Dr. Alvin Crawford, MD, vividly remembers Gail Kimball.
Her tenacious attitude and commitment to her child are hard to forget. In some ways, it was Gail’s tireless efforts on behalf of her daughter, Erin, that helped transform the Crawford Spine Center into the worldwide leader it is today.
They met in 2003. Gail had sought out Crawford, founder of the Spine Center, in hopes he would be able to treat Erin, who was born with congenital scoliosis.
At the time, the spine center was not capable of handling complex cases such as Erin’s. Born not only with scoliosis, she also suffered from VATER syndrome, Klippel-Feil syndrome and torticollis. Scoliosis also caused her to develop thoracic insufficiency syndrome (TIS).
From online research, Gail knew about Crawford’s reputation and his expertise in treating scoliosis. But she also had an idea of what surgery her daughter needed, and she was persistent in her efforts to convince Crawford. It was a surgery never done at Cincinnati Children’s − VEPTR surgery, otherwise known as vertical expandable prosthetic titanium rib procedure.
"She was fully engaged and tenacious,” recalls Crawford, from their first meeting onward. “If the technology was not here, she was the one pushing, saying, ‘Let’s get it.’ She was a big advocate for her daughter.
"The surgical expertise was on me. But she pushed me. She stimulated me, to reach out and to do whatever we could do. Mom wanted more than just a cast and a brace. And at that time we had not expanded our [surgical] situation for VEPTR.”
As a leading innovator in scoliosis surgery, Crawford often traveled the country, speaking at scoliosis symposiums and conferences. Along the way he had met Dr. Robert Campbell, MD, of Philadelphia, who co-created VEPTR and later perfected the prosthetic device. The two became friends, and before long they were discussing Erin’s case and agreed that she would be an ideal candidate.
"I think I just found the right people at the right time. It felt like everything was falling into place,” said Gail.
The VEPTR device had been designed specifically to treat patients with TIS, whose chests are unable to support normal breathing and lung growth. In a VEPTR surgery, a curved metal rod is attached to the ribs to straighten the spine and separate the ribs. By creating more space in the chest, the lungs are able to expand and grow as the child grows.
In 2005, Campbell traveled to Cincinnati Children’s to assist Crawford as he performed the VEPTR surgery. How long does it take to perform a surgery for the first time? Long enough to do a good job, said Crawford.
“When you are doing something unique, speed is not the issue. It’s getting the job done with hopefully no complications and something that will achieve a lasting result,” said Crawford, who now serves as professor emeritus of orthopaedic surgery at UC Health.
The results were beyond Gail and her husband, John’s, expectations. As Erin grew, 10 more surgeries would follow with the last taking place when she was 12 years old. But she never required spinal fusion surgery, and throughout the journey the family felt surrounded by support.
"The nurses at the spine center are top notch. I don’t think anything would get done without them. They are just phenomenal,” said Gail. “Our main goal was to get her as straight as possible and to prevent damage to her lungs. We have been lucky that she has not needed spinal fusion so far. For what has been accomplished for her, I am thrilled. She is able to do most things her friends can, and she is going after her dreams.”
The 5-foot-3 Erin said she was never going to allow her scoliosis to hold her back in life.
“I’ve always kind of seen it as a thing that I have and I’m going to keep on going with it,” she said.
As a member of the Fairfield Senior High School theater program, she found her creative calling – working behind the scenes on set design and other aspects of production.
Erin, 18, will attend Northern Kentucky University’s School of the Arts with the goal of a degree in stage management. Nothing is holding her back.
“I don’t think having the surgery has inhibited me in any way. I guess you can say I didn’t get to play any contact sports. But I’m not a sports-oriented person,” she said. “I guess I could’ve run track and field, but it just never really appealed to me. I was always more into the creative arts.”
For his part, Crawford won’t hide his pride and happiness in Erin’s continued success. Her recent graduation and plans for the future brought back many happy memories of both her and her mother, Gail.
"She helped me as much as I helped her child. She prompted me into a new space,” he said, adding how important it is for doctors to know when to talk and when to listen.
"It's what I teach my resident students: It’s amazing what you can hear if you are listening, but it’s hard to listen when your lips are moving.”
(Published June 2020)
Erin and her mother, Gail.
Erin, 3, approximately one month after her first surgery.
There are two types of spinal curvature that require surgical correction. The first, sometimes called idiopathic scoliosis, occurs when the spine curves abnormally for unknown reasons.
The second type of curvature, congenital scoliosis, is usually associated with other diseases that affect a child's muscles, nerves and bones.
In Erin’s case, her spine curves side-to-side in the thoracic region, but in the cervical region, where she has kyphosis, it curves front-to-back.
In addition to scoliosis and the TIS diagnosis that followed, Erin was born with an abnormal fusion of two vertebrae in her neck (Klippel-Feil syndrome) and wore a brace between the ages of 2 and 3 in order to minimize the early signs of facial dysplasia.