Dr. Derek Lee

06/18/2023

Ask the Scoliosis Experts

I started my private Facebook group 12 months ago and it's evolving quickly and on the verge of 2K members.

Part of the plan was to create a safe space where parents, patients and anyone affected by scoliosis can mingle with health care practitioners who specialize in scoliosis. By mingle, I mean learn from the experience and expertise of professionals and learn from the experience and journeys of those trying to get a handle on their own personal struggles with scoliosis. It's a two way street.

We created a VERY unique scoliosis community where those affected by scoliosis can interact with top scoliosis healthcare practitioners from around the world.

Check out our scoliosis expert list below and join my private Facebook group here: https://www.facebook.com/groups/1198200727630801/

Introducing Experts!!
😳 UPDATE! Experts List Below (and counting). 😃

HEALTH CARE PRACTITIONER EXPERTS:

SPINE SURGEON:
Dr. Bob Cho , MD, Pediatric Spine Surgeon, Chief of Surgery Shriners Hospital for Children, Pasadena
Dr. Michelle Cameron Welborn , MD, Pediatric Spine Surgeon, Chief of Surgery Shriners Hospital for Children, Portland
DrNoelle Larson , Pediatric spine surgeon, Mayo Clinic, Rochester, Minnesota.
Dr. Stephanie Da Paz , MD, Spine Surgeon, Eifelklinik St. Brigida, Germany
Dr Mike Selby , MD, Pediatric/Adult complex spine surgeon, South Australia
Dr. Baron Lonner , Pediatric/Adult surgeon, Professor of surgery, Mount Sinai Hospital, NYC
Dr. Ron El-Hawary , Pediatric surgeon, Chief of Orthopedics, IWK Health Centre, Professor of Surgery Dalhousie University, Nova Scotia, Canada
Dr. Jean Claude de Mauroy , MD, Lyon, France
Dr. Ryan Goodwin , MD, MBA, Pediatric spine surgeon, Assoicate Professor of surgery, Cleveland Clinic
Prof. Dr. Ahmet Alanay, MD, Pediatric and Adult spine surgeon, Director Comprehensive Spine Center at Acibadem Maslak Hospital
Dr. Darryl Antonacci MD Facs, Institute for Spine and Scoliosis, New Jersey
Dr. John Braun, MD, Massachusetts General Hospital, Boston
Dr. Sajan Hegde, MD, Apollo Hospitals, Chenai, India

More experts incoming!

02/26/2023

Navigating Scoliosis: Bridging the Information Gap Between Families & Health Care Practitioners

Happy to be participating in a free webinar on my attempt at navigating scoliosis for my son. I'll talk about our experience trying to avoid surgery at all costs with bracing, Schroth, chiropractic, etc which led to a 20% reduction of a 53 degree curve in 3 months. How I knew it wouldn't hold, would progress and searched for surgical options. I'll review how I did my research homework, how I reached out to expert scoliosis surgeons, PTs and orthotists trying to find treatment consensus and avoid internet misinformation. I'll talk about why and how I created a scoliosis YouTube channel and this Facebook group to try and share current/peer reviewed scoliosis info and to connect scoliosis health care practitioners with patients and families affected by scoliosis.

Thanks to Andrea Lebel for inviting me to present. Check out the registration link to the free webniar below. 🙂

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04/18/2022

In spine surgery, shared decision making is an important component of ensuring patient safety. Dr. Derek Lee shares his thoughts in our video. "As a parent…the best way to ensure safety is to be informed, is to be educated. Know as much about the whole process of surgery as you can, the pros and the cons."

04/20/2021

07/07/2020

How Ongoing Stress Drives Obesity and Other Chronic Diseases, Dr. Derek Lee's Obesity Canada Interview.

https://youtu.be/feqZ9F7RM9Q

Dr. Derek Lee discusses the science of stress and how ongoing stress produces inflammation leading to chronic diseases.

06/02/2020

Dr. Derek Lee - Scoliosis Awareness Month -

Since June is Scoliosis Awareness Month, I wanted to share my son's scoliosis experience. The whole point of this email is to detail my family's experience so that others can learn from our mistakes and successes to hopefully navigate the medical maze of scoliosis treatment. Please forward this to any friends or family members who you think my benefit from this information.

Later this month, I will be sharing my video interviews with one of the top scoliosis surgeons in Europe, the top scoliosis bracing expert in North America, and the most experienced scoliosis physiotherapist in Canada. I'll also write about the mechanics of how scoliosis progresses.

Let's start at the beginning. Twenty two months ago my son at 14 years of age, was diagnosed with a 27 degree right thoracic curve which basically looks like a 'C' shaped curved in his upper back. This was picked up with a chest x-ray. The x-ray was initially prescribed to confirm a case of pneumonia which was the case. Scoliosis often comes with reduction in lung capacity which makes the upper respiratory system vulnerable to pathogens.

It took 3 months to get referred to a paediatric orthopaedic surgeon who specialized in scoliosis and she recommended bracing to try and stop curve progression and monitoring to keep track of changes. It took another month to get measured and fitted for a brace.

This is when I went from trusting the medical process to going absolutely ballistic. I had no choice and started advocating for my son outside the Ontario medical system. Unfortunately, the surgeon had recommended a brace that was at least 10 years out of date and that her process for monitoring scoliosis progression was borderline incompetent. She also wasted 4 months over which time his curve had increased to 53 from 27 degrees.

When a curve passes 40 degrees and especially crosses the 50 degree threshold, it moves into surgical range which means fusion of the spine. In my son's case, fusion would involve placing screws into the vertebrae from just below his neck all the way to his low back (T1-L3) which is basically his full spine. Two metal rods would be attached to those screws on either side of the spine to straighten the scoliosis. He wouldn't be able to move or bend along the fused regions which means the areas above and below would take on much more stress leading to degenerative disc and joint disease and eventual chronic pain. Of course, this was an option we wanted to avoid but might have to accept if his curve continued to worsen.

We asked for a referral to Toronto Sick Kids. More on that later.

Over the next 2 months, we travelled to Virginia, USA for a modern asymmetric brace, and commuted to Ottawa to see the most experienced Schroth physiotherapist in Canada. I knew a combination of the right brace and the right type of scoliosis exercises was the only way to help slow the curve and maybe reduce the curve a little. Of course, I spoke to many colleagues throughout North America about additional conservative treatments for scoliosis which I added to his daily treatment regimen.

He wore his brace 21 hours a day and worked out 45 minutes a day every day for 9 months. He never complained.

With all that work, his curve reduced by 20% from 53 to 42 degrees which is unheard of. The vast majority of curves in the 50+ range either stay the say or most likely get worse, especially during adolescent growth spurts. Although we were happy with the result, I knew it wouldn't improve beyond 42 degrees and with his growth spurt approaching, I started researching surgical options.

I spoke to a total of 7 surgeons around the world including Canada, the United States, Spain and Turkey in addition to other experts about non-fusion surgical options. The surgical procedure that we pursed is called vertebral body tethering (VBT). Unlike fusion, VBT maintains spine flexibility and by a process known as bone growth modulation, it corrects the curve as the child grows. At each vertebrae, screws are inserted on the convex side of the curve and a tether or cord is attached to each screw and tightened. This theoretically stops bone growth on the convex side of the curve and stimulates growth on the concave side of the curve. According to the Hueter-Volkmann Law, this will straighten the spine as the child passes through their growth spurt.

At that time, there were only 6 surgeons in Canada (I spoke to 3 of them) who performed VBT. One in Nova Scotia, 3 in Montreal, 1 in Alberta and 1 in British Columbia. There were no VBT surgeons in Ontario which means only fusion was offered in Ontario.

Remember my referral to Toronto Sick Kids? They gave my son an appointment with a physiotherapist, not even a surgeon, to assess him 11 months later. It didn't matter because we didn't want fusion anyway. But still, that was ridiculous.

Five months later we travelled to Shriner's Hospital in Montreal to consult with a VBT surgeon where he was declined VBT and offered fusion. Unfortunately, many Canadian surgeon's have narrow parameters for accepting patients as VBT candidates. From my research I knew Montreal would likely decline him VBT surgery but my back up plan was to travel to the USA which is what we did 2 months later.

My son had VBT surgery 6 months ago in Philadelphia with Dr. Amer Samdani, one of the top VBT surgeons on the planet. His curve has reduce by 50% to 25 degrees with no loss of flexibility and a 90% chance that he will NOT require fusion in the future. His curve will hopefully drop to around 15 degrees for a total of 75% reduction as he continues through his growth spurt but even a correction to 25 degrees is an excellent non-fusion result.

- I would like to make several points that are very important.
VBT is the most effective for kids that have growth remaining. So girls might be out of VBT range at 12 or 13 and a year post-menarche. Boys might be out of range by 16. For this technique, timing is critical.

- If your child is at the end of their growth spurt, there is another option called ASC which is only offered outside of Canada. For a list of surgeons and their contact information, just contact me.

- The vast majority of scoliosis surgeons are fusion surgeons. They will not even mention VBT as an option. For example Toronto Sick Kids surgeons will do only fusion surgery. To be considered for VBT in Canada, don't hesitate to reach out to me for a list of surgeons and their contact information. Thankfully we now have 1 surgeon in Ontario (Ottawa) who now does VBT.

- Bracing can be effective for mild and moderate curves. It can slow down severe curves. If you would like trusted bracing experts, contact me for a list.

- Specific asymmetric exercises for scoliosis of all severities in children and adults can reduce pain and asymmetry. Try and see a physiotherapist that works with lots of scoliosis patients every day. An inexperienced therapist can make things worse. For physiotherapists that have scoliosis experience, contact me.

Scoliosis is personal to me. If you or anyone has any questions or concerns regarding scoliosis bracing, exercises, surgical options, which surgeons to contact or how to navigate the health care system, just contact me and I'll be happy to schedule a phone call or trade emails at no charge. If I can save parents, their children or adults time, frustration and dead ends and direct them to the right practitioners, that's all that matters.

A final reminder, this is Scoliosis Awareness Month and I'll be posting my video interviews with a VBT surgeon, a Schroth scoliosis physiotherapist and a scoliosis brace expert in the coming weeks.

Sincerely,

Dr. Derek Lee

05/03/2019

Don Mills Clinic. Here's a short tour of the clinic within the Rogers Communications Don Mills campus located at Don Mills and York Mills. I've been at this particular location for over 18+ years and it is most definitely a thriving community. That's one thing I like about different locations... the diversity of people keeps me curious and energized.

04/26/2019

Swedish ladders (stall bars) are used as a basic piece of equipment for rehabilitation but are rare these days. The Schroth method of physical therapy uses it to target scoliosis and posture conditions. I thought it would be both a worthy weekend DIY project and a great addition to my home gym! 🧘‍♂️🏋️‍♀️ It was a bit more difficult than I thought but turned out OK. 😉

04/23/2019

👀 Just a quick look inside our Markham Boutique Clinic off Woodbine north of Major Mackenzie Drive. This is 1 of 3 locations including Don Mills and Brampton.

04/18/2019

04/18/2019

03/01/2019

Dr. Lee - Our Markham Office has Moved! 🚚 - https://mailchi.mp/betterhealthproviders/dr-lee-our-markham-office-is-moving-765825

01/29/2019

Dr. Lee - Our Markham Office is Moving 🚚 to -Cathedraltown Health Clinic , 5 Cathedral High St, Markham, ON L6C 0N9 https://mailchi.mp/betterhealthproviders/dr-lee-our-markham-office-is-moving