! STOP BENDING NOW !

Saturday, 26 September 2015

Fast, high-tech scanner helps in diagnosis, treatment of scoliosis

Scoliosis, or a curvature of the spine, is a structural problem affecting as many as seven million Americans. While it affects both genders, females are eight times more likely to require treatment, including braces and spinal fusion surgery, and that can mean dozens, even hundreds of X-rays. Now, there’s finally a breakthrough in X-ray technology.


Scoliosis, or a curvature of the spine, is a structural problem affecting as many as seven million Americans.

In less than 20 seconds, a new high-tech scanner takes two extremely clear full-body images of a patient’s surgically-repaired spine.


Scoliosis patient, Amy Cominsky remarked, “I will have more confidence that the doctors will be able to see more, with better images.”


The EOS scanner is a three-dimensional system that scans patients in a natural, standing position. It allows orthopedic specialists to get the most accurate view of the spine with the lowest dose of radiation possible.

“It’s 80 percent less, or one- fifth of the radiation involved with the old type of x-rays,” explained Mark Rahm, MD, Orthopedic surgeon at Scott & White Memorial Hospital in Temple, Texas.


The thirty-four year old Cominsky had surgery to repair her scoliosis when she was 15. She’s had more than 200 X-rays.

Dr. Rahm explained, “The new machine takes an individual X-ray of each bone as opposed to the old way, where the amount of radiation wasn’t right for each individual level.”

Doctors say other advantages of the EOS scanner include clearer pictures, simultaneous scans of front and side and improved surgical accuracy and precision.


Inspired by her own medical condition, Cominsky became a surgical technician. She sees on a daily basis how the EOS scanner is improving the diagnosis and treatment of scoliosis patients.

“It’s such an improvement in technology and the pictures itself are so much clearer,” said Cominsky.

Too much exposure to radiation can lead to cataracts and in some cases, cancer. The EOS scanner is only available in about 25 hospitals so far, but those numbers are expected to increase.


Source : WNDU , 22nd Sep 2015

Dynamic braces for kids with scoliosis now in development


 Prototype wearable spine brace: sensors record the force and motion data and transmit the information to a computer for monitoring and treatment. Source: Jane Nisselson/Columbia Engineering


Prototype wearable spine brace: sensors record the force and motion data and transmit the information to a computer for monitoring and treatment.

--------------------------------------------------------------------------

Some six million people in the U.S. suffer from scoliosis, a sideways curvature of the spine. These include approximately 2 to 3% of adolescents who are diagnosed each year with idiopathic scoliosis, which is usually identified during puberty and progresses until skeletal maturity. One in 500 children today require treatment using spine braces and 1 in 5,000 need spinal surgery. The typical spine brace is made of rigid plastic that fits around the child’s trunk and hips and applies counter-pressure on the spine’s abnormal curve, on the theory that pressure and support on the curve from outside will stimulate more normal growth of the spine.



The rigid braces have several shortcomings: they “freeze” the child’s upper body and limit movement to such an extent that users often avoid wearing the brace. And as the child grows, the required external forces to correct the abnormal posture change along the length of the curve and over the course of treatment. Having the flexibility to move when wearing a spinal brace while still applying corrective forces would be a very useful feature for both patients and physicians.

Sunil Agrawal, professor of mechanical engineering and of rehabilitation and regenerative medicine, is working on solving the problem. He and his collaborators—David P. Roye, St. Giles Foundation Professor of Pediatric Orthopedic Surgery at the Columbia University Medical Center (CUMC), and Charles Kim, professor of mechanical engineering at Bucknell University—are developing a dynamic spine brace that is more flexible than the rigid braces now in use. Their work is so promising that they have just won a $1 million grant from the National Science Foundation’s National Robotics Initiative.

“Every year, 30,000 children use a rigid brace to treat scoliosis, while 38,000 patients undergo spinal fusion surgery, so this award will make a big difference,” Agrawal said. “If we can design a flexible brace that modulates the corrective forces on the spine in desired directions while still allowing the users to perform typical everyday activities, we will bring revolutionary change to the field.”

Agrawal and his team have already developed prototype wearable spine braces that consist of rings that fit on the human torso. These rings are dynamically actuated by servomotors placed on adjacent rings to control the force or position applied on the human body. Onboard sensors record the force and motion data and transmit the information to a host computer for monitoring and adjusting the treatment. The team has also developed a second brace that is fully passive, made of compliant components able to adjust stiffness in specific directions. However, both these braces have drawbacks. The dynamic brace needs an active power source while the passive brace cannot provide active controls.

“While we are the first group to propose parallel-actuated spine braces and compliant braces, these are just in initial phases,” Agrawal explains. “What we will do, thanks to the NSF award, is to design hybrid semi-active spine braces that combine the merits of the two. These will be less power hungry and can be worn over a longer duration of time.”

The team, which has drawn together experts in robotics and pediatric orthopedics, plans to test all three types of braces on children with scoliosis at CUMC. Preliminary experiments have already started to characterize the feasibility of the dynamic braces on healthy subjects with normal spines to characterize the body’s stiffness in different directions during activities of daily living.

“Scoliosis impacts the quality of life of those affected, limiting their activity, causing pain, and diminishing their self-esteem,” Agrawal adds. “We expect our work will transform treatment due to the ability of the brace to modulate force or position at specific locations of the spine and will greatly improve the quality of life for children with this debilitating condition.”



Source : RD Mag , 23rd Sep 2015 

Mazor Robotics Technology to be Featured in a Live Surgery Presentation at the Congress of Neurological Surgeons Annual Meeting 2015

Mazor Robotics Renaissance® Guidance System will be featured in a Live Surgery presentation entitled, "Spine: Robotics-guided MIS TLIF" at the Congress of Neurological Surgeons (CNS) Annual Meeting 2015 in New Orleans, Louisiana.   The surgery will be performed live by Hunaldo J. Villalobos, MD, FACS, in Orlando, Florida, and broadcast into the exhibit area from 11:45 am – 12:15 pm on Tuesday, September 29.




The Renaissance system uses advanced 3D planning and mechanical guidance with 1.5mm accuracy to provide surgeons with a better solution for minimally invasive and percutaneous fusions, complex spinal deformity, trauma cases, and cranial procedures. Access Mazor Robotics series of 'How Renaissance Works' videos here.

"The Mazor Robotics Renaissance system gives me the ability to perform minimally-invasive procedures for my patients, while providing high accuracy with minimal radiation exposure," said Dr. Villalobos. "I am excited to share this technology with fellow neurosurgeons to help advance this technique in spine surgery."

"The Congress of Neurological Surgeons Annual Meeting is known for its leading-edge, progressive program and we are proud to partner with them this year to showcase our technology," said Mazor Robotics CEO Ori Hadomi. "Viewing a live surgery is the best way to see the advantage that the Renaissance Guidance System brings to a spine procedure."

Not attending CNS 2015 in New Orleans this year? Mazor Robotics will also have an exhibit booth and hold Bioskills Labs at the North American Spine Society (NASS) Annual Meeting and the Society for Minimally Invasive Spine Surgery (SMISS) Global Forum later this year.
 
To test-drive the Renaissance system for yourself, sign up for a Bioskills Lab today.
 
Mazor Robotics (TASE:MZOR) (NASDAQ:MZOR) believes in healing through innovation by developing and introducing revolutionary robotic-based technology and products aimed at redefining the gold standard of quality care. Mazor Robotics Renaissance® Guidance System enables surgeons to conduct spine and brain procedures in a more accurate and secure manner. For more information, please visit www.MazorRobotics.com.

A photo accompanying this release is available at:
http://www.globenewswire.com/newsroom/prs/?pkgid=36371
- See more at: http://www.globenewswire.com/news-release/2015/09/24/770696/10150458/en/Mazor-Robotics-Technology-to-be-Featured-in-a-Live-Surgery-Presentation-at-the-Congress-of-Neurological-Surgeons-Annual-Meeting-2015.html#sthash.X0GyNXKk.dpuf

Model Rebecca’s back on her feet

Rebecca Buss, 22, from St Helens, who suffers from scoliosis, a condition which caused her spine to violently curve sideways, has responded well to radical new treatment and has been able to resume her modelling career.

Rebecca Buss, 22, from St Helens, who suffers from scoliosis, a condition which caused her spine to violently curve sideways, has responded well to radical new treatment and has been able to resume her modelling career.

-------------------------------------------------------------------------------

A model who dreamed of making it big on the catwalk has told how she rebuilt her career after a rare illness left her ambitions in tatters.

Rebecca Buss was a fit and healthy young woman when she developed scoliosis, a condition which caused her spine to violently curve sideways.

It left the 22-year-old in near-constant pain and with the energy levels of a woman four times her age.

She was told major surgery – which would have left her with a large scar and seriously hampered any chance of resurrecting her modelling career – was the only hope of alleviating her pain.


Then she discovered a radical exercise programme called ScolioGold method which, she says, has given her back the freedom to pursue her dreams.


Rebecca said: “I actually feel really overwhelmed. The support I got from the clinic was amazing.


“I no longer felt like I had been brushed off by so many different people.


“I don’t think people always take you seriously when you say you want to model – they just think just another young girl desperate to make it in such a competitive world.”

Rebecca, of City Gardens, St Helens, had always been fit and active but after developing the spinal deformity she could barely walk and often spent her time curled up in bed.


Scoliosis, which affects around four per cent of the population - causes the spine to excessively curve sideways.


If left untreated it can lead to fatal heart and lung problems. Current surgery involves inserting metal rods on either side of the spine, before the spine is fused solid.


Rebecca’s treatment at the ScolioGold clinic took four weeks and within weeks of completing the course her condition dramatically improved to the point where she is now ready to re-launch her modelling career.

She learnt a set of exercises which strengthened the muscles surrounding her spine and meant that her scoliosis stabilised.

She said: “It was not just my appearance I needed to correct; I wanted to get rid of my pain. The pain kept me awake at night and unless I took painkillers I could not function.”



Source : St Helens - The Reporter , 25th Sep 2015




Sunday, 20 September 2015

Hong Kong hospital to use 3D printer to make braces for children with crippling scoliosis


                 The Hospital Authority is reviewing guidelines on organ transplants.

Duchess of Kent Children’s Hospital will use a 3D printer to make braces for patients suffering a spinal condition – a breakthrough that will slash waiting times and benefit 275 youngsters in the coming year.


In announcing details of its 2015/2016 annual plan, the Hong Kong West group of hospitals also said it would hire 300 more staff – mostly nurses – to combat shortages and growing demand for medical services.

Scoliosis patients now have to wait up to four months for a brace – to treat curvature of the spine – but the new machine will cut production time to a matter of hours as patients will no longer have to undergo plaster-casting. Waiting times will be shortened to around six weeks.


The machine will arrive at the hospital in Sandy Bay, Pok Fu Lam, late next month. Prince of Wales Hospital in Sha Tin, which also treats scoliosis, has already adopted similar technology.

Every year about 1,500 scoliosis patients are referred to the two public hospitals.

Dr Luk Che-chung, chief of the hospital group, admitted yesterday that the private Gleneagles Hospital in Wong Chuk Hang, which will start running in 2017, had created more manpower pressure.


“We are a bit worried as the hospital is close to us,” Luk said, adding that some staff might be tempted to move in pursuit of their careers.


Queen Mary Hospital in Pok Fu Lam will hire 30 extra nurses to ease the manpower shortfall, while the hospital group will also carry out an extra 570 endoscopic procedures.

And four rehabilitation beds in the children’s hospital in Sandy Bay are to be converted into designated beds for ventilator-assisted patients.

Meanwhile, the Hospital Authority is reviewing guidelines on organ transplants after cancer was detected in the body of an organ donor last month, forcing a liver transplant to be aborted at the last minute. It has also found a contractor to replace Shum Wan Laundry, believed to be the source of a fungal infection at Queen Mary Hospital in the summer.




Source : South China Morning Post , 17th Sep 2015


YOGA POSES


Yoga , Use these yoga poses and techniques to strengthen your back and reduce pain and slouching..

Yoga Kyphosis Exercises Rehabilitation exercises mid- pain & kyphosis, A collection of the best strengthening, stretching and mobilising exercises for the mid/upper back to help with pain and stiffness. these exercises will. Yoga Kyphosis Exercises5 simple yoga poses pain - spineuniverse, Tired of battling back pain? try yoga. yoga not only eases your body and mind, but it can help you manage back pain. in this slideshow, you’ll discover what 5 yoga.

Yoga Kyphosis Exercises



Back strengthening exercises: Thumbnails
BodyPlanes.jpg
BodyPlanes.jpg
Image Source: http://2.bp.blogspot.com/-s4DJcvEGLtc/TWF5Ru11e6I ...

Half Moon Pose
Half Moon Pose
Shen 神 Acupuntura e Tratamento da Dor
Shen 神 Acupuntura e Tratamento da Dor




Source : YOGA POSES




Growing Rods for Scoliosis

Children with severe scoliosis often spend their entire childhood going through a series of painful surgeries to correct the curve in their spine, but all of those surgeries are no longer necessary thanks to breakthrough technology.

Twelve year old Brooke Olson may be small for her age, but karate has taught her to stand tall and proud. You’d never guess that just a few months earlier, Brooke had a hard time standing at all.

Inside Brooke’s back are two titanium growing rods, surgically implanted to correct the curve in her spine that worsened to 60 degrees last year.



Source : KSAT 12 , 17th Sep 2015 


Brooke’s mother, Lynise Olson, told Ivanhoe, “Her back was in pain pretty much all the time at that point.”
Traditional treatment would have required Brooke to undergo surgery to lengthen the rods every six months, until she stopped growing.


Lynise said, “So that would’ve been, you know, 10 surgeries she might’ve had to have.”

Brooke was one of the first patients to have “magnetic” growing rods implanted. Now, instead of surgery, her doctors use a non-invasive, magnetic remote control to adjust them.


Pediatric orthopedic surgeon and professor and chief of Pediatric Orthopedics at Monroe Carell Jr Children’s Hospital at Vanderbilt University, Gregory Mencio, MD, said, “It’s an office visit every four months as opposed to an operative procedure every six to nine months. Pretty good trade off.”

And Dr. Mencio points out, no more surgeries also means no more X-rays or anesthesia. It also means Brooke can spend more time at the dojo instead of the hospital.


Because the magnetic growing rods are non-invasive, they can be adjusted more frequently and some doctors believe this will allow them to get an even better handle on a child’s scoliosis.

Dynamic braces for kids with scoliosis now in development

Some six million people in the U.S. suffer from scoliosis, a sideways curvature of the spine. These include approximately 2 to 3% of adolescents who are diagnosed each year with idiopathic scoliosis, which is usually identified during puberty and progresses until skeletal maturity. One in 500 children today require treatment using spine braces and 1 in 5,000 need spinal surgery. The typical spine brace is made of rigid plastic that fits around the child's trunk and hips and applies counter-pressure on the spine's abnormal curve, on the theory that pressure and support on the curve from outside will stimulate more normal growth of the spine.
The rigid braces have several shortcomings: they "freeze" the child's upper body and limit movement to such an extent that users often avoid wearing the brace. And as the child grows, the required external forces to correct the abnormal posture change along the length of the curve and over the course of treatment. Having the flexibility to move when wearing a spinal brace while still applying corrective forces would be a very useful feature for both patients and physicians.

Sunil Agrawal, professor of mechanical engineering and of rehabilitation and regenerative medicine at Columbia Engineering, is working on solving the problem. He and his collaborators—David P. Roye, St. Giles Foundation Professor of Pediatric Orthopedic Surgery at the Columbia University Medical Center, and Charles Kim, professor of mechanical engineering at Bucknell University—are developing a dynamic spine brace that is more flexible than the rigid braces now in use. Their work is so promising that they have just won a $1 million grant from the National Science Foundation's National Robotics Initiative.

"Every year, 30,000 children use a rigid brace to treat scoliosis, while 38,000 patients undergo spinal fusion surgery, so this award will make a big difference," Agrawal says. "If we can design a flexible brace that modulates the corrective forces on the spine in desired directions while still allowing the users to perform typical everyday activities, we will bring revolutionary change to the field."

Agrawal and his team have already developed prototype wearable spine braces that consist of rings that fit on the human torso. These rings are dynamically actuated by servomotors placed on adjacent rings to control the force or position applied on the human body. Onboard sensors record the force and motion data and transmit the information to a host computer for monitoring and adjusting the treatment. The team has also developed a second brace that is fully passive, made of compliant components able to adjust stiffness in specific directions. However, both these braces have drawbacks. The dynamic brace needs an active power source while the passive brace cannot provide active controls.

"While we are the first group to propose parallel-actuated spine braces and compliant braces, these are just in initial phases," Agrawal explains. "What we will do, thanks to the NSF award, is to design hybrid semi-active spine braces that combine the merits of the two. These will be less power hungry and can be worn over a longer duration of time."

The team, which has drawn together experts in robotics and pediatric orthopedics, plans to test all three types of braces on children with scoliosis at CUMC. Preliminary experiments have already started to characterize the feasibility of the dynamic braces on healthy subjects with normal spines to characterize the body's stiffness in different directions during activities of daily living.

"Scoliosis impacts the quality of life of those affected, limiting their activity, causing pain, and diminishing their self-esteem," Agrawal adds. "We expect our work will transform treatment due to the ability of the brace to modulate force or position at specific locations of the spine and will greatly improve the quality of life for children with this debilitating condition."



Source : Medical Express , 17th Sep 2015

Heartwarming pictures show unique bond between dwarf father and four-year-old daughter who helps him tie his shoelaces and even climbs up on him to get yoghurts out of the fridge

  • Richard Willis, 46, suffers from diastrophic dwarfism, which stifles growth
  • He has faced string of medical problems and needs specialised wheelchair
  • But his daily life is made easier by his four-year-old daughter, Cherry
  • Cherry helps her father tie his shoelaces and reach food on the top shelf


    These touching photographs capture the special bond between a dwarf father and his daughter.



    Richard Willis, from North Frodingham, Yorkshire, was born with diastrophic dysplasia, a rare form of dwarfism that stifles growth and leaves joints malformed.
    As a result of the condition, the 46-year-old, who is 3ft 8in tall, suffers from extreme arthritis and double scoliosis and now needs a specialised wheelchair to support his movement.
    But his life is made easier by his four-year-old daughter, Cherry, who helps her father tackle everyday tasks.


    Helping hand: Cherry is happy to help her father tie his shoelaces, as he finds it too painful to do for himself


    Helping hand: Cherry is happy to help her father tie his shoelaces, as he finds it too painful to do for himself

    Special bond: Richard gives Cherry a lift to reach their yogurts on the top shelf of the fridge
    Heartwarming: Cherry and Richard



    Special bond: Richard gives Cherry a lift to reach their yogurts on the top shelf of the fridge. Right, together
    Tiny: Cherry (pictured) was born nine weeks early in 2011, at a time when Mr Willis could not walk properly
    Tiny: Cherry (pictured) was born nine weeks early in 2011, at a time when Mr Willis could not walk properly

    The schoolgirl, who did not inherit her father's condition, ties his shoelaces, washes the dishes and even climbs up on him to reach food on the top shelf in the fridge.

    And when Mr Willis heads out on his hand-trike cycle, a specialised wheelchair he needs to move around, Cherry pedals along beside him on her bike.

    Mr Willis said they share a 'unique' relationship and that he couldn't be more proud of his daughter.



    We're like a little double act. We do everything together and I don't think we could be any closer,' he said.


    'She crouches down to tie my shoe laces because it's painful for me to do it myself and she climbs up on me every day to take two yoghurts from the top shelf of the fridge for us to eat.


    'When she plays with her miniature baking set, it's the perfect height for me so it even helps when she's playing with her toys. We even wash the dishes together - it's a real tag-team effort!'

    Family: Mr Willis' wife, Charli, works part-time for the council while he stays home with Cherry
    Family: Mr Willis' wife, Charli, works part-time for the council while he stays home with Cherry
    Close: Mr Willis, who took medical retirement in 2006, said his daughter's birth was like a 'breath of fresh air'
    Close: Mr Willis, who took medical retirement in 2006, said his daughter's birth was like a 'breath of fresh air'
    Quality time: Mr Willis said they share a 'unique' bond and that he couldn't be more proud of his daughter
    Quality time: Mr Willis said they share a 'unique' bond and that he couldn't be more proud of his daughter
    Mr Willis, who took medical retirement in 2006, said his daughter's birth was like a 'breath of fresh air' during a time in his life when he was recovering from a number of major operations.  

    WHAT IS DISATROPHIC DWARFISM? 

    Diastrophic dysplasia, which is also known as disastrophic dwarfism, is a rare disorder of cartilage and bone development.   

    The range and severity of symptoms can vary greatly, but is often characterised by short stature and unusually short arms and legs; abnormal development of bones and joints; and progressive abnormal curvature of the spine. 
    Mr Willis suffers from extreme arthritis and double scoliosis of the spine. 
    It is estimated that roughly one in 100,000 newborns is affected with the condition. 

    About half of infants with diastrophic dysplasia are born with an opening in the roof of the mouth.  

    He claims the double scoliosis of his spine caused by his condition has altered his walking position and subsequently a string of ongoing back problems.

    Mr Willis said his movement has been permanently impaired since he was forced to have surgery on his left leg in 2006, and his right leg and shoulder in 2008. 
    When Cherry was born he could not walk properly. 

    'I've had some tough times but the birth of my daughter was like a breath of fresh air,' he said.

    'Because of the operations I had to have it felt a little bit like I was starting out again because I had to teach myself to walk and all sorts but Cherry being around made it so special.

    'When she was learning to crawl, I was just learning how to walk again so it really is like we've done everything alongside each other. It's a unique bond, there's no other way to put it.'

    Mr Willis spent most of his day with Cherry while his wife, Charli, worked part time at the council. 

    But Cherry started school last week so the pair will now have less time together.
    Playful: Mr Willis said his movement has been permanently impaired since he was forced to have surgery on his left leg in 2006, and his right leg and shoulder in 2008. Pictured, with daughter Cherry and wife Charli
    Playful: Mr Willis said his movement has been permanently impaired since he was forced to have surgery on his left leg in 2006, and his right leg and shoulder in 2008. Pictured, with daughter Cherry and wife Charli

    Staying strong: Mr Willis, pictured with Cherry and Charli on holiday, said he had faced some tough times
    Staying strong: Mr Willis, pictured with Cherry and Charli on holiday, said he had faced some tough times

    Support: When Mr Willis heads out on his specialised wheelchair  Cherry pedals along beside him on her bike
    Support: When Mr Willis heads out on his specialised wheelchair Cherry pedals along beside him on her bike

    He said: 'I'm really proud of her and she seems to have really taken to school life.
    'Cherry's a really confident little girl, probably because of how much time she's spent in adult company at such a young age.

    'She's really proud of her dad and there's no issue at all with the other children just because I'm a dwarf.

    'I don't think she could have settled in any better than she has, she's a lovely girl and we're so proud of her.

    Challenges: When Cherry was learning to crawl, her father was teaching himself how to walk again
    Challenges: When Cherry was learning to crawl, her father was teaching himself how to walk again
    Mr and Mrs Willis on their wedding day
    An X-ray of Mr Willis' legs with titanium joints
    Mr and Mrs Willis on their wedding day, left. Right, an X-ray of Mr Willis' legs with titanium joints
    New chapter: Cherry started school last week so the pair (pictured together )will now have less time together

    Cherry started school last week so the pair (pictured together )will now have less time together




    Source : Daily Mail , UK

7 notes on scoliosis braces molding to children's movements



Columbia University School of Engineering and Applied Science researchers are developing dynamic scoliosis braces for children.

Here are seven notes:

1. Sunil Agrawal, professor of mechanical engineering and of rehabilitation and regenerative medicine at Columbia, N.Y., is heading the project.

2. David P. Roye, St. Giles Foundation professor of pediatrics orthopedic surgery at Columbia University Medical Center in New York, and Charles Kim, professor of mechanical engineering at Bucknell (Pa.) University are working with Mr. Agrawal on the project.

3. The three professors want to create a scoliosis brace void of rigidity, that moves flexibly with children.

4. The National Science Foundation's National Robotics Initiative awarded a $1 million grant for the project.

5. The team developed prototype wearable spine braces with rings that fit on the torso. Dynamically actuated by servomotors on adjacent rings, these rings control the pressure on the body. Motion data from the sensors is received by a computer, where physicians can adjust treatment.

6. A passive brace is also in the works, in which compliant components adjust stiffness in certain directions.

7. Mr. Agrawal and his team plan to test their different prototypes on children with scoliosis at CUMC


Source : Beckers Spine , 18th Sep 2015

Saturday, 12 September 2015

'Grow with me' magnetic rod helps children with scoliosis avoid multiple surgeries

For children with scoliosis – an abnormal twisting of the spine -- the diagnosis can mean repeated invasive surgeries to lengthen growing rods that need to grow with them.

A new magnetic rod option means that, instead of facing surgery every six months for years to lengthen the growing rod, children can have it done non-invasively in the doctor's office via an external remote control that expands the rod to straighten the spine.


"Spine surgery is at best unpleasant and there are the risks associated with putting the child to sleep so anything we can do to minimize the number of times we need to do that is progress," said Dr. Gordon Armstrong, director of the division of pediatric orthopedic surgery at Penn State Milton S. Hershey Medical Center.


Scoliosis varies in age of onset and severity, but it can lead to serious breathing problems. Left untreated, children face a shorter lifespan due to the spine curvature that inhibits breathing.


The magnetic growing rod, which goes by the brand name Magec (MAGnetic Expansion Control), was FDA approved in February 2014. The only place in the midstate to offer it beginning a year ago, Hershey has so far used it in 11 children, Armstrong said. 


More natural option
 


The overwhelming benefit is, of course, fewer surgeries for children, but it also allows the doctor to increase the length of the rod sooner – at three months vs. six months – which may be more akin to the natural way the spine would grow, Armstrong said.

The ideal candidate for the growing rod is a child between the ages of 5 and 10'
"


The rod placement can control the deformity, maintain the chest wall and prevent the development of pulmonary problems," he said.

The ideal candidate for the growing rod is a child between the ages of 5 and 10 with a curve of 50 degrees and beyond.


During surgery, doctors move skin and muscle away from the spine and place anchors – hooks or screws – on the spine below the neck and at the lower back to which the expandable rod is attached. They may put a rod on either side of the spine. The rods contain a magnetic motor that is about the diameter of a pen.


At subsequent visits in the clinic, doctors place an external remote controller at the location of the magnet in the rod, which allows the rod to extend.


Life-threatening condition
 

In determining the severity of scoliosis, doctors measure the spine's curvature by looking at the tilt of the vertebrae along the spine. Normally, there should be less than 10 degrees of angulation along the spine.  Curves less than 25 degrees may not progress and probably won't cause problems, so likely will not be treated but will be monitored, Armstrong said.


"Children with early onset scoliosis have a high risk of progression of the curve and they are at risk for compromised pulmonary development," Armstrong said. "From birth to age 8 is a critical period for lung development, which is by expansion of the chest as lung cells increase. Anything that affects lung function before that is permanent."


The most common form of scoliosis – idiopathic scoliosis – occurs in about 2 percent of the population and has no known cause or coexisting conditions. Early onset scoliosis refers to a deformity that develops before age 5; infantile idiopathic scoliosis develops between birth and age 3.

How a child is treated depends on their age and the severity of the curve. Traditional treatments include casting, spinal bracing, and spinal fusion, Armstrong said.



Because of their small size and fragile bones, children ages 1 to 4 do not do well with rod placement and may instead be placed in body casts that are changed every few months.


"This sounds old fashioned and it is, but it actually works to cure the problem in some cases and to buy time in others," Armstrong said.




In children with idiopathic scoliosis – meaning the child is not suffering from any other disorder or medical condition – a brace will usually be tried to control the curve. This is a wrap-around plastic corset that starts below the arms and extends to the hips and is worn under clothes over a light shirt. It's typically worn 16 or more hours daily to age 14 or 16, Armstrong said.




"A large amount of children don't respond well to bracing and we would not consider fusion until the child is older because it stops the spine from growing," Armstrong said.




The magnetic rod is ideal for most patients in the target age range, however because the area of the rod where the magnetic motor is located cannot be manipulated around a curve, it may not work with some curvatures, he said.




Fusion necessary later 




Although the magnetic rod helps children avoid multiple rod-lengthening surgeries, the vast majority will ultimately need fusion when their bones are mature enough to handle it, Armstrong said.


"The magnetic rod is not a magic bullet; it's a tool to manage a challenging condition. We are treating a biological problem with a mechanical solution," he said. "We are always hoping that someday there will be a biological way of managing this condition, such as – if it would turn out to be caused by a neurological condition – modifying the cellular growth of the spine in some way."
Source: Pennlive , 10th Sep 2015 

Using magnets to elongate surgically-implanted spines

A life-changing procedure using magnets is showing great promise for Colorado children with scoliosis.
Children with severe cases have rods implanted into their torso to control the curvature of their spines and prop up their chests.
As children grow, those rods need to grow with them. Every six months they must endure surgery in which doctors open them up and manually extend the rods. Recovery can be tough, and there is always a risk for infection, as is the case with any surgery.
Now, there is new technology that can keep these kids out of the operating room.
"This is just really a blessing to have this available to us now," Heather Viano said.
Viano's 10-year-old son Ryan has scoliosis that was brought on by Spinal Muscular Atrophy, an inherited neurological disorder where his nerves are unable to control his muscle function.
"This is a progressive disorder where you start losing the strength of your muscles ... the muscles that help you walk, the muscles that help you use your arms, and the chest muscles that help you breathe," Dr. Sumeet Garg, a spine specialist and orthopedic surgeon with Children's Hospital Colorado, said.
In May, Ryan became the first patient at Children's Colorado to have new magnetic rods bracketed onto his spine.
At an office visit every four months, a hand-held magnetized device will be placed on his back. The magnetic field causes the magnet inside the implanted rods to spin. As the magnet spins, the rods expand.
At Ryan's first appointment in which the magnetic technology was put to the test, the two rods were lengthened by a fifth of an inch, which is the amount Dr. Garg had planned.
"It is a total shift in how we take care of kids with scoliosis," Dr. Garg said. "It's still a very big decision to implant these rods in a child, but you can feel good knowing you can do the expansions in the office. You're not making a patient go into the operating room multiple times during childhood."
Before his first magnetic lengthening session, Ryan was nervous. This was something new for him.
The tingling sensation he felt from the hand-held device was startling at first but didn't last.
The entire rod lengthening procedure only lasted five minutes.
"To be able to do something like this in the office with him awake is remarkable," Dr. Garg said. "There is no risk of infection like there would be with surgery. He doesn't have anesthesia that can compromise his lung function. So, it's really wonderful for him and for us to be able to do this in the office."
"Having this done in a five-minute period is quite nice," Heather said. "There is no wait time afterward, no pain meds, no recovery and no missing school. It's going to be a big difference for us."
Dr. Garg said the magnetic rods in Ryan's back can be fully extended to two inches over the next three to four years. This will alleviate the need for Ryan to have seven surgeries.
"Thumbs up," Ryan said with a big, confident smile.
"I'm so anxious to see what else they come up with," Heather said. "This is just one of the many things I'm sure that will be in his future."
The MAGEC (MAGnetic Expansion Control) Spinal Bracing technology was developed by Ellipse out of California.



Source: 9News.com , 9th September 2015