Physical activities of Patients with adolescent idiopathic scoliosis (AIS): preliminary longitudinal case-control study historical evaluation of possible risk factors

To our knowledge there are no publications that have evaluated physical activities in relation to the etiopathogenesis of adolescent idiopathic scoliosis (AIS) other than sports scolioses. In a preliminary longitudinal case-control study, mother and child were questioned and the children examined by one observer.

The aim of the study was to examine possible risk factors for AIS. Two study groups were assessed for physical activities: 79 children diagnosed as having progressive AIS at one spinal deformity centre (66 girls, 13 boys) and a Control Group of 77 school children (66 girls, 11 boys), the selection involving six criteria.A structured history of physical activities was obtained, every child allocated to a socioeconomic group and examined for toe touching.

Unlike the Patients, the Controls were not X-rayed and were examined for surface vertical spinous process asymmetry (VSPA). Statistical analyses showed progressive AIS to be positively associated with social deprivation, early introduction to indoor heated swimming pools and ability to toe touch.

AIS is negatively associated with participation in dance, skating, gymnastics or karate and football or hockey classes, which might suggest preventive possibilities. There is a significantly increased independent odds of AIS in children who went to an indoor heated swimming pool within the first year of life (odds ratio 3.88, 95% CI 1.77-8.48; p = 0·001).

Furthermore fourteen (61%) Controls with VSPA compared with 9 (17%) Controls without VSPA had been introduced to the swimming pool within their first year of life (P <0.001). Early exposure to indoor heated swimming pools for both AIS and VSPA, suggests that the AIS findings do not result from sample selection.

Source: 7th Space, 18th Feb 2015 

Teenage gymnast who grew 6 inches in just TWO months

Teenage gymnast who grew 6 inches in just TWO months was left with a 45° bend in her spine - but is now back in training thanks to daily exercises to straighten her back

• Lauren Hill grew six inches in the space of two months last year
• Sudden growth spurt caused her spine to bend 45° resembling a c-shape
• She was diagnosed with scoliosis - an abnormal curvature of the spine
• The condition meant she couldn't perform her gymnastic routines and threatened to put an end to her hopes of competing on the world stage
• But daily physiotherapy sessions have helped straighten her spine
• Lauren is now back in training ahead of World Championships next year 

As a teenager Lauren Hill had always been short for her age.

For the gymnast her growth spurt came later in life, when last year, as a 15-year-old she suddenly shot up six inches in just two months.

But with it came a devastating blow to her dreams of competing on the world stage.

Lauren was diagnosed with scoliosis - an abnormal curvature of the spine.

Her mother, Alison, said experts revealed the condition had been caused by her daughter's rapid growth, leaving her spine bent at 45 degrees and resembling the shape of a 'c'.

The teenager faced the heartbreaking reality of having to give up the sport she had loved since the age of two.

But today Lauren is back in training, preparing for the World Championships in China next year after experts helped straighten out her back with daily physiotherapy sessions. 

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Teenage gymnast Lauren Hill was diagnosed with scoliosis - an abnormal curvature of the spine - last year, after she went through a growth spurt and shot up six inches in the space of two months. Her spine was left bent at a 45 degree angle, right, resembling a c-shape, her mother Alison said

The condition threatened Lauren's career as a gymnast, preventing her from performing certain routines. But thanks to daily treatment, the 16-year-old is now standing tall and back in training. She is pictured with her physical therapist Michael Bradley

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Ms Baker, 47, left with her daughter, said: 'She (Lauren) had a big growth spurt in 2014. She was short for her age and developed much later because of her sport, so when she grew five or six inches in a month it caused her spine to curve off in this c-shape'

Her mother, 47, from Feltham in Middlesex, said: 'Acrobatics is Lauren's whole life, so it was so hard when we thought she'd have to stop - it really is everything to her so she was really upset.

'She had a big growth spurt in 2014. She was short for her age and developed much later because of her sport, so when she grew five or six inches in a month it caused her spine to curve off in this 'C' shape.

'The exercises she does now are specific to the individual and make the person really aware of their condition.

'Lauren now does 45 minutes of exercises per day - it's signing up to a different way of life but it's a small price to pay for something that improves her condition, halts progression of it and reduces pain as well.'

Lauren's coach first noticed something was wrong when he saw her hips and shoulders appeared uneven, with one shoulder blade protruding. 

Her mother took the teenager to the GP, where she was initially diagnosed as having one leg shorter than the other.

But Lauren began to suffer a lack of flexibility and agonising pain that prevented her from performing specific routines.

On returning to hospital again, specialists diagnosed her with scoliosis. 

Ms Hill said she was told her daughter faced an operation to surgically straighten her spine.

But the procedure would have put an end to Lauren's acrobatics for good.  

Ms Baker said: 'When I questioned the consultant over whether Lauren would still be able to participate in acrobatics or any other sport he replied "she will only have flexibility at the base of her spine and will be able to swim".

Determined, Lauren refused surgery, deciding to look at alternative therapy with her mother instead.

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Lauren's back has now straightened out, left. And the gymnast, right, is preparing to take part in the World Championships next year in China

WHAT IS SCOLIOSIS AND WHAT ARE THE SIGNS OF THE CONDITION? 

Scoliosis is the abnormal curvature of the spine in an S-shape.

Signs include a visible curve in the spine, one shoulder or hip being more prominent than the other, clothes not handing properly and back pain.

Pain usually only affects adults with the condition.

In most cases, the cause of the scoliosis is not known but it can be caused by cerebral palsy and muscular dystrophy.

In the UK, scoliosis affects three to four children could of every 1,000.

It is also thought that as many as 70 per cent of over 65s have some degree of scoliosis.

It is more common in women than in men.

Most children with the condition do not require treatment as it is mild and corrects itself as the child grows.

However, in severe cases the child may need to wear a back brace until they stop growing.

Occasionally, a child needs surgery to straighten their spine.

In adults, it is usually too late to treat the condition with a back brace or surgery so treatment revolves around reducing pain.

Lauren said: 'I was trying to train for the world championships when I found out I had scoliosis and it hurt so much. 

'There were points where I thought I wouldn't be able to carry on, but I still would have hated surgery because I knew the outcome to that would not have necessarily been good either.'

Ms Baker then discovered Scoliosis SOS - the only clinic in the world to offer treatment following the ScolioGold method, which is the combination of non-surgical treatments. 

While undergoing treatment, Lauren was taught a customised exercise programme specific to her condition over a span of four weeks.

Charlie Meekings, patient care co-ordinator at Scoliosis SOS Clinic, said: 'It is important to know that there are other effective treatments available for scoliosis, not just those provided by the NHS.

'However, due to current legislation many health professionals are unable to disclose or discuss treatment options outside of the public sector.

'Our clinic prides itself on our ability to give free, impartial advice with no obligation to visit the clinic.'

Lauren will now be trialing for a place to represent Team GB at the European Acrobatics and Gymnastics Championship in Germany later this year.

Ms Baker said: 'She now has her eyes set on another World Championship trophy in China next year: something that seemed impossible only four weeks ago.'

Traditional NHS treatment for Scoliosis explained

Source: Daily Mail , 10th Feb 2015 

New Hope for Newborns With Rare Deforming Disease

A device for thoracic insufficiency syndrome that has been evolving for years is now more widely available

Thomas Morrow, MD

Thoracic insufficiency syndrome (TIS) is a collection of rare disorders of the thoracic skeletal system affecting about 4,000 newborns in the United States each year. TIS may cause pulmonary failure because of decreased lung volume: The ribs fuse together, the thoracic spine twists and rotates, and the patient may slowly suffocate unless reconstruction is done to multiple ribs and the spine, and is repeated as the child grows.

TIS is sometimes secondary to trauma. It may also be caused by resection of large tumors from the chest wall and surgical separation of conjoined twins.

Other cases are associated with well-defined genetic disorders and disorders that are less well characterized from a genetic perspective but also cause deformities of the bones in the thorax. These disorders include constrictive chest wall syndrome; progressive congenital, neurogenic, or idiopathic scoliosis without rib fusion; and hypoplastic thorax syndrome, which includes Jeune’s syndrome, also called asphyxiating thoracic dysplasia; Ellis-van Creveld syndrome, also called mesoectodermal dysplasia, and Jarcho-Levine syndrome, which has gone by nearly a dozen different names.

As you might imagine, the deformities can come in a wide variety of forms because each of these conditions can affect the ribs and individual vertebrae in different ways.

Early surgical interventions include fusion of the vertebrae to prevent twisting and turning and insertion of custom manufactured expandable instruments called “growing rods.”

The rib cage in children with TIS has a variety of missing, fused, and deformed ribs. The fused ribs needed to be split apart and kept apart with spacers. Missing ribs have been replaced with artificial ribs of a fixed size or cadaver bone. In some cases, surgeons have resorted to splitting the breastbone—anything to allow the lung space to expand, not only for respiration but also growth of the child.

VEPTR device can be configured for rib-to-rib, rib-to-lumbar lamina, and rib-to-ilium (not pictured) attachment.

The Vertical Expandable Prosthetic Titanium Rib (VEPTR) addresses many of the deformities of the rib cage and spine. The device was developed by Robert Campbell Jr., MD, a surgeon at Children’s Hospital of Philadelphia, who spent 25 years refining it. It consists of curved titanium rods that are surgically attached to the ribs, lumbar vertebra, or sacrum. VEPTR is perhaps the most configurable device ever approved by the FDA. Because there is no standard presentation, any device for the condition either needs to be entirely customized or capable of being assembled, like parts of an erector set, to create a unique solution for each child.

Increasing life expectancy

According to an FDA staff report, VEPTR is the only treatment available that allows the chest cavity to be enlarged vertically, providing room for the lungs to grow and improving the function of the lungs and heart, thereby increasing the life expectancy of these terminally ill children. The VEPTR is also unique because it treats the deformities of both the spine and thorax. Moreover, it can be adjusted through minor surgery as the child grows. Other devices need to be replaced, and that often requires major surgery.

The FDA originally approved Campbell’s VEPTR device in 2004 under its special humanitarian device exemption for conditions that affect small numbers of people. Late last year, the agency gave the device 501(k) clearance, which means it can now be used more widely.

The 501(k) clearance was based upon a single-arm, nonrandomized, prospective multicenter trial done in two phases. The children served as their own control because there is no “typical” pattern on which to create a control group.

All subjects in the study were children six months or older, up to the age of skeletal maturity, which is typically at 15–17 years of age. The endpoints included increases in thoracic spinal height, hemithoracic height and width, and scoliosis correction.

Because the patients are young and sometimes developmentally delayed, standard pulmonary tests often can’t be done. This study used “assisted ventilator rating” outcomes as an endpoint instead. Those ratings reflect whether a child needs supplemental oxygen and other kinds of assistance to breathe.

Because the 257 patients treated were growing, the study device would periodically require expansion or replacement of its components. Each child was expected to need many adjustments as a normal course of treatment. Surgeons performed 1,538 surgical procedures during the study’s 14 years. Twelve children died but in the opinion of the investigators none of the deaths were related to the device.

The results can only be termed remarkable: 92% of the subjects displayed either stabilization or improvement in a statistic called assisted ventilator rating, which sums up indirect measurements of pulmonary function and quality-of-life measurements. Radiographic success was measured across four different types of deformity. Some of the subgroups had 100% of patients reaching the predetermined goal. In most of the 24 individual measures, more than 3 out of 4 of subjects reached the goal.

Not all the studies of VEPTR have been positive. Last year, surgeons at the University of Pittsburgh Medical Center reported that the forced vital capacity of their VEPTR patients improved during six years of follow-up but that it didn’t keep up with the child’s growth. They also observed increased chest wall stiffness and increased thoracic kyphosis.

TIS is a life-threatening and, in some patients, a terminal condition that almost without exception requires some sort of surgical intervention. The previous static surgical treatments were unable to adapt to the growing child’s needs. No prior treatments were able to address the various deformities effectively. The development of the VEPTR now provides the potential benefits of continued spinal growth, decreased deformity, and improved breathing ability.

This device is the result of more than two decades of development and is another example of how continual refinements over long periods of time can lead to Tomorrow’s Medicine!

Thomas Morrow, MD, is chief medical officer of Next IT. He is the immediate past president of the National Association of Managed Care Physicians and has 24 years of managed care experience at the payer or health plan level. The views expressed here are his alone. Contact him at TMorrow@ManagedCareMag.com.

Source: Managed Care, Feb 2015 

13-year-old ‘Curvy Girl’ launches scoliosis support group; STGnews Videocast

  13-year-old girl with scoliosis is reaching out to find others with the same condition to join the Utah chapter of an international scoliosis support group, Curvy Girls. 

Ella Christilaw, 13, watches in the side mirror as she works through her physical therapy exercises to improve her scoliosis condition, St. George, Utah, Feb. 12, 2015 

Ella Christilaw, of St. George, found out she had minor scoliosis when she was 9 years old, but the condition developed into a severe condition by the time she was 12. Christilaw moved to St. George from Washington state where she first became a part of the international support group.
“When I moved down here, there wasn’t one in Utah and … it was kind of a bummer because it was fun,” Christilaw said.


Her story


After Christilaw’s third-grade teacher made her aware of the abnormality in her back, she was checked out at the doctor, who excused her saying the scoliosis was minor and needed no treatment.

I was only 15 degrees from the surgery point

“They said they were going to monitor it, but they didn’t do a very good job,” Christilaw said.

“When I was 12 we went in for a checkup and my mom really, really wanted me to get it checked on. My mom insisted that we see some specialists and as it turned out I really needed a brace, and I was only 15 degrees from the surgery point.”


She encourages anyone who might be told by a doctor that a minor case is nothing to worry about, to be issued a brace before it gets worse, Christilaw said. She wears her brace 18-20 hours per day, which makes it hard for her to bend, get up while laying on the floor and other activities.


Under the direction of Intermountain Healthcare Physical Therapist Mark Mills, Christilaw participates in various physical therapy exercises known as the Schroth Method.

From left: Image 1, 5-year-old boy, scoliosis resulting from polio; image 2, after 3 weeks of intensive Schroth treatment; image 3, after 8 weeks of Schroth scoliosis exercise therapy| Photo courtesy of Schroth Method. St. George 

The method is proved to help correct the spine with breathing and moving the body to keep it in line, she said.


Over the past two months, Christilaw has done the exercises everyday at home and every few weeks with Mills and, she said, has seen the improvement in her spine.


“I went to my doctor the other day and they said ‘you can barely see the hump on your back;’ and I said ‘really?!’” she said. “So I won’t have to wear the brace as much.”


Curvy Girls: We’ve got your back


As president and one of two members of the Utah chapter of Curvy Girls Scoliosis Foundation, Christilaw said she seeks to find others to join who feel they need someone to talk to about their condition and want friends who understand their situation.

The foundation’s mission statement is to support the emotional impact that scoliosis has on girls

The foundation’s mission statement is to support the emotional impact that scoliosis has on girls by empowering them through mutual support and acceptance to become leaders, make healthy lifestyle choices and improve their self-esteem.


Currently, one girl besides Christilaw is in the Utah chapter of Curvy Girls, and, Christilaw said, girls, women, boys and adults are welcome to the group meeting which take places at her home on the last Sunday of the month.


“We help with peer support and encouragement because having scoliosis can be hard,” she said. “With having a back brace, sometimes people tease you or you just don’t want anyone to know. It’s nice to know there are other people out there like you.”


To join Curvy Girls, call Christilaw at 435-275-2839 or email her here.

What is Scoliosis?


Scoliosis is a sideways curvature of the spine that occurs most often during the growth spurt just before puberty, according to the Mayo Clinic.

Ella Christilaw, 13, watches in the mirror as she works with IHC Physical Therapist Mark Mills to improve her scoliosis condition, St. George, Utah,

“While scoliosis can be caused by conditions such as cerebral palsy and muscular dystrophy, the cause of most scoliosis is unknown,” Mayo Clinic states on its website. “Most cases of scoliosis are mild, but some children develop spine deformities that continue to get more severe as they grow.”
Severe scoliosis can disable the patient, Mayo states. With a severe spinal curve the space in the chest and near the lungs is limited. Children with minor cases are monitored to keep the condition from worsening and, if necessary, surgery is performed.


According to WebMD LLC, a scoliosis patient needs surgery if:

• He or she has a moderate to severe spinal curve he or she has a moderate to severe spinal curve
• The spinal curve is getting worse
• Pain increases, continues and gives the patient trouble doing daily activities
• Bracing cannot be used or does not work

Curvy Girls contact

• To join Curvy Girls call Ella Christilaw at 435-275-2839 or email her here.

Resources

• Curvy Girls Scoliosis Foundation | Website| Facebook
•  Mayo Clinic
• WebMD,LLC Resources
• The Schroth Method

Check Video : https://www.stgeorgeutah.com/news/archive/2015/02/20/hrc-13-year-old-curvy-girl-launches-scoliosis-support-group-stgnews-videocast/#.VOiblSxfE_o

Source: St George News, 20th Feb 2015 

New Surgery Offers Hope for Cerebral Palsy Patients with Scoliosis

Millions of individuals in the U.S. suffer from scoliosis, which can be caused by cerebral palsy, among other causes. Normally, the spine curves slightly. However, if viewed from the front or back, it will appear straight. In an individual with scoliosis, the spine curves abnormally so that when viewed from the back or front, it does not appear straight. Many people with mild degrees of curvature do not require treatment.

However, in severe cases of scoliosis, surgery is required. The traditional surgical approach is to fuse vertebrae and place metallic implants in an attempt to correct some of the abnormal curvature and prevent it from getting worse. Now, scoliosis patients have a new option: Robot technology that can improve results and limit complications.

Innovative robotic surgery for scoliosis:

This new technology is the Mazor Robotics Renaissance Guidance System. With traditional open surgery, surgeons make one very large incision. This gives the easy access to bodily structures and a clear field of view. However, it also leads to a longer recovery time for the patient, which is why laparoscopic surgeries have become so popular. This approach involves several small incisions, which, although it limits complications, also limits the surgeon’s field of view. With the Mazor Robotics Renaissance Guidance System, patients can have the best of both worlds. It allows for minimally invasive surgery with the superior imaging of open surgery.

The system involves advanced 3-D planning software, which allows the surgeon to customize the spine surgery to the unique needs of the scoliosis patient. In the operating room, the robot technology guides the surgeon to the precise site where therapeutic intervention is needed. However, the surgeon remains in full control of the robot technology at all times.

Mazor Robotics states that their innovative guidance system offers numerous benefits for scoliosis patients and others who are undergoing complex spine surgery. It is said to reduce postoperative pain, lower rates of complications such as infections, and facilitate an accelerated recovery. What’s more, patients with scoliosis caused by cerebral palsy who have undergone this type of surgery can typically enjoy a significant correction of their abnormal spine curvature, allowing them to move more freely, participate in physical activities, and even wear clothes properly without being limited by a severe tilt to the side.

Causes of cerebral palsy

Scoliosis is just one of the many complications that cerebral palsy can cause. Cerebral palsy can also lead to malnutrition, mental health conditions, lung disease, contracture, and many other health problems. 

Sometimes, cerebral palsy isn’t necessarily preventable, such as when it’s caused by a fetal stroke or random genetic mutations. However, in other cases, this devastating diagnosis is entirely preventable.

Many children afflicted with cerebral palsy developed the condition because of birth injuries. Sometimes during labor and delivery, the fetus suffers from oxygen deprivation to the brain, which causes brain damage and, in turn, cerebral palsy. Cerebral palsy may sometimes be the result of medical malpractice. For example, a doctor or nurse may fail to properly monitor the fetal heart rate or to respond to an abnormal fetal heart rate.

They may delay performing a C-section that would have restored oxygen to the baby’s brain. Or, they may improperly use instruments such as vacuum and forceps. Because of these preventable medical errors, a child may suffer from lifelong complications. When the causes of cerebral palsy can be traced back to negligent medical care, victims may have the right to legal compensation.



Source: Injury Lawyer, 29th Jan 2015

Discovery of a gene responsible for familial scoliosis

The discovery could be the first of many in the complex battle against a largely misunderstood condition

The discovery of the first gene causing familial scoliosis was announced by an international France-Canada research team today.

"Mystery surrounds the cause of scoliosis, which is a three dimensional deformation of the vertebral column. Many researchers have been attempting to uncover the origins of this disease, particularly from a genetic point of view," explained leading co-author Dr Florina Moldovan of the University of Montreal and the CHU Sainte Justine research hospital.


"To date, many genes have been suspected of causing scoliosis amongst different populations, but the gene that causes the familial form of the disease remained unknown. Our discovery of this first causative gene is due to the support of the Fondation Yves Cotrel and our international teamwork, in particular with leading co-author Dr. Patrick Edery of CHU de Lyon hospital and Dr. Pierre Drapeau of the CRCHUM."

A variation in the POC5 gene was initially identified by DNA sequencing (exome sequencing) in the samples Dr Patrick Edery collected from a large French family, of whom several members are affected by idiopathic scoliosis. Others variants of the POC5 gene were detected in scoliotic families and in people whose scoliosis had no precedence in their families. 

"The POC5 gene encodes for a centrosomal protein involved in microtubule-organising centres and cellular polarity," explained first author Dr. Shunmoogum (Kessen) Patten, who undertook his post-doctoral work at the CHU Sainte-Justine and CHUM research centres. "The pathogenicity of POC5 variants was documented by using the zebrafish, a well-established genetic animal model that has a spine." This model revealed that the over-expression of mutated human POC5 gene led to the rotational deformation of the anterior-posterior axis of the spine in half of the zebrafish embryos. The deformations are similar to the deformations observed in scoliosis patients.

The data suggest that the mutations are dominant, confirming the human genetic analysis. Interestingly, the protein is strongly expressed in the brain, within very precise structures in the midbrain. This leads the research team to believe that there is an association between the brain and idiopathic scoliosis.


"This is a very heterogenous disease and probably more than one gene is required for disease expression. This discovery has enabled the identification of the first causative gene and represents an important step towards decoding its genetic causes," Dr. Moldovan said. "This crucial first step will open the door to future studies that will identify the complementary genes and pathways that play a role in scoliosis in other populations. In particular, a full portrait of genetic events would enable the perfecting of effective preventative methods and strategies for understanding scoliosis," said Dr. Drapeau.

Source: Medical Express, 2nd Feb 2015

Woman becomes world’s first adult to get ‘robotic spine’

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AN Irish woman has become the first adult in the world to receive a revolutionary remote-controlled spine, which uses magnets to combat the effects of scoliosis.
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After years of painful operations Deirdre McDonnell has had a 'robo spine' inserted Deirdre McDonnell, 34, can now stand tall for the first time after undergoing the pioneering MAGEC rod operation.

The surgery, also known as the magnetic expansion control system, involves the insertion of a magnetic rod that is screwed onto the spine and controlled externally in order to correct the curvature caused by scoliosis.

Up until now, the £15K procedure has only been performed on children, as it was thought only to be effective for early onset scoliosis – typically diagnosed before the age of ten.

But thanks to the success of Deirdre’s operation, doctors are now hopeful that the bone implant will help other adults, many of whom have undergone a number of unsuccessful and painful invasive surgeries in an attempt to straighten and lengthen their spine.

“The operation has completely changed my life. Before, I could only walk short distances without being in pain but now I love to walk everywhere," said Deirdre, from Drogheda, County Louth.


“After more than 30 years of operations and taking painkillers, I’m finally hopeful for the future.”

The 34-year-old had a magnetic rod screwed onto the spine to correct the curvature.

 

 

Deirdre underwent her first operation at just six weeks old after she was diagnosed with congenital scoliosis, which affects one in 10,000 new-born babies.

Her spine was so malformed that doctors warned she wouldn’t live past the age of seven.

Over the next ten years, she underwent eight painful operations as doctors battled to save her life.

Beating the odds, Deirdre survived childhood and trained at college to become a teacher.

I’m no longer in pain, and I feel so much more confident in myself

~ Deirdre McDonnell

But the secondary effects of her scoliosis eventually left her unable to work.

She said: “Because my spine was curved at 130 degrees, it formed into a C-shape and my lungs didn’t have room to expand so they never grew to full size.

"At my worst, my lungs were operating at only 30% of what they should have been.

“This meant that I was constantly poorly with pneumonia and chest infections. Doctors said they didn’t know what else they could do.

“Things got so bad that my doctor told me that if he didn’t operate, I’d be dead within ten years.”

As a child her spine was so malformed doctors warned she wouldn’t live past the age of seven.

Although MAGEC rod technology has existed since 2011, doctors initially didn’t see it as an option for Deirdre as it had previously only been performed on children.

However, after running out of options, doctors decided to operate.

Tallaght Hospital in Dublin was able to secure funding from the Health Service Executive (HSE) and Deirdre underwent the three-hour operation in June last year.


Over the following months, her spine was straightened at regular intervals.

Now fully recovered, Deirdre says she is looking forward to a healthy, happy future with her boyfriend, solicitor Robbie Slattery, 32.


She said: “I’m no longer in pain, and I feel so much more confident in myself. Even little things like being able to wear pretty dresses or sit comfortably have made such a change.


“I feel so lucky to have been able to have this operation – it really has changed my life.


“Before my dad passed away in 2009, he told me that he hoped I’d one day get my dream of living a normal life. I just hope I’m making him proud.”


Consultant orthopaedic surgeon at Tallaght Hospital, Doctor Patrick Kiely, said: “This is a big step forward for us.


“The largest benefit of MAGEC rod technology is that it removes the need for repeat operations.


“With the rod, once the initial procedure has been carried out, the patient doesn’t have to undergo any more incisions. The spine is straightened externally using a remote control, which is painless and is performed without anaesthesia.

“This in turn minimises the risk of infection and limits the impact of the procedure on the patient.”

Scoliosis comes from the Greek word ‘skoliõsis’ which means ‘crooked’.

Now Deirdre is looking forward to a healthy, happy future with her boyfriend Robbie

Symptoms of the condition include a curved spine, prominent ribcage or shoulder blades and uneven arm and leg lengths.

It is estimated that 273 million people worldwide suffer from the condition, including celebrities such as Elizabeth Taylor and Olympic runner Usain Bolt.


In the UK alone, approximately 45,000 children have scoliosis, with many having to undergo up to 20 corrective surgeries during their lifetime – at a massive £20K per procedure.


The MAGEC rod, which is manufactured in California by Ellipse Technologies, aims to not only change lives, but also cut costs by removing the need for repeat surgeries.


For more information on scoliosis, visit the Scoliosis Association's website at sauk.org.uk

Source:  Express U.K , 29th Jan 2015

Magnet Replaces the Scalpel for Treating Kids with Early-Onset Scoliosis

Pediatric orthopedic surgeons at Columbia are using a new device with magnetic technology that avoids the need for multiple spine-lengthening surgeries to correct early-onset scoliosis, a severe curvature of the spine in young children.


In April 2014, Michael Vitale, MD, the Ana Lucia Professor of Pediatric Orthopedic Surgery at CUMC and 1995 graduate of P&S, performed the first procedure in the New York area, using the device to treat a 5-year-old boy.

When braces and casts cannot control scoliosis in young children, surgeons turn to growing rods, which help correct the curve while allowing the spine to grow. When spinal maturity is near, the rods are removed and a spinal fusion can be performed.

But during years of treatment with growing rods, patients must undergo surgery every six months to lengthen the rods to keep up with the patients’ growth. A patient may undergo eight to 10 procedures, which are costly and result in lost time for parents at work and children at school.

The new device—MAGEC (MAGnetic Expansion Control) rods—contains a mechanism inside the growing rods that allows surgeons to lengthen the rods with a handheld external magnet, without surgery.


Dr. Vitale expects this advance to improve outcomes in children with early-onset scoliosis in whom spinal curves exceed 40 degrees. Early-onset scoliosis accounts for about 10 percent of all children diagnosed with scoliosis. Left untreated, children with this condition are at risk for developing cardiac and/or respiratory problems related to stunted growth and development.


“This new approach is designed to remove the need for repeated trips to the operating room, as well as to eliminate complications from infections and the psychosocial effects of multiple surgeries,” says Dr. Vitale.


Once the MAGEC rods are implanted, the rod-lengthening procedure, which takes approximately 15 minutes, is performed every three to six months.


The MAGEC system has been used successfully to treat more than 750 children in 24 countries. For the past five years, Dr. Vitale has been part of efforts to advocate for FDA approval of the device. In February 2014 the MAGEC system was cleared by the FDA for use in young patients with severe spinal deformities associated with, or at risk of, thoracic insufficiency syndrome.




Source: Health Canal , 31st Jan 2015 

Minimally invasive treatment based on electrical muscle stimulation corrects spinal curvature in children

Adolescent idiopathic scoliosis (AIS) affects 2 to 3% of children aged between 10 and 16. It is more common in girls than in boys (with a ratio of 10-1). Besides the obvious physical signs derived from the visible spinal deformity, AIS can cause psychological and emotional problems (low self-esteem, poor body image, etc.) that significantly reduce patients' quality of life.

Although bracing has been basic in non-surgical treatments for AIS for almost fifty years, some studies suggest that this technique is able only to stop the curve progression, but cannot reduce the deformity. Furthermore, bracing often conditions or boosts psychological disorders in patients wearing the brace for a long period of time.

Patients developing high-magnitude spinal curves or those who show a rapid and significant curve progression, often require a very aggressive surgery. More than 4,000 European adolescents undergo this procedure each year with the risk of long-term side effects.

"Surgery corrects the curve deformity, but fuses the spine, eliminating its function. The long-term consequences of spinal fusion cause several complications," says Professor Carlos Barrios, director of the Institute for Research on Musculoskeletal Disorders of the Universidad Católica de Valencia, Spain. "Efforts are currently being made to find techniques that do not involve extensive spinal fusion to correct the scoliotic deformity, preserving the physiological range of motion of the spine.

A high proportion of diagnosed patients are normally subject to mere observation, without receiving specific therapy. However, if the disease is diagnosed late or develops faster than anticipated, current medical practice only has treatments with brace or surgery, each one with its drawbacks".

Recent studies provide evidence that suggest possibilities for alternative treatments. "Recent findings show that AIS is a musculoskeletal expression of a central nervous system disorder, in other words a neurological disease," explains Professor Barrios, awarded twice for his publications in the EuroSpine Annual Meetings.

StimulAIS project

"Neurological dysfunction affects deep paraspinal muscles inducing an imbalance of forces acting on the vertebral segments." The StimulAIS Project is based on this research. The initiative is supported by an international consortium of businesses, research institutes and universities and aims at introducing alternative AIS treatments based on electrical muscle stimulation of deep paraspinal rotator muscles - a technique known as functional electrical stimulation (FES).

The consortium consists of three SMEs: the Project coordinator Tequir S.L. (Spain), Synergie Ingeniere Medicale SARL (SYNIMED, France) and Bentronic Gesellschaft Für Medizintechnik GMBH (BENTRONIC, Germany), as well as three reference research centres: the Instituto de Biomecánica de Valencia (IBV, Spain), the Universidad Católica de Valencia (UCV, Spain) and Fraunhofer-Gesellschaft zur Förderung der Angewandten Forschung E.V. – IPMS (IPMS, Germany). Uniting their expertise, the project has developed the first prototypes of the device that provides the FES treatment.

As a spokesperson of Tequir, a Spanish company that specialises in innovative medical technologies in the fields of spinal medicine, orthopaedics and traumatology, explains, "The unit should provide personalized treatments. It is primarily aimed at not only inhibiting the curve progression, but also potentially correcting it significantly."

To achieve this, the project has developed an implantable device to sense and stimulate the key muscles as well as the integrated stimulation control software to modulate it into safety thresholds. To implement the device subcutaneously, the team has developed minimally invasive surgical instruments.

The findings obtained in the research phase have been incorporated into a stimulation protocol which allows real-time adaptation to the data received and therefore the treatments are more effective.

As indicated by the project partners, "We have met the initial objectives and our proposal is significantly closer to commercialisation. The next aim of the consortium to continue the project is to produce a fully operational prototype in terms of greater efficiency-cost ratio" explains Professor Barrios. "After reaching collaboration with specialised suppliers, this version of the product will take part in Phase II and III clinical trials in order to validate the device."

Source: Medical Express, 30th Jan 2015 

New procedure may help individuals with scoliosis

About six million people in the U.S. have scoliosis, an abnormal curvature of the spine.

When left untreated it can get worse and cause chronic back pain.

Bonnie Wilson is walking tall today, but she suffered with severe scoliosis for years.

"I was bent to one side,” said Wilson.

She tried everything from nerve blocks to cortisone shots, but the intense back pain persisted.

"They'd always say one to ten and I would say 50, 20, I don't know it was terrible,” said Wilson. “It was off the chart."

Dr. Andrew Cannestra, a neurosurgeon at Baptist Medical Center, was able to straighten Bonnie's back through a two-part surgery using new robot technology known as the Mazor Robotics Renaissance Guidance System, and a 3D map of the spine.

"It's precise, said Dr. Cannestra. “It's accurate, and I can maximize the size of the screw I put in there. That then allows me to exert as much force on the spine as possible to straighten the spine."

The robot technology can be used to help with other spine conditions like fractures, reconstructive spine surgery, degenerative disc disease and herniated discs.

The new technology has also been used for bilateral deep brain stimulation for Parkinson’s disease.

Bonnie went from having a 38 degree curve, down to eight degrees.

"She has very close to a normal curvature of her spine now," said Dr. Cannestra.

Now an inch taller, "Clothing fits normally, sitting is normal,” said Bonnie. “I don't' have all those muscles getting tired from being leaned one way or the other."



Source: WNDU, 30th Jan 2015 

Davenport sisters deal with scoliosis; help others, too

Mallory Obenauf, 16, left, talks with her sister Megan, 14, about acrobatic water skiing this summer with the Backwater Gamblers. The daughters of Bill and Donna Obenauf of Davenport, Mallory and Megan both have scoliosis of the spine. Mallory wore a back brace and had surgery for the condition three years ago. Megan underwent surgery in December.





Zachary Obenauf, 11, talks with his older sisters Megan, 14, and Mallory, 16, in their Davenport home. Both girls have had surgery for scoliosis, but Zachary, who is being monitored, has not been diagnosed with the condition, which may run in families.






Sisters Megan Obenauf, 14, and Mallory, 16, of Davenport, look at one of the books Mallory wrote while being treated for scoliosis of the spine. Megan had spinal fusion surgery for scoliosis in December and is dealing with a variety of restrictions on her physical activity for the next six months.





These are photos of Mallory Obenauf's spine before and after the 16-year-old from Davenport underwent spinal fusion surgery for scoliosis. Her spine was measured at an 85 percent angle when she had the operation. 





These are photos of Mallory Obenauf's spine before and after the 16-year-old from Davenport underwent spinal fusion surgery for scoliosis. Her spine was measured at an 85 percent angle when she had the operation. 

When Mallory Obenauf was only 5 five years old, it was discovered that her spine curved at a 30-degree angle.

“That is not good,” her mother, Donna Obenauf, said from the living room of the family's Davenport home. But that was not the worst of it.

After the curvature was discovered, Mallory’s father, Bill Obenauf, said his eldest child was taken to a Davenport orthopedist, who immediately sent the family to Dr. Stuart Weinstein at the University of Iowa Children’s Hospital in Iowa City.

Weinstein, an expert on the condition, diagnosed early-onset scoliosis in little Mallory and fitted her with a back brace. She wore that brace 16 hours a day for eight years. By the time she turned 13 years old, her spinal curve had worsened — despite the brace — to an 85-degree angle and she underwent spinal fusion surgery.

Weinstein performs almost all of the scoliosis surgeries in Iowa, including many patients from western Illinois. Weinstein does about four surgeries per week and has been in practice for 39 years. He is also a lead author and researcher on studies that show the effectiveness of using braces in scoliosis patients, having been published last year in the New England Journal of Medicine among other respected publications. 

Today, Mallory is 16 years old and almost three years removed from her serious spinal surgery. She is back to her regular activities, including acrobatic water skiing.

However, her sister, Megan, 14, also was diagnosed with scoliosis and underwent spinal fusion surgery in December.

The experience with both girls has led the Obenaufs to try to help other families in the same situation as what they have faced. So far, Mallory has written two books and a third is being produced. She serves on an advisory panel for the children’s hospital.

The family has also counseled more than a dozen others with children facing the surgery, both at the Iowa City hospital and at the Mayo Clinic in Rochester, Minn.

Bill Obenauf, who goes by Bill Michaels in his job as one-half of the Dwyer and Michaels morning radio show on 97X (WXLP-FM, 96.9) in the Quad-Cities, said most people had no idea that either of his daughters were dealing with scoliosis.

“They looked normal, but the spine twists inside with the muscles and ligaments. They (doctors) go in and straighten it out. Every case is different, but the twisted spine will contract internal organs," he said.

Both diagnosed with idiopathic scoliosis

The scoliosis cases faced by the Obenauf girls are different. Essentially, Mallory had a more serious condition, but Megan’s worsened quickly in 2014 and she is now at a critical point in her recovery.

Mallory is in the 10th grade and Megan in the ninth grade at Pleasant Valley High School in Bettendorf. They have a brother, Zachary, who is 11 years old and attending school in Davenport. Zachary is being monitored for scoliosis, but so far his spine is straight.

When Megan attends school, she is helped by a friend because she is not allowed to carry more than five pounds at a time or raise her hands over her head. Megan meets the friend about five minutes before classes end. The two either go to her locker to get books for her next class or they may continue to the nurse’s office so Megan can lie down and rest for a while.

“We do this before the bell rings so I’m not stuck in a crowd where I could get bumped and hurt,” she explained.

“These first few months after surgery are critical,” her father pointed out.

Origins of the illness

Donna Obenauf had scoliosis when she was a teenager, and the condition may run in families. However, the cause of most cases is unknown, according to the Mayo Clinic.

“My scoliosis was discovered when I was in high school, but my degree was never as severe as Mallory or Megan,” their mother said, adding that she neither had to wear a brace nor undergo surgery. But having dealt with it, she was more aware of scoliosis and made sure her daughters were checked.

Weinstein said scoliosis affects 2 percent to 3 percent of children 10-16 years old. Of those, only 10 percent need further treatment such as braces or surgery. Mallory had early-onset scoliosis as it was diagnosed when she was 5 years old. Megan had a more traditional case.

At one point, the girls' father decided to talk about their condition on his popular radio show.

It was a difficult topic to discuss, he said, but the complicated surgery and extended recovery time gave him something to consider.

“It was eating at me. I knew I would not leave the hospital, and I didn't want to say I was on vacation or anything. So I decided to talk about it,” he explained. He has received a great deal of positive feedback from going public with the information. 

A Backwater Gamblers family 

The entire Obenauf family is involved with the Backwater Gamblers Water Ski Show Team. Megan was first to join; her interest began after she and Mallory were invited by a PV swimming club friend who is in the show. Both girls ski, as do their brother and father. Their mother works as a volunteer.

Right now, Megan is on the sidelines because of the recent surgery and is counting the days until she can resume the activity in June. “But I’m going to practices anyway, and I can collect money or help vendors. I want to be part of it,” she said.

Mallory has resumed all her previous activities, including the Piranhas Swim Club at PV, cheerleading, playing the flute in the band and performing in stage plays. Both girls are on the varsity swim team and swim almost year-round.

Also, Mallory is continuing her scoliosis outreach activities. She is on the Youth Advisory Council for the children's hospital, which she calls a "tremendous honor." She was invited by Dr. Weinstein to go to Washington, D.C., to lobby for scoliosis research funds at the National Institute of Health.

"It was pretty impressive," Donna Obenauf said. "Physicians from all over the United States came with patients, and it put a face on the condition."

That is something the entire family continues to do, around the Quad-Cities and beyond.

Some 10 years ago, the U.S. Preventative Services Task Force recommended that scoliosis no longer be part of routine screenings in the school setting.Read more

TESTING FOR SCOLIOSIS

About one in 25 adolescent girls and 1 in 200 teenage boys develop scoliosis, according to the American Academy of Pediatrics (healthychildren.org).

Normal spines exhibit no curvature when seen from the rear. Those with the condition have a more pronounced S shape when examined with an X-ray. A youngster is said to have scoliosis if the curvature is greater than 10 degrees.

The condition can occur as a complication of polio, muscular dystrophy and other central nervous system disorders, but four in five cases among teenage girls are idiopathic — meaning the cause is unknown. Very often, though, a family member will also have had scoliosis.

Exams are done on a patient’s back to check conspicuous curving of the upper body, uneven, rounded shoulders, a sunken chest or leaning to one side. Back pain with the condition is rare.

— American Academy of Pediatrics

Source: QC Times, 30th Jan 2015