They went for a second opinion, then a third. They scoured the Internet. They asked friends, made calls.

But there was no getting around it: Keyara Milliner, 13, was going to need surgery for scoliosis, an abnormal curvature of the spine typically diagnosed in children between ages 10 to 15.

The operation, invasive in the extreme, would involve long incisions down Milliner's spine, stripping all the surrounding muscle and then fusing the spine to straighten the curves and prevent future abnormal curvatures.

For a girl passionate about dance, who would routinely fling her body about with acrobatic moves, this was not welcome news. It got worse when an expert at Stanford University told the Oakland girl that she could possibly do tap dancing – and tap only – post-op.

But that same doctor also had a suggestion, remembers Keyara's mother, Charlotte.

"He said if his child needed scoliosis surgery, he'd go to Dr. Picetti," she recalls.

That would be Dr. George D. Picetti III, a renowned pediatric spine surgeon at the Sutter Neuroscience Medical Group in Sacramento. Thirteen years ago, Picetti developed a minimally invasive surgical procedure for scoliosis, using an endoscope and considerable fine motor skills, to correct curvatures without the trauma of major surgery.

Advantages: significantly shorter recovery time and less chance of residual spine problems.

Over the year, Picetti has performed more than 800 such surgeries and has trained hundreds of other spine surgeons. "But only a handful (of surgeons) do it regularly because it's technically demanding," Picetti says.

Which is why he is much in demand. And why Charlotte Milliner dashed off her daughter's complete medical records, including scans, to Picetti in Sacramento and included "a letter pleading with him."

It worked.

Picetti saw that Milliner had a significant curvature, 68 degrees on her previous scans and 77 degrees at the time of surgery. He also saw that she had an accompanying condition, Chiari's malformation, a genetic structural defect at the base of the skull.

He wanted to operate right away and found that he had a more than willing patient.

"I really wanted to get back to dancing and, well, I didn't want to look like that for the rest of my life," Milliner says.

Keyara's mother had been told by a Pilates instructor that her daughter's back was curved, but it wasn't until Keyara had a growth spurt (two inches in three months) that the situation worsened.

"She developed this immense, borderline deformity," Charlotte says. "It was clear. Her ribs were sticking out in front and her back was sticking out the other way. She needed it corrected."

Last March, Picetti operated on Milliner's spine. He made five incisions – each 2 centimeters (less than an inch) in length – through the chest cavity, weaving between muscles, put in small portals to remove disks and insert implants. (A colleague, Sutter neurosurgeon Samuel Ciricillo, corrected the Chiari's defect.)

Keyara missed only a month of school, after surgery, and wore a back brace for three months. By the sixth-month mark, she was back dancing (ballet, jazz and modern dance) with nearly the same flexibility as before.

That is the norm with the endoscopic procedure, Picetti says.

"I've looked at kids who've had the standard (operative) approach and the endoscope," Picetti says. "There's a two- to four-week recovery time compared to eight to 12 weeks standard. That's a huge difference."

Anecdotally, he's often found that adults and children who've had the less-invasive surgery need less pain medication. "Some kids, when they leave the hospital, they're already off the pain meds," he says.

Milliner says she took nothing stronger than Tylenol after the first 10 days and started walking a mile a day to strengthen her back.

"The big back incisions are tough for anyone to recover from," Picetti says. "It's a big insult to the body. What we try with this (procedure) is to minimize it."

Picetti first hit upon the idea of a less-invasive procedure when he was a resident and observed a general surgeon opening a chest.

"She was moving the lung and whisked it away from the chest wall, and I looked and said, 'Wow, the spine is right there,' " Picetti recalls.

Back then, a few doctors were using arthroscopy for the relatively simple task of removing disks. Picetti eventually found a way to weave all the implants and portals through an endoscope to be able to correct scoliosis curvatures.

"The hardest thing for surgeons to do is to completely remove the disk and prepare for the fusion," he says. "It's not an open procedure in which they can put their hand in and touch, which is normally what a spine surgeon does.

"With a scope, your hands are working in one direction and you're looking in a totally different direction. That's not something spine surgeons generally do."

And the elaborate dance moves Milliner is performing are not what standard post-op scoliosis patients normally do.

"The first week or so, I wanted to go slow because I didn't know my limitations," Milliner says. "After the second week, I just let it go. I'm back to my normal routine."

Call The Bee's Sam McManis, (916) 321-1145. Read his postings on the Sacramento Health & Fitness blog at sacbee.com/blogs.