Endoscopic Spinal Surgery
Since 1993, the Division of Orthopaedics at Cincinnati Children's Hospital Medical Center has become one of the leaders in endoscopic spinal surgery in children. With the support of Ethicon Endo-Surgery, Inc., and a 1995 Trustee Grant from Cincinnati Children's Research Foundation, we completed mechanical testing to compare open versus endoscopic release of the porcine spine. This basic science results showed thoracoscopy to be as effective as thoracotomy. The results were published in the premier refereed journal, Spine, in January 1998. The benefits of thoracoscopy, or video assisted thoracoscopy (VATS), over thoracotomy to patients with severe deformity, including decreased pain, shoulder disability, hospital stay, and cost containment, are significant. We have performed over 160 cases in children and adolescents as of January, 2004.
In cooperation with Ethicon Endo-Surgery and the Cincinnati Children's teleconferencing center, we have performed live interactive surgical procedures which were viewed by more than 100 national and international spine surgeons. We conducted the first international training course in VATS to correct spinal deformities for the University of Tokyo. We are currently performing VATS spinal instrumentation and fusion for correction of scoliosis in very select cases. The patient response has been encouraging.
We have a patent on a novel spine implant system, which has been shown capable of altering spine growth. The implants are being developed to correct adolescent idiopathic scoliosis using an entirely endoscopic technique. The work was presented to the 2003 Scoliosis Research Society where it won the prestigious Hibbs Award for clinical research and the 2004 Orthopaedic Research Society, and has been accepted for publication in Spine in 2005.
Studies on the histological structure of vertebral growth plates were presented at both the 2004 and 2005 meetings of the Orthopaedic Research Society. This was a collaborative effort with Cincinnati Children's Pathology. Techniques in molecular biology have begun to be defined by collaborating with Cincinnati Children's divisions of Pediatric Surgery and Pathology.
To determine the mechanical state of stress that alters growth, we are preparing to directly measure pressures in the spine in an in vivo model. The data acquisition system for the miniature pressure transducers that will be implanted has been acquired, calibration and testing procedures continue. Subminiature pressure transducers are being fabricated in collaboration with UC Electrical Engineering. The work was presented at the 2004 IEEE Engineering in Medicine and Biology conference; extensions of the work have been submitted to the 2005 International Society of Biomechanics.
