The Risks of Spinal Deformity Surgery

In order to minimize the risks of spinal deformity surgery for scoliosis, kyphosis, spondylolisthesis, spondylolysis, etc….. Obtaining a thorough medical history is necessary, along with a physical examination, blood work and imaging studies.  Shared decision-making is important during discussion about surgery, along with the alternatives to surgery, the benefits of surgery, potential complications and risks.  […]

Shilla Growth Guidance Procedure

1. What is the Shilla procedure? The Shilla technique is one which passively guides spine growth, rather than actively distracting across like a growing rod system.  I refer to it as a “track and trolley” system.   2. Who is a candidate for the Shilla technique?  Many patients who are candidates for traditional growing rods […]

Vertebral Body Stapling (VBS) Part 2

1.  What is the success rate for VBS?  Two centers have reported their outcomes of VBS in patients (Washington University in St. Louis, and the Philadelphia Shriner’s).  Overall success rates for lumbar and thoracic curves are around 70%, which means the curve improved, did not change or changed less than 6 degrees.     2.  What […]

Vertebral Body Stapling (VBS) Part 1

What is Vertebral Body Stapling?  How is it different from Vertebral Body Tethers?  In a previous blog the surgical technique of Vertebral Body Tethering was presented.  This technique places a compressive force over the convex side of the spine (slowing down growth), to permit the concave side of the spine to relatively grow more and […]

Vertebral Body Tethering Part 5

In earlier posts VBT has been extensively detailed.  One question that commonly is asked during discussion of VBT with patients and caregivers is: “What are the long-term issues with VBT?” The simplistic answer is: “We don’t know”. One layer to this question is what happens to the actual tether?  If we look at other implant […]

Patient Feature: World Pediatric Project

The World Pediatric Project’s winter fundraiser called “Treasures in Paradise” happened last week, Friday January 26th, The keynote speaker was Erickson Hernandez, a wonderful young man who Drs. Manke and Goldfarb, and myself treated at our Shriner’s Hospital. Check out the web address (copy and paste in your browser) below for a video of Erickson’s […]

Vertebral Body Tethering Part 4

  Primum non nocere or “do no harm” is a basic tenet of medicine.  This is why for surgical procedures, such as Vertebral Body Tethering or VBT, safety is the pre-eminent concern, even more so than its efficacy or how well it works.  If a surgical procedure is safe (infrequent, minor complications, with no significant […]

Vertebral Body Tethering for Scoliosis Part 3

  In Medicine, and in particular the area of spine deformity, the development of new treatments and technologies which can demonstrate improved outcomes, lower frequencies of complications, and/or faster recovery can create a “buzz” and enthusiasm depending on its potential of improvement.  Physicians typically see these innovations earlier than the general public at medical meetings […]