Followed by conversion to Growth Guidance Surgery 6-26-2024 This case is a continuation of the last post in which a very young male was treated with a unilateral MAGEC rod. In that post the case ended at 3 years after placement of the MAGEC rod with it being maximally lengthened. He is now 6 years […]
Category: Decision Making
Blog Post: Use of Unilateral Magnetically Controlled Growing Rod (MAGEC) in severe, progressive infantile scoliosis
6-17-2024 Below is a case showing use of a unilateral growing rod in a young patient. Above are the radiographs of a 3-year-old male whose scoliosis has progressed despite casting and brace wear. Options were presented and the decision was to proceed with operative management. The surgical treatment was a single rod, placed on the […]
ApiFix
3-12-2024 This is a 10 year old female with idiopathic scoliosis. Radiographs measured out a 64 degree right thoracic curve. To determine the treatment options some of the additional information is crucial. Specifically, the amount of growth remaining which is best determined by the Sanders classification. This patient is a 3- which means the spine […]
Development of a Treatment Matrix for Adolescent Idiopathic Scoliosis (IS)
The following post is an abridged version of a PowerPoint talk I recently presented to the Washington University School of Medicine Orthopaedics Residents on 3-21-2023. It is important to understand the purpose of this talk is to present these big treatment topics in a high-level manner, a 30,000 foot view, to provide a framework to […]
Recent Talk on Early-Onset Scoliosis and Treatment Decision-Making
Talking Points about Thoracic Vertebral Body Tethering vs. ApiFix
Vertebral Body Tethering (VBT) and the ApiFix device are procedures which have garnered a lot of attention from surgeons, patients and families. Below is a list of talking points which should be known about VBT and ApiFix so there can be informative, educated, transparent discussions about VBT and ApiFix, when compared to the other commonly-performed […]
Talking Points for Early-Onset Scoliosis Patients: Magnetically-Controlled Growing Rods vs. Shilla Growth-Guidance
In the surgical treatment of Early-Onset Scoliosis (EOS) the options boil down to two main constructs: Distraction-Based: this encompasses both Traditional Growing Rods (TGR) and Magnetically-Controlled Growing Rods (MCGR) Growth-Guidance: this is also called the “Shilla Procedure” We will not go into detail about these two spine constructs, but ask you go […]
Talking Points between Surgeon and Patient/Family about Thoracic Vertebral Body Tethering vs. Thoracic Posterior Spinal Fusion
Vertebral Body Tethering (VBT) is a procedure which has garnered a lot of attention from surgeons, patients and families. Below is a list of talking points which should be known about VBT so there can be informative, educated, transparent discussions about VBT, when compared to the other commonly-performed procedure Posterior Spinal Fusions. Discussions on these […]
“Doctor, What Would You Do?”
“Doctor, what would you do?”….DWWYD…or more precisely: “What would you do if this was your child?” Fifteen years ago I rarely heard this question from parents and caregivers. Now this is a commonly asked question. The media (e.g. Parents Magazine) and advocacy groups have advocated this question as a good one to ask medical providers, […]
What is the best surgery for a patient with Early-Onset Scoliosis (EOS) who needs to have surgery?
This is a question parents commonly ask me in the office. The question is a fair, reasonable question. So why is it so hard for me to give an answer? Well…..EOS is a problem which has many facets or things which need to be considered to be able to optimally answer the question. Every child […]
Treatment Decision-making: Age and Magnitude
When posed with a pediatric spinal deformity in their child, parents/caregivers must decide on the optimal treatment for their child. This can be a daunting task because each patient is unique and there are often multiple treatment possibilities. In addition, the perspectives and beliefs of the parents/caregivers about their child and their particular problem are […]
How do I find a physician for my child with spinal deformity?
When looking for a physician to care for pediatric spinal deformity it is recommended to seek out providers who are member of the Scoliosis Research Society (SRS) and the Pediatric Orthopaedic Society of North America (POSNA). The SRS is an organization which requires its member surgeons to have the care of spinal deformity occupy a […]