CENTER FOR EXCELLENCE IN SPINE

Known for our world-renowned patient care, Scottish Rite Hospital has been specializing in the treatment of spinal conditions since the 1970s. The Sarah M. and Charles E. Seay/Martha and Pat Beard Center for Excellence in Spine Research provides a forum for experts from many disciplines to collaborate on specific challenges in the treatment of spinal deformities.

Directed by Chief of Staff Daniel J. Sucato, M.D., M.S., the center focuses on developing innovative techniques for treating the most common and straightforward to the most complex spinal conditions. Spine research at Scottish Rite Hospital guides our doctors and researchers to determine the cause of scoliosis, identify scoliosis earlier and better understand the factors that lead to curve progression. This research then helps to prevent these factors from occurring and, finally, enhances surgical treatments while avoiding complications. The research allows our integrated team to develop new and innovative procedures and implant systems for treating scoliosis and other spinal conditions. Ultimately, the goal is to answer the seemingly unanswerable questions we have regarding spinal deformity. 

Current Studies

Early onset scoliosis (EOS) can be defined as patients with scoliosis who are under 10 years of age. Since these patients are very young, it is an extremely challenging clinical problem as scoliosis progression is highly dependent on the growth of the spine. The goal of this study is to determine clinical and radiographic outcomes in a series of patients with early onset scoliosis treated by multiple methods – operative and nonoperative. 

In addition to the typical treatments of bracing and fusion surgeries performed in other types of scoliosis, these young patients have other options that are necessary to try to maintain continued growth of the spine using traditional growing rod techniques, the MAGEC™ (MAGnetic Expansion Control) system and casting for a cure. We have several hundred patients enrolled in this study. 

Our early onset scoliosis patients are also enrolled in collaborative research efforts with other leading institutions through the Growing Spine Study Group. Although this is a rare condition, Scottish Rite Hospital has a high volume of patients who are diagnosed with EOS. Collaboration with multiple centers is critical and allows our team to study this complex and challenging disease much more thoroughly. 

Inclusion criteria

  • Spinal deformity with any diagnoses
  • Onset of scoliosis under the age of 10
Adolescent idiopathic scoliosis (AIS) is the most common type of scoliosis and is treated with observation, bracing or surgery. The surgical treatment of scoliosis has dramatically changed over the last 15 years with improvements in implant design, surgical technique and preoperative and postoperative protocols to maximize patient outcomes while limiting hospital stay. The Prospective Pediatric Scoliosis Study (PPSS) is actively recruiting patients between the ages of 10 and 21 who are having their AIS surgically treated. The goal of this study is to utilize information gathered from the surgical procedure, clinic visits, X-rays and patient questionnaires to determine the best forms of treatment for AIS and to observe the outcomes of those patients at two, five and ten years after their surgery.

Inclusion criteria

  • Includes all idiopathic spine deformities
  • Ages 10 and up
  • Operative patients only
The sagittal plane (the front-to-back shape) of one’s spine is the best predictor of long-term health of the spine. Kyphosis is defined as the curvature one sees on the lateral X-ray in the thoracic (chest area) of the spine and is normal up to 45 degrees. Beyond that degree, the kyphosis is considered abnormally high, can progress with time, can be painful and is often a cosmetically concerning condition. The indications for treatment have not been well agreed upon as the natural history (course without treatment) is not well known, and the surgery to achieve correction is significant. The Prospective Pediatric Kyphosis Study (PPKS) involves patients diagnosed with pediatric or adolescent kyphosis who are 10 years of age or older and who are treated either operatively or nonoperatively. The long-term goal is to determine the best method of treatment to provide the best outcome for the long-term health of the spine.

Inclusion criteria

  • Diagnosis of Scheurmann’s kyphosis
  • Ages 10 and up
  • Operative and nonoperative
Children who have scoliosis associated with other muscle or nervous system diseases or syndromes have been shown to be at the highest risk for infection following surgery for their scoliosis. Our hospital is employing a multimodal modern approach to prevent infections in these patients. The purpose of the study is to decrease the infection rate in scoliosis spinal deformity surgery in patients with a spinal deformity due to an underlying syndrome and neuromuscular (functioning of the muscles) scoliosis. Scottish Rite Hospital’s goals are to make our patients as healthy as possible, both before and after surgery, to protect them from the risks associated with infections.

Inclusion criteria

  • Noncongenital and nonidiopathic scoliosis diagnosis
  • Ages 8-20
  • Operative cases only

The Division of Clinical Scoliosis Research, directed by Brandon A. Ramo, M.D., oversees all retrospective and prospective clinical studies and promotes continued collaboration between Scottish Rite Hospital’s orthopedic staff, genetics department, fellows, residents, nurses and research coordinators to address important issues for the hospital’s spine patients.

Through clinical research using the hospital’s spine research database, along with participation in multicenter study groups, we strive to improve the evaluation and management of our patients. A consecutive enrollment of all of our early onset scoliosis, adolescent idiopathic scoliosis and complex severe spinal deformity patients will enable us to better evaluate our patient outcomes in an effective manner. Since the inception of this collaborative group of hospital staff, we have witnessed improved communication between our physician and nursing teams as well as significant strides in improved outcomes for our patients, such as shorter hospital stays, improved pain and nausea control after surgery, and reduced infection rates. We also constantly strive to improve our nonoperative care, such as improved standardized bracing protocols and expanded usage of our low-radiation-dose EOS imaging studies.

The Scottish Rite Hospital Spinal System, originally developed by Chief of Staff Emeritus J. Tony Herring, M.D., Assistant Chief of Staff Emeritus Charles E. Johnston, M.D., and Rich Ashman, M.D., in collaboration with Medtronic Sofamor Danek, has been widely used for the treatment of spinal deformity for nearly two decades. Scottish Rite Hospital has improved on this foundation with the TSRH® SILO™ 5.5 Spinal System. 

Through the Division of Spinal Implant Development, directed by researcher Hong Zhang, M.D.*, a multidisciplinary team of surgeons and researchers concentrates on understanding spinal deformity and develops methods to improve on the surgical treatment of this condition using various new surgical technologies. This has recently led to the development of the Rod-Link-Reducer in partnership with Globus Medical, Inc. This design was developed at Scottish Rite Hospital by Zhang, Daniel J. Sucato, M.D., M.S., and former Director of Biomedical Engineering David Ross, now retired. This is a supplemental technology that can be used with any implant system in the deformity correction of the spine.  

*Medical degree from Tianjin Medical University, China.

The Division of Creative Innovations and Novel Strategies for Treatment, directed by Daniel J. Sucato, M.D., M.S., concentrates on developing a better understanding of spinal deformity to promote the investigation of innovative treatment methods.

This division promotes the investigation of minimally invasive techniques, nonfusion technology, advanced imaging, spinal cord monitoring techniques and other innovative strategies to better treat patients with spinal deformities. Through the development of basic science that mimics the clinical challenges of spine deformity, this division focuses on developing a better understanding of the growth and biology of the spine and developing more effective methods of treatment.

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