Less Surgery for Kids With Scoliosis

By ABC News

Apr 19, 2012 7:00am

By DR. CHRISOPHER TOKIN

Ashley Crane, a 24-year-old nursing student, had her first scoliosis surgery when she was 14.

“I had two surgeries, a week apart,” she said. “I remember my spine was very unstable…then I had the rods and screws placed.”

It was no simple operation. Doctors took out part of one of her ribs and a portion of her hip for bone grafts. In total, they fused 16 of the bones in her back.

Crane’s mother, Susan, said she was “devastated” when she learned that her daughter would need surgery — and even more distraught that two trips to the operating room would be needed.

“Even one surgery was devastating news for me, and of course, multiple surgeries are even more devastating, if that is possible,” she said. “She had an incredible amount of pain…but if you ask her, she will tell you she doesn’t remember much.  Luckily they probably gave her something that blurred her memory.  I was there though, and it was difficult for me to watch.”

Scoliosis is an abnormal bend or curve in the spine that usually affects children and young adults.  For up to 80 percent of scoliosis cases, the cause is unknown.  More than 4 percent of the population is affected by scoliosis; however not all will require surgery.  For those who do, surgery can be extensive.

For Crane — who today  is a student as well as a competitive tap dancer — two operations were enough. But for most younger patients with scoliosis, many more surgeries await.

The reason spinal fusion doesn’t work well in these patients is that they are still growing. Instead, doctors use adjustable rods that they can lengthen as time goes by.

It works, but it has a price — these children and teens must undergo surgery every six months to lengthen the rods appropriately. Because of this, these young patients may require half a dozen operations — or even more. Each of these surgeries requires full general anesthesia and re-opening of the old wounds to access the rods.

While this technique has proven successful and beneficial for many children afflicted by the disease, it is invasive, painful, and requires multiple hospitalizations, which often keeps these children in the hospital and out of school. With multiple procedures also comes an increased risk of complications and infections.

But hope may be on the horizon for these kids.

A new study released in the journal “Lancet” reports the results of a new device that has been developed to minimize the number of operations required to help straighten the spine of young children affected by severe scoliosis.

This device uses the same concept of the growing rod, but instead of relying on surgery for adjustments, the rods instead are lengthened non-surgically using magnets — thus eliminating a great deal of pain and recovery time.

In the new study, researchers from Hong Kong report its use in five patients. So far, two of these patients have gone two years after the initial surgery with good results and no complications.  The device was able to straighten their spines by an average of 38 degrees.

Most importantly, they required no additional operations.

“This is a huge advantage for kids because this technology does not require any additional surgery,” said Dr. John T. Smith, professor of orthopedics at the University of Utah.

Smith said that this technology is not yet being tested in the United States because of excessive FDA barriers, requiring much of this research to be done in other countries.

As of yet, there is no indication as to whether or when this technology will be available in the U.S.

The authors of the new study said that the technology could be used for other problems as well, such as limb lengthening, or limb salvage procedures that require progressive change to bone structures.

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