Dr. Anthony Romeo helped Jake Peavy regain his 95 mph fastball.
But he’s just as proud of helping 15-year-old Stephen Greene lift a cup to his lips.
Stephen has muscular dystrophy and Dr. Romeo is one of only a few surgeons in the United States who have the opportunity to perform this surgery on a routine basis.
Specifically, Dr. Romeo performs a complex operation called a scapulothoracic fusion; he fuses the inner edge of the shoulder blade to the ribs below them. The result literally allows helpless patients to once again lift their arms.
Stephen’s case is typical. Two years ago the active El Paso, IL teenager noticed some shoulder pain throwing a baseball, gradually both arms became weaker. His local doctors were stumped for two years. However, when a neurologist discovered Stephen also had trouble smiling, couldn’t whistle, and slept with eyes slightly open, he made the diagnosis.
Stephen had Facioscapulohumeral Muscular Dystrophy (FSHD). It’s the most common form of MD, affecting 7 in every 100,000 people. For unclear reasons the muscle cells of Stephen’s face, upper arms, and shoulders were progressively becoming weaker and dying.
After two years Stephen could barely raise his arms. The problem is his illness had weakened his serratus anterior, a critical muscle that binds our shoulder blades to our rib cage. By pulling the shoulder blade towards the ribs and stabilizing the bone against the chest wall, the muscle allows us to lift our arm forward. Without this muscle, Stephens should blade had become unstable and it was difficult or impossible for him to raise up his arm.
Stephen’s left arm had become useless. He couldn’t lift a glass of milk to his lips. In his daily life he couldn’t eat, drink, lift or reach. In addition, Stephen’s unanchored shoulder blades now popped outward, a familiar sign of FSHD called “winging.”
“The best treatment,” says Dr. Romeo, “is to remove the useless serratus anterior muscle and literally fuse the shoulder blade to the 3rd-6th ribs. Patients can then lift their arms because the shoulder blade is stable and fixed to the chest wall.” The orthopedic surgeon heads the Shoulder Service at Rush Medical College and is a co-Team Physician for the White Sox.
The problem is the operation takes place right against the lungs. That means a strong risk of a pneumothorax (punctured lung) or injury to the nerves and vessels along the ribs. In the close-knit muscular dystrophy, Dr. Romeo has become a “go-to” surgeon.
Last January Dr. Romeo operated on Stephen’s left shoulder. Operating from behind, he dissected the shoulder area’s muscles and tissue. He then removed the serratus muscle and used wires and a bone graft to fuse the inner shoulder blade to the ribs below them. The surgeon also took samples of Stephen’s affected and unaffected muscles. Researchers will use them to search for clues to Muscular Dystrophy’s cause.
“Stephen is absolutely thrilled with the results,” says his father Larry Greene. “Now he can lift his arm up and keep it there. He can take a drink and hold it up without having to use the other arm. He can dress and do normal activities again.”
“And with 15-year-olds appearance is important,” he continues. “There’s no winging of his back and it’s changed his posture back to normal.”
Muscular Dystrophy is one of the most common muscle diseases. Over the next ten years, the illness will strike tens of thousands of Americans. There is no cure; but at least there’s an operation that can make a world of difference for many patients.
Stephen is scheduled to get that operation on his right shoulder on Monday. “He can’t wait,” says his father.
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