be greatly reduced.

Nearly half a million Americans suffer from cerebral palsy. Not all are candidates for SDR, but Park estimates that as many as half may be. He gets the best results with children between ages 2 and 6 who were born prematurely and have stiffness only in their legs. He is known for performing the operation very high up in the spine, right where the nerve roots exit the spinal cord. It's riskier that way, but the recovery is faster, and in Park's skilled hands, the success rate is higher.

Cindy and Jeremy Hickman will testify to that. Just a few weeks after the procedure, two of their sons are walking almost normally and the third is rapidly improving.