SCOLIOISIS SURGEON BANGALORE SCOLIOSIS SURGEON INDIA Website: http://spinesurgeonbangalore.com/ My goal is to provide spine care with a patient centeric-holistic approach in Bangalore, encompassing all aspects of non-operative and operative management of spinal disorders with special interest in the management of spinal deformities (scoliosis and kyphosis). Bangalore Spine Specilaist Clinic. For Appointment contact : Call: 08025442552( 9 am to 9 pm). Whatsapp: +919448311068. Email: drshashidharbk@gmail.com.

1. DR. SHASHIDHAR B K
Consultant Spine Surgeon
Bangalore Spine Specialist Clinic
Website: http://spinesurgeonbangalore.com/
For Appointment contact : Call: 08025442552( 9 am to 9 pm). Whatsapp: +919448311068.
Email: drshashidharbk@gmail.com.
Evolution of Surgical Strategies/ Instrumentation In Scoliosis

4. The Hierarchy of Evolution
Halting of curve progression
Solid bony fusion
Safe and solid instrumentation
Coronal plane correction and balance
Sagittal plane correction and balance
Surveillance and preservation of spinal cord and nerve root function
Better understanding the 3D biomechanics of the normal and scoliotic spine
3D spine and trunk correction
Preservation of function
Non-fusion techniques
Less is more None is Perfect

5. Hippocrates (400BC)
Axial traction , External distraction and gravity assisted
correction

6. Galen
Coined terms 2nd century AD:S, K , L
Rigid jackets and chest binders

7. Ambroise Paré (1579)
New breast plates be made as the individual grew.
Bracing had little use once a patient reached skeletal maturity.

8. First spinal fusion for scoliosis.
Goal was to halt curve progression
Feathered fusion
The pseudarthrosis rate 60%.

9. Hibbs and Risser
Turnbuckle cast preoperatively, with hinges in the orthogonal planes to generate
traction and bending forces to maximize correction
Window in the cast’s dorsum – To operate.

10. Walter Blount (left) and Albert Schmidt (right)
Milwaukee Brace in the early 1950s
Removable distraction jacket for the treatment of progressive idiopathic
spinal deformity

11. He emphasized the importance of bone graft placement in the facetectomy defect and
hinged transverse process fragmentation and rotation.
Advocated for longer constructs
Fusion begin and end with neutral vertebrae at the proximal and distal ends of the curve.
Dramatic improvement in fusion success rates to nearly 85%

13. Pseudarthrosis
Implant corrosion and breakage
Hook dislodgements.
Long-lasting postoperative immobilisation
Flattening in both the coronal and sagittal plane
Non segmental fixation
Large rods
Limited correction

15. TRANSLATION

16. Titanium cables and polyester bands (universal clamps, Zimmer Spine,
Bordeaux/France)
Bands provide more contact area than wires or cables
Lower risk for cut out through the lamina

17. 1980s Cotrell-Dubousset instrumentation system (CD).
Multiple fixation points
Variety of hook and rod combinations.
Correction of the spine in the coronal, sagittal, and axial planes

19. Hybrid variants:
Hook anchors at the top and the bottom of the curve with Wisconsin wires in between
Hook anchors at the top and pedicle screw anchors at the bottom of the curve with
sublaminar wires in between;
Proximal hook anchors and distal pedicle screw anchors.

24. NEURO MONITORING

25. ALLOGRAFT

26. EOS X RAYS

27. NAVIGATION

28. 3 D PRINTING

29. “Evidence-Based Medicine: Corporate Medicine's Corrupted Instrument

30. POSTERIOR
SURGERY NOT
GOLD
STANDARD?

31. Evolution of Anterior surgery
for scoliosis

32. FUSION LESS ANTERIOR
SOLUTIONS : FUTURE?

33. THANK YOU