Scoliosis Spine Surgeon Interviews

Scoliosis Spine Surgeon Interviews Scoliosis Spine Surgeon Interviews includes extended discussions with the top scoliosis surgeons, researchers, orthotists and therapists from around the world.

Interesting article on when to wean off scoliosis bracing.  See the full paper below. :)
06/06/2024

Interesting article on when to wean off scoliosis bracing. See the full paper below. :)

This randomized clinical trial compares gradual weaning vs immediate brace removal in patients with adolescent idiopathic scoliosis.

Whisper Brace Demo.Jamie dropped by my Toronto clinic about a month ago and gave me a hands on demo of the Whisper.  In ...
06/04/2024

Whisper Brace Demo.

Jamie dropped by my Toronto clinic about a month ago and gave me a hands on demo of the Whisper. In return, I introduced Jamie to Toronto's legendary gridlocked traffic. ⛔😂

It's a quick 6:46 minute demo that gets to the point.

Check it out below! 🙂

This interview is for educational purposes and covers information provided by Jamie Haggard regarding his opinions on the Whisper Brace. His answers and commentary represent his opinion and everyone should consult their physicians and treating team. This video is not an endorsement.

This interview is for educational purposes and covers information provided by Jamie Haggard, CEO regarding his opinions on the Whisper Brace. This video is...

10/16/2021

Dr. Peter Newton, Vertebral Body Tethering (VBT) Non-Fusion Surgery interviewed by Dr. Derek Lee.

This interview is for educational purposes and covers information provided by Dr. Peter Newton regarding his opinions on Vertebral Body Tethering (VBT) Non-Fusion Scoliosis Surgery. This video is not an endorsement. Viewers should consult their physicians and treating team accordingly. See highlights via timestamps below.

From engineering to spine surgeon. 00:37
First exposure to VBT concept developed from bone growth modulation research in animal models. 2:30
Verifying bone growth modulation and maintaining disc health were critical to evolution of VBT. 4:24
The importance of disc health when tethered. 4:52
Initially used a non-fusion system from Europe to begin tethering in the US. 6:21
Initially metal cables were used for tethering. 7:38
Thoughts on disc release. 9:10
Unclear whether disc release will lead to pain or other issues down the road. 11:04
Shortening the anterior column offers advantages in surgical curve correction. 11:19
Is there a difference between thoracic and lumbar discs? 12:44
What were the initial factors leading to tether breakage? 14:34
Incidence of tether breakage is high after 3-4 years. 16:18
Best patients for VBT are those that have 2-3 years of remaining growth to optimize bone growth modulation. Once vertebrae have changed shape, dependence on the tether is no longer necessary. 16:45
What parameters discussed early in the evolution of VBT? 17:53
Substantial growth remaining parameter for VBT. Preferred 3 years of growth to take full advantage of maximum bone growth modulation. 18:38
50 degree curve size parameter for VBT. 20:19
Prediction of VBT correction is currently an area of research. 21:29
Evidence of bone modulation of vertebrae in sagittal plane is mixed. 23:11
Anecdotally, more anterior screw placement may increase sagittal vertebrae bone modulation. 24:36
Evidence for coronal vertebral bone modulation is as anticipated. 26:15
importance of tether tension and disc compression in VBT. 27:10
VBT correction to 25-30 degrees standing seems to initiate bone growth modulation. 28:35
Greater the curve magnitude, the greater the time needed to maximize bone modulation. 29:52
Magnitude of curve, growth remaining, initial correction. Guiding Principles for VBT. 30:52
Post approval FDA study and Zimmer Biomet 31:34
Perfect VBT parameters? Thoracic , Lenke A/B modifier, Cobb 45-55 degrees, Sanders 2-3, Risser 0. 33:57
Hybrid - selective thoracic fusion with lumbar tether. 36:56
Use of single and double tethers. 38:12
Impact of thoracic hypokyphosis on neck/low back. 39:33
Thoughts on RASO, Relative Anterior Spine Overgrowth. 41:13
Why aren't mild/moderate curves braced into kyphosis to stimulate bone modulation? 44:57

drdereklee.com

08/09/2021

This interview is for educational purposes and covers information provided by Dr. Firoz Miyanji regarding his opinions on Vertebral Body Tethering (VBT) Non-Fusion Scoliosis Surgery. This video is not an endorsement. Viewers should consult their physicians and treating team accordingly. See highlights via time stamps below.

Career Path. 0:28
When did Dr. Miyanji's interest in VBT begin? 3:02
Relative Anterior Spinal Overgrowth (RASO). Biomechanical driver of scoliosis. 4:28
Bone modulation of vertebrae in the sagittal plane. 7:34
Dr. Miyanji's first VBT surgery. 8:51
Dr. Miyanji's is the 1st VBT surgeon in Canada. 10:03
VBT surgeons are a small collegial community. 10:43
Tether breakage and revision rates. 12:07
Multiple tether breaks at maturity preferred. 13:26
Revisions are more common for over correction than tether failure. 14:55
How do surgeons decide how many levels to tether? 15:31
Double tethers. 17:20
Dr. Miyanji's VBT parameters. 19:45
Sanders Score for best VBT outcome. 20:50
Disc Release. 21:38
Type of VBT instrumentation used. 23:57
Future tether availability. 25:09
Reduction in hypokyphosis with VBT? 26:07
State of VBT in 5-10 years. 27:23
Dr. Miyanji's evolution with VBT. 31:42
Training VBT surgeons in Vancouver. 36:59
Where was Dr. Miyanji's VBT training? 39:04

drdereklee.com

05/27/2021

This interview is for educational purposes and covers information provided by orthotist Luke Stikeleather regarding his opinions on bracing for scoliosis. This video is not an endorsement. Viewers should consult their physicians and treating team accordingly. See highlights via time stamps below.

What's your new scoliosis patient procedure? 1:18
We're not treating an x-ray, we're treating a whole person. Critical to build a report with the child to put them at ease with the process. 2:57
Building a relationship helps with bracing compliance. 4:52
Bracing assessment. 5:34
EOS X-Ray System 6:20
24 hour brace manufacture & fitting turnaround. 7:42
Child assists Luke in making their own brace. 8:38
Important to have a brace look good, feel comfortable and function properly. 9:22
What are the goals of bracing? 10:04
When is bracing not the best option? 10:36
What is the age range for bracing? 11:33
What type of curve responds best to bracing? 12:16
Why is it important to brace when a child is growing? 14:23
Growth modulation in bracing. 15:38
In brace x-rays confirm that the brace is working. 16:59
In brace x-rays should be taken 2-4 weeks after fitting. 17:09
In brace x-rays offers predictive value for long term outcome of bracing. 17:39
Why is there so much variation in timing of in brace x-rays? 18:07
Minimum 50% in brace correction to determine bracing effectiveness is a MYTH! 20:21
How do you improve bracing compliance? 23:21
What is the optimal amount of time for being in brace? 25:19
Importance of Schroth therapy while bracing. 26:46
Is curve progression after bracing due to muscle atrophy if exercises were not part of the bracing program? 29:59
When is it time to stop bracing? 7-8 Sanders, 4-5 Risser. 32:56
If a curve continues to progress while bracing, what are the next steps? 34:29
There is a large disparity in quality of braces. 35:26
Luke's experience with 3D brace design. 36:09
The difference between asymmetric and symmetric brace design. 38:22
Rigo Cheneau 3D braces are becoming more popular. 43:22
Level of expertise of orthotist is critical to the effectiveness of bracing. 44:35
Providence night time bracing effectiveness. 45:19
Future of bracing technology. 49:10

05/21/2021

Dr. Bob Cho, Vertebral Body Tethering (VBT) Non-Fusion Surgery interviewed by Dr. Derek Lee

This interview is for educational purposes and covers information provided by Dr. Bob Cho regarding his opinions on Vertebral Body Tethering (VBT) Non-Fusion Scoliosis Surgery. This video is not an endorsement. Viewers should consult their physicians and treating team accordingly. See highlights via time stamps below.

Career path to paediatric orthopaedic surgeon. 0:51
Shriners Hospital Philadelphia residency. 3:46
Vertebral Body Stapling - VBS 5:20
Path to San Diego 6:29
Is the close knit relationship among Shriners surgeons typical? 10:31
What was Dr. Cho's motivation to adopt VBT surgery? 14:41
What's involved in learning a new surgical technique - VBT? 17:14
Zimmer Biomet VBT training. 18:01
Observing surgeries is a critical part of training. 19:21
Zimmer Biomet surgical support. 21:33
New Zimmer Biomet instrumentation. Modified tether, different size tethers, low profile screws. 23:33
Do VBT parameters vary by surgeon, hospital, and experience level? 29:02
VBT surgical indication as defined by FDA. Skeletally immature children, progressive scoliosis, Cobb 40-70 degrees. 29:57
Surgical decision making may impact VBT parameters. 30:19
Ideal Sanders staging is 3-5. 30:34
Aiming for initial 50% VBT correction with additional 25% with growth. 31:33
Will VBT parameters expand over time? 32:49
What is the risk of over-correction? 34:14
Anterior vertebral overgrowth leads to scoliosis. Front of the spine grows faster than the back of the spine driving hypokyphosis, rotation and scoliosis. 36:47
Is there research indicating anterior and posterior vertebrae bone modulation with VBT? 40:23
Disc release with VBT. 42:18
History of fusion surgery development. What is the difference between older fusion techniques today's modern techniques? 44:34
Beginning of VBS which evolved to VBT. 48:06
Chief of Staff - Shriners Ambulatory Clinic Tijuana. 49:01
VBT surgeons are a small tight knit community. 52:03

Robert H. Cho, MD, FAAOS, FAOA
UCLA Clinical Assistant Professor
Pediatric Orthopedic Surgeon

Chief of Staff
Shriners For Children Medical Center
909 S. Fair Oaks Ave.
Pasadena, CA 91105
Main: (626) 389-9300 ext. 9569

www.shrinershospitalsforchildren.org/pasadena

Chief of Staff
Shriners Ambulatory Clinic Tijuana
Paseo de los Heroes 10999 5to piso
Zona Rio , Tijuana B.C. 22010
Main: +52 664 972 9000

POSNA Board of Directors, Ex-Officio
POSNA Communications Council Chair

drdereklee.com

05/09/2021

Dr. Juan C Rodriguez-Olaverri, Anterior Scoliosis Correction (ASC), interviewed by Dr. Derek Lee

This interview is for educational purposes and covers information provided by Dr. Rodriguez-Olaverri regarding his opinions on Anterior Scoliosis Correction (ASC) Non-Fusion Scoliosis Surgery. This video is not an endorsement.

05/09/2021

Dr. Amer Samdani, Vertebral Body Tethering (VBT) Non-Fusion Surgery interviewed by Dr. Derek Lee

This interview is for educational purposes and covers information provided by Dr. Amer Samdani regarding his opinions on Vertebral Body Tethering (VBT) Non-Fusion Scoliosis Surgery. This video is not an endorsement. Viewers should consult their physicians and treating team accordingly.

04/20/2021

Dr. Ahmet Alanay, Vertebral Body Tethering (VBT/ASC) Non-Fusion Scoliosis Surgery

This interview is for educational purposes and covers information provided by Dr. Ahmet Alanay regarding his opinions on Vertebral Body Tethering (VBT) Non-Fusion Scoliosis Surgery. This video is not an endorsement. Viewers should consult their physicians and treating team accordingly. See highlights via timestamps below.

Chapters:
0:00 Introduction
1:56 What causes scoliosis? 1:56
4:39 Mechanical theory to manage scoliosis. 4:39
5:56 Role of Schroth physiotherapy and brace treatment. 5:56
7:18 What drives scoliosis curve progression? 7:18
9:55 Role of Anterior Vertebral Overgrowth in causing scoliosis. 9:55
11:58 If hypokyphosis (flat-back) drives scoliosis, will VBT correction conflict. 11:58
14:28 VBT influences mostly the coronal plane, followed by sagittal and rotation. 14:28
16:19 Patient Parameters for best VBT correction. 16:19
19:39 Anticipated correction relies on remaining growth potential. 19:39
20:16 Sanders 3a/3b had the best corrections with less complications. 20:16
22:22 For Sanders 3a/3b he corrects up to 1-20 degrees. 22:22
22:40 Sanders 4 and 5 aims for 50-60% correction. 22:40
23:09 Use of bracing and Schroth physiotherapy at Sanders 2 to delay until Sanders 3a/3s. 23:09
23:55 Collaborates with in house orthotist & PT's to monitor/treat low Sanders curves. 23:55
25:14 For non-compliant brace patients, he can operate at lower Sanders score with loose tether.
2:46 High 40's curves dropped to high 30's with intensive Schroth and bracing. 26:46
28:32 Exercise while bracing is critical. 28:32
29:29 Bracing compliance is the #1 issue with bracing effectiveness. 29:29
31:34 Collaboration between surgeon, orthotist and PT is important for best outcomes. 31:34
34:38 More exercise leads to better spine flexibility and preserves motion segments. 34:38
37:32 VBT can reduce hypokyphosis with a tighter tether but risks over correction. 37:32
39:11 Obsessed about sagittal plane based on experience with adult spinal deformity. 39:11
43:53 4 factors for successful bracing outcome. 43:53
45:36 Treats adults with sagittal/coronal problems, spinal stenosis, nerve root entrapment. 45:36
48:07 Global Alignment & Alignment (GAP) approach to predict successful adult fusion. 48:07
49:54 Working on predicting ideal kyphosis angle for each patient. 49:54
50:57 Use of GAP for AIS in upcoming seminar. 50:57
51:11 Dr. Alanay's opinion on Disc Release with VBT 51:11
56:52 Quality of life of a patient with a 0-20 degree curve is the same and a reason he doesn't touch the discs. 56:52
57:16 Prefers not to cut ribs since it may compromise rib function but will do so if requested. 57:16
58:39 Surgical decisions are based on experience, research, and patient needs. 58:39
59:13 His 2 year post VBT study indicates discs remain healthy with no auto-fusion. 59:13
1:00:36 Dr. Alany's Fees. 1:00:36

04/19/2021

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