By John Morgan, Spotlight Health
With medical adviser Stephen A. Shoop, M.D.

As the #1 ranked female pool player in the world from 1994-1996, Jeanette Lee can make a pool ball slam, bend, spin, and curve magically into pockets. But another kind of curve nearly scratched her career - scoliosis, often called curvature of the spine.

"I was 12 and my mom and I went to the beach -- which was pretty special," recalls Lee, who is nicknamed the "Black Widow" for her all black outfits and lethal pool game. "I took off my shirt and she saw my back as I headed down to the water and she just sort of gasped and took me immediately to the doctor."

"The doctor took one look and immediately knew it was scoliosis," Lee adds. "My spine was shaped like an S with both curves over 55 degrees so it was very severe. And they told me what the options were and that I'd need surgery, but I don't think it really made sense to me what was happening."

What was happening was Lee's spine was becoming severely deformed.

The word scoliosis is derived from the Greek word meaning curvature and happens when the spine curves to one side or the other in the thoracic and/or lumbar areas. This typically appears during adolescence but can occur in younger children.

Scoliosis affects 2% of women and 0.5% of men in the general population. But while boys and girls are equally likely to have some degree of scoliosis, girls are four times more likely to have their curvature progress and require surgical or other intervention.

Lee is intervening by helping raise awareness about scoliosis.

"I want people to know what scoliosis is so parents and schools can catch it early," says Lee, who also designs pool tables for Mosconi billiards. "If more parents are aware about scoliosis and what it can do, they will be better equipped to check their child themselves."

And making sure kids get checked is critical.

If untreated, scoliosis can lead to a deformed spine which can be painful depending on where the curve is located. There is also some risk that the curve will continue to increase and could then interfere with the function of the heart and lung.

Learning curve

Most schools test children in the fifth or sixth grade using the forward bending test.  This simple exam is basically a bubble level inside a protractor that is used to measure the spine when the child bends forward at the waist.

Lee somehow missed this evaluation and owing to her private nature, her parents never really saw her naked back until the day at the beach.

"I must have been sick that day at school because I never got examined," states the Women's Professional Billiard Association's #4 ranked player in the world.

Another mystery is the cause of scoliosis.

About 80%-85% of the patients have idiopathic scoliosis which means the cause is unknown. The remaining 20% or so of scoliosis cases can be caused by:

• Nerve and muscle disorders such as cerebral palsy, muscular dystrophy and polio
• Congenital abnormalities in the vertebrae
• Connective tissue disorders like Marfan's Syndrome
• Chromosomal abnormalities such as Down syndrome

However, contrary to popular belief, heavy book bags or poor posture do not cause scoliosis.

"I never had any symptoms, which is part of the silent nature of scoliosis," says Lee. "One minute I was fine and the next I was in a daze because everything was happening so fast."

Lee immediately underwent surgery to correct the curvature by fusing her spine and was placed in a brace that she was told she would have to wear for a year.

"When I woke up after surgery, the pain was incredible because they really had to tear apart my spine to correct the curvature," Lee says. "I was really in incredible agony."

But spinal surgery has advanced dramatically.

First, scoliosis is usually confirmed with an x-ray, CT scan, or MRI .  The patient's degree and location of curvature, skeletal age, and development along the growth curve are all factored into whether the spinal specialist recommends observation, bracing or surgery.

"Nowadays the kids who require surgery are in the hospital for only a few days," reports Terry Trammell, an orthopedic spine specialist at Orthopaedics Indianapolis and Lee's current surgeon.  "They walk out of the hospital and for the most part do not have to wear a brace. And the instruments we use to correct the scoliosis are more sophisticated than when Jeanette was operated on. Some of the surgeries can even be done minimally invasively."

The gold standard treatment is still a posterior surgery, meaning it is done from an incision on the back. Screws are now usually employed to affix stabilizing rods to each vertebra to reduce the likelihood of something coming loose or developing a pseudoarthrosis, a demineralization of a weight-bearing bone that is followed by fracture, impaired healing, and a deformed joint.

But Lee wasn't so lucky.

Bad break

"I wish I had been told more clearly how important wearing that brace was," says Lee, who co-authored The Black Widow's Guide to Killer Pool. "Because I really did not wear it like I should have. At school I was so self conscious and shy that I would take it off because I was too embarrassed and put it in my locker until it was time to go home."

"Well by not wearing the brace enough, my spine did not heal fully - and I developed a small gap between two of my vertebrae (a pseudoarthrosis)," Lee explains. "As I got older the pain got a lot worse. But I just would not even consider surgery again because the first experience was just too traumatic and painful."  This complication can occur even when patients are fully compliant with wearing their braces, however.

But Lee developed a herniated disc in her neck and also began having serious shoulder pain.

"Eventually it got so bad I couldn't even play pool," Lee says. "That's when I decided to have all the surgeries I needed done three weeks apart and just get it over with."

"We saw the pseudoarthrosis on a plain X-ray and a split where the fusion didn't heal," says Trammell, who is also the orthopedic consultant to CART and the on track medical presence for the auto racing series. "It was painful for Jeanette because it was in an area where she would bend to shoot a pool ball."

"The only thing you can do is go back in and refuse it surgically," Trammell explains. The surgery was a "complete dream success" according to Lee, who returned to the WPBA tour after a short twelve week recovery.

But even on tour Lee continues to support those with scoliosis, donating any money she won during last week's Canadian Club Showdown in Las Vegas to the Scoliosis Association.

 "I feel really lucky because my experience was difficult but I overcame it," Lee says. "I became the National Spokesperson because I want to help other girls avoid a lot of pain, embarrassment and loneliness. The reason I had really long hair was to hide my scars because I felt horribly insecure and ugly. Now I show people my scar. The more I have talked about this -- the better I felt."

"I felt weak my whole life and I don't want to feel weak any more," Lee states. "I don't want the girls I know, like Holly Swain and Kellee Miller, who are going through this to ever feel weak. I know I went through this for a reason.  Mine was so I can make a difference helping others and myself with scoliosis."

For more information about scoliosis, go to the Scoliosis Association.

Spotlight Health is the leading creator of celebrity-featured health-issue awareness campaigns, connecting consumers with impassioned celebrities whose personal health battles can open eyes, dispel myths and change lives. Spotlight Health helps sufferers and caregivers meet the challenges of difficult health circumstances with understandable, in-depth medical information, compassionate support and the inspiration needed to make informed healthcare choices.

Created: 4/26/2003  -  John Morgan & Stephen A. Shoop, M.D.