Sunday 1 September 2019

Surat woman with 80 degree bent spine gets new life

For 28-year-old Surat resident Farah Abdul (name changed), life has been very challenging. From losing her parents to suffering from a deformity in the spine since early childhood, she never thought she will be able to walk normally, look straight, or could lead a normal life.

80 degree bent spine

However, a team of doctors at Civil Hospital here has given a new lease of life to her by going for a critical surgery of the spine that has corrected her hunched-over posture to near normal. The surgery was risky as correcting a bent spine could result in paralysis, but doctors decided to do it considering the poor condition of the patient.
According to the hospital's superintendent MM Prabhakar, the woman came with an 80-degree curvature of the spine due to ankylosing spondylitis and she was suffering from the problem for over a decade

"We decided to operate on her to correct her posture. After a critical surgery that continued for over six hours, the curvature of her spine has been reduced to 10 degrees and even that too will be corrected with proper rehabilitation," the superintendent said.

Orthopedic surgeon Mitul Mistry told DNA that the surgery was carried out with near-perfect precision and 20 screws were implanted to correct the posture. He said the entire surgery was carried out under real-time neurological monitoring of the patient as one wrong step could lead to severe complications.
"The patient is currently undergoing rehabilitation for the past two-week and once discharged, she will be able to lead a normal life, walk properly," Mistry said. He added an estimated 40 lakh people suffer from ankylosing spondylitis in India.

Post successful surgery Farah while speaking to DNA said, "I stay with my brother and his family. I was unable to see anything straight due to my hunched-over posture. Being ashamed of myself for my deformed posture, I used to remain confined to the four walls of my brother's house. Now that I can walk normally like others, I am planning to take up a job, work hard, and build a house from my hard-earned money. I do not want to remain dependent on others".

Source : DNA , Aug 2019

Spinal surgeons body to screen 1.5 lakh school children for spinal deformities

In a first-of-its-kind initiative, the Association of Spinal Surgeons of India (ASSI) has launched a screening programme in multiple cities to identify spinal deformities, including scoliosis, among school children.
The screening program aims to reach out to around to 1.5 lakh school students in two years, a statement said.

Scoliosis, characterised by abnormal curvature of the spine, are usually occur among children below 14 years of age. However, experts say, due to lack of awareness and absence of medical screenings, late identification of the disease remains a major problem in India.

Spinal abnormalities such as scoliosis and kyphosis need to be identified early so that effective intervention can be undertaken to prevent progression of the deformity.

The first phase of the programme will target schools in nine cities and then the screening program is expected to be extended to 14 cities, the statement said, adding plans are afoot to launch an e-learning programme to enable people identify spinal deformity.

ASSI has reached out to schools in Delhi, Mumbai, Chennai, Coimbatore, Bangalore, Bhubaneswar, Indore, Lucknow and Patna in the first phase.

Notably, several applications, such as Scoliometer and Angle meter, are available online for people to
check spinal deformities themselves. The ASSI awareness program will also educate parents about the availability and usage of such apps.

The ASSI also recommends that all children between the age of 10 and 14 be screened for spinal abnormality.

"Spinal deformities can have devastating consequences on cosmetic appearance and neurological function. While many cases of curvature are mild and require only ongoing observation, other cases can worsen with time and require active treatment such as bracing and surgery," ASSI president Dr H S Chhabra said.

"Screening for spinal deformity is an established process worldwide. However, in India we do not have comprehensive screening programmes which lead to late presentation of the condition.

"Through our screening programme, we aim to reach out to around 10,000 kids in each city. This will be a first-of-its-kind major country-wide study," said Dr Chhabra, who is also the chief of spine service and Medical Director of Indian Spinal Injuries Centre in New Delhi.

The purpose of the screening program is to identify students with spinal curvatures that will require follow up by a healthcare provider.

Collation of long-term data under the study will help experts study the prevalence of spinal deformities and their prognosis in India, Dr Chhabra said.

Free counselling of the parents will be facilitated under the drive and treatment process will initiated where required.

ASSI president-elect Dr Shankar Acharya said, "Scoliosis, a sideways curvature of the spine, is the most common spine deformity in the pediatric population. Other less common curvatures include lordosis, which is an accentuated forward curvature of the lower spine, and kyphosis, a rounding of the upper spine."

"In the absence of medical screening, kyphosis is often confused with poor posture among children when it is actually a structural deformity. Lack of awareness remains a major challenge and is a major factor behind late identification of the condition.

"With the development of curvatures occurring most often between 10-18 years, it is important that it is detected in early adolescence. Progression occurs at rates 7-8 times higher in girls than boys," Dr Acharya said.

Experts underline that recent advances in spine surgery, including neuromonitoring, navigation, robotic technology and minimally invasive surgery, have helped make the process safe and effective. PLB PLB NSD NSD

Source : Outlook India , 26 August 2019

Sunday 21 April 2019

Scientist cures her constant back pain by taking up BELL-RINGING at church

  • Natalie Bleackley was diagnosed with idiopathic scoliosis condition as a child 
  • Severe back stiffness made her uneasy about going on walking holidays 
  • She goes to St Mary and St Nicholas in Leatherhead, Surrey, twice a week to cure
A scientist who suffered a lifetime of back pain has cured herself by bell-ringing.
Natalie Bleackley was diagnosed with the back condition idiopathic scoliosis as a child and underwent surgery for her curved spine.
But, by the time she reached her 30s, she experienced constant pain in the lower spine.
Severe back stiffness made her uneasy about going on walking holidays, rock climbing and canoeing, all activities she had enjoyed before.
Natalie Bleackley was diagnosed with the back condition idiopathic scoliosis as a child and underwent surgery for her curved spine

Natalie Bleackley was diagnosed with the back condition idiopathic scoliosis as a child and underwent surgery for her curved spine

The mother of two makes sure she goes to St Mary and St Nicholas in Leatherhead, Surrey, twice a week

The mother of two makes sure she goes to St Mary and St Nicholas in Leatherhead, Surrey, twice a week

Then in 2014 her daughter Jemima saw an advert for a 'taster day' at their local church. 
Mrs Bleackley went along and at first the 49-year-old did not feel any improvement. But a few months later her condition had miraculously improved.
'I was walking down the street one day and I realised that the pain had completely vanished,' she said.

'I think the regular action of pulling down on the bell ropes and then being pulled up by them has stretched out my back and somehow fixed whatever it was that was causing me the pain for all those years.' 
The mother of two makes sure she goes to St Mary and St Nicholas in Leatherhead, Surrey, twice a week.
She added: 'It never occurred to me before I decided to give bell-ringing a go that this might have a benefit for my back. I just saw it as a social activity.

She never thought that bell ringing would alleviate her back pain but just saw it as a social activity (pictured with her mother Ann Steed, left, and her daughter Jemima, right)

She never thought that bell ringing would alleviate her back pain but just saw it as a social activity (pictured with her mother Ann Steed, left, and her daughter Jemima, right)

In 2014 her daughter Jemima (right) saw an advert for a 'taster day' at their local church

In 2014 her daughter Jemima (right) saw an advert for a 'taster day' at their local church

'The fact that it has helped to cure a lifelong health problem has been both amazing and unexpected.'
The mother of two, who works as a clinical scientist at the Royal Marsden Hospital in Sutton, first suffered back problems at the age of 12.
She noticed she had developed a 'hump' at the top of her spine one day while looking at her hair in a mirror.
Doctors told her that her spine had curved to one side as a result of a growth spurt and she had a five-hour spinal fusion operation, similar to the one golfer Tiger Woods underwent.
Surgeons fused some of her vertebrae together by placing an additional section of bone in the space between them, helping to strengthen and realign her back.

Mrs Bleakley said: 'It can be quite scary at first because these bells, of which there are ten at St Mary and St Nicholas (pictured), are extremely heavy'

Mrs Bleakley said: 'It can be quite scary at first because these bells, of which there are ten at St Mary and St Nicholas (pictured), are extremely heavy'

Mrs Bleackley went along to bell-ringing classes and at first the 49-year-old did not feel any improvement but a few months later her condition had miraculously improved

Mrs Bleackley went along to bell-ringing classes and at first the 49-year-old did not feel any improvement but a few months later her condition had miraculously improved

She started secondary school wearing a plaster cast around her torso for nine months to stabilise her spine as she grew.
But a few years later she began to suffer intermittent sharp pain at the nape of her neck and base of her spine and the condition worsened.
But it seems making bells peel is the perfect antidote.
Mrs Bleackley, who lives in Ashtead, Surrey with her husband John, 53 and their other daughter Maddie added: 'It can be quite scary at first because these bells, of which there are ten at St Mary and St Nicholas, are extremely heavy, with the smallest weighing around 400kg.
'It's a real physical challenge being able to control the bells, as well as a mental one, playing in a band with nine other people.
'I really took to that, along with the social aspect of playing as a group.'
The NHS says idiopathic scoliosis cannot be prevented and is not thought to be linked to bad posture, exercise or diet

Source : Daily Mail Online , 20th April 2019 

Sunday 7 April 2019

FDA clears first molybdenum rhenium pedicle screw

The FDA today cleared Mirus‘s Europea pedicle screw system, which is composed of its MoRe proprietary molybdenum rhenium superalloy, making it the first such device approved with the new class of implant material.
The Atlanta-based medical device company said that the MoRe proprietary alloy is intended to provide improved strength, ductility, durability and biological safety.
“Spine deformity surgery in adults remains plagued by the poor performance of current implants with rod failure occurring in 18%-20% of patients. The MoRe alloy shows great promise in improving the durability of adult spine deformity constructs. This advance will help prevent early revision surgery and improve outcomes in adult deformity surgery in particular,” Dr. Munish Gupta of Washington University said in a press release.
“This new material with its greater strength, fatigue resistance and superior biological properties will allow us to make lower profile foot and ankle implants leading to smaller surgical exposures and reduced revision rates,” Dr. James Nunley of Duke University said in a prepared statement.
Mirus added that it believes the MoRe alloy will allow for a new generation of smaller, stronger, more durable and bio-friendly implants which it hopes will result in less tissue disruption, faster recovery and improved patient outcomes.
“FDA approval of the Europa Pedicle Screw System with our patented MoRe superalloy is the culmination of over ten years of research and development.  Our scientists and engineers working with world class metallurgists have created the greatest advance in medical implant material technology in at least four decades. The MoRe superalloy will revolutionize many aspects of the medical device industry as the first alloy approved by the FDA for use in an implant which is not based on titanium, cobalt or iron with their inherent limitations. The FDA requires a rigorous level of scientific investigation to establish the safety and effectiveness of a spine implant that utilizes a new medical alloy. In response to FDA guidance, our scientific team led by Jordan Bauman, VP of Regulatory, developed a comprehensive body of evidence which served as the basis for approval of this major advance in patient care. We are fortunate to be collaborating with an outstanding worldwide group of orthopaedic and neurosurgeons in developing transformative spine solutions. Additionally, MiRus is rapidly expanding into other orthopaedic applications such as foot and ankle and has made significant progress in cardiovascular applications of the MoRe® superalloy,” founder & CEO Dr. Jay Yadav said in prepared remarks.

Source : Massdevice ,  27 March 2019

3D printing makes spine surgery easier

3D printing makes spine surgery easier

An orthopedic surgeon from All India Institute of Medical Science (AIIMS) has developed 3D printing technology for complex orthopedic, spinal and reconstructive surgeries while saying it can help to reduce complications significantly, apart from aiding in difficult cases. With the help of the 3D images from the CT scan, expert can develop the stereolithograpy of the damaged bone. This can be of great assistance to doctors because even a minor mistake or miscalculation during the correction of the spine deformity can cause paralysis or deformity," said Dr Bhavuk Garg. He also added with use of these "navigational template fit the vertebra perfectly' and provide a great assistance to the surgeon to avoid any single mistakes.

"Spinal deformities are usually associated with significant morbidity and mortality. These problems are very challenging to treat and have a great risk of neurologic complications because of hardware placement during corrective surgery. After the introduction of pedicle screws, scoliosis correction surgeries have witnessed a revolutionary shift, necessitating the placement of a screw within the pedicle with accuracy and safety," he said.

This precision is essential to avoid potential complications because of small bone geometry and the juxtaposition to the spinal cord, he added. "Surgical time was significantly less in the 3D printing group compared with the freehand group , moreover blood loss was higher in the freehand group but not statistically significant, Dr Garg added. He also said that we found a statistically significant higher rate of accurate screw positioning with 3D printing. In spite of a similar vertebral fusion span, more screws were inserted in the 3D printing group, which was possible because of enhanced safety, particularly at apical levels. "Soft tissues have to be stripped completely to make templates fit. Preoperative preparation of these templates takes around 10–12 hours per patient; however, the preoperative preparation is justified in view of statistically significant less surgical time and radiation exposure. Because bigger and less rotated pedicles do not require much surgical expertise and time compared with difficult ones, we are now using this technique only for difficult pedicles to save time and cost," he added. 

Source : Millennium Post , 31 March 2019 

Exercise-based physical therapy method helps people with scoliosis

April Gerard had been a physical therapist for decades when she discovered a treatment method that helped with her own scoliosis.
Now, she's using the same method to help her patients.
"I was always in front of the class showing off my terrible spine or my bad knees," said Gerard, 63, who practices at the St. Luke's Mount Royal Medical Clinic.
Once a top downhill skier — she was 13th in the country in 1968 — Gerard was diagnosed with scoliosis, a curvature of the spine most often found in females, at age 13. The condition, which affects 2-3 percent of the population, can cause an awkward posture and chronic pain and in some cases requires a back brace or surgical spinal fusing.
With help from exercises taught by a physical therapist, Gerard was able to avoid a back brace and continue skiing. But as she proceeded in her own career, she wondered if there was something better for herself and her patients.
She looked in the same place you might look.
"I googled it," Gerard said.
She learned about the Schroth method, developed by Katharina Schroth in Germany in the 1940s. Schroth, whose own scoliosis had been unsuccessfully treated with braces, devised breathing techniques and exercises to manage her condition, then treated other patients with scoliosis.
Gerard also learned about Beth Janssen, co-owner of the Scoliosis Rehab Inc. in Stevens Point, Wis., who had traveled to Germany to learn the method. Five years ago, Gerard went to Stevens Point as a patient.
"I had an intensive twice-a-day for four hours working on this," she said. "I got taller and looked way straighter."
Won over, she took a nine-day certification course and later a six-day advanced course. Three years ago, she became the only physical therapist north of the Twin Cities offering the Schroth method.
The Schroth method employs 120 different exercises that are specific to each of the spinal curvatures, Gerard said. But they come in three major categories. One group involves hanging from a bar, another involves lying on your back with your knees up while practicing breathing techniques and a third involves lying on the side of the biggest curvature.
Physical therapist April Gerard demonstrates verbal and tactile queues to relax and de-rotate Patsy Ingebrigtsen's spinal curve at St. Luke's Mount Royal Medical Clinic recently. Gerard uses a non-invasive method called the Schroth method
Physical therapist April Gerard works to elongate a curve in Patsy Ingebrigtsen's spine at St. Luke's Mount Royal Medical Clinic. Gerard has 120 exercises available through the Schroth method

There also are "fancy ones," such as one in which the patient hangs on the bar and swings like a pendulum. That one is popular with her younger patients, Gerard said.
"They love it," she said. "You gotta have one exercise that's fun."
Gerard was practicing in Grand Marais at the time, and one of her patients was Patsy Ingebrigtsen, now 65.
After decades of living with chronic pain and an awkward posture, the change was startling, Ingebrigtsen said during an interview in Gerard's office.
"I wish I had taken pictures, but I didn't want to," Ingebrigtsen said about the "before." "It looked so bad. ... When I would lie on my back on the floor, the only thing I could get off my back on the floor was my left side."
Retired and enjoying her privacy after years of work in visible jobs, Ingebrigtsen had misgivings about being interviewed for this story. She agreed to it, she said, in hopes her story might lead to sparing someone else the decades of chronic pain she experienced because of scoliosis.
She's not exactly sure but thinks she was in her 20s when she started experiencing the pain associated with scoliosis, Ingebrigtsen said.
She'd get occasional relief from physical therapy or massage therapy or chiropractic adjustment, Ingebrigtsen said, but it never lasted. When she visited a doctor, she'd check "chronic pain" on the form, but no one ever followed up on that.
"You get so used to being in pain that you accept it as normal," she said.
But three years ago, another physical therapist referred her to Gerard.
The exercises are different from anything that had been suggested before, Ingebrigtsen said. They seemed complicated and awkward at first. Standing up correctly didn't feel right because she was used to standing with a crooked posture.
"Just think of all those decades of getting yourself into this predicament," she said. "Your muscles feel like they're doing the right thing when they're not. But it feels very awkward to get them to do the right thing."
She stuck with the visits to Gerard, though, and with the 30-minute daily exercise regimen.
Soon, Ingebrigtsen was noticing a straightening of her spine in the mirror. She found that for the first time in years, she was able to sit comfortably in a car. She no longer had to prop herself up with her elbow on the counter while she washed dishes.
"I still have some chronic pain, but it's much more manageable," Ingebrigtsen said. "I know what to do about it. I'm not doing things that injure myself further."
Ingebrigtsen said her insurance covered her visits to Gerard but not her visits to the massage therapist.
The benefits patients receive depend partially on how much work they're willing to put into it, Gerard said, and also whether they've been active people, such as soccer players and dancers. But she estimated that four out of five of the 200-some scoliosis patients she has seen so far have experienced improvement.
Doctors of scoliosis patients are warming to the therapy as a no-harm alternative to try before turning to braces or surgery, Gerard said. It's still not getting the attention in the physical therapy world that she would like.

April Gerard poses with a model spine in front of a chart that helps her determine problem areas in people's posture. (DNT)
April Gerard poses with a model spine in front of a chart that helps her determine problem areas in people's posture
"They talk about it for about five minutes in PT school," she said.
It's a tool that ought to be in the physical therapist's toolbox, Gerard said.
"It's very specific and it's very helpful," she said. "It matters a lot to people not to be all bent over or crunched over. Not only does it hurt and you can't breathe as well and your organs don't work as well — we're all a little vain, and we don't like to look different than other people."

Source : DuluthNewsTribune , 2nd April 2019 

Martha Hunt feels "empowered" by her scars

Martha Hunt
Martha Hunt

The 29-year-old model was born with scoliosis - a curvature of the spine - so had to undergo surgery to correct the problem and she loves having a "symbol of strength" on her skin that tells a "triumphant" story about her past.
She said: "I do feel empowered by my scars. I think they are a symbol of strength, all scars are beautiful and they tell a story, a very triumphant one, about oneself."
Even after having fusion surgery, the Victoria's Secret Angel's hips are not symmetrical and she doesn't have the "perfect walk", but Martha doesn't mind.
She said: "I accept my 'limitations' and welcome that as a positive tool."
Last October, Princess Eugenie's own scoliosis scars were on display in her wedding gown when she tied the knot with Jack Brooksbank and Martha felt the royal's public statement was "very inspiring".
She said: "It was very inspiring and made me so proud.
"When I had the opportunity to meet her in London, over the summer, we discussed some of the insecurities we had as young women dealing with this illness, so seeing her wedding gown was so important because scoliosis was getting representation, because when we were younger, we didn't hear anybody talking about it so openly."
And the model is happy to speak about her own experiences with the condition because she wants to inspire other women.
She told Britain's Grazia magazine: "If we don't talk about something then we won't be able to 'see' it. And if we don't see it, it almost doesn't exist.

"But scoliosis is a real issue and I want to keep the conversation going. My story helps [others with the condition] feel less lonely, but also to keep the faith that they will be able to accomplish their dreams."

Source : Female First, 7 April 2019