it's come a long way...

Hippocrates Ladder
To encourage myself through this long recovery, I thought I'd do a little research on the history of scoliosis treatment. After sifting through many articles and startling images on the web, I am very thankful that I was born in America in 1982, and had surgery in 2010. Here is a brief synopsis of what my treatment may have looked like if I wasn't blessed to be born when I was:
  • As early as 3500-1800 BC: Ancient Hindu religious literature shows scoliosis "treatment" accomplished by the pressing down on the feet and pulling up on the chin.
  • Around 400 BC Hippocrates describes two different methods of "treating" scoliosis. One is spinal manipulation and traction. The other is a method called succusion. This is done by strapping a patient to a ladder, pulling them into the air, and then dropping them! He thought that scoliosis resulted from a dislocation of the spine,much like a dislocated shoulder, and all that needed to be done was put the dislocated spine back in the correct place. He describes further treatment as "It is also safe for a person to sit upon the hump while extension is being made, and raising himself to let himself fall down again upon the patient." He also goes on to suggest "putting one foot on the hump or using a long wooden lever" but he has no method for keeping the spine in place. So basically the options were being strung up on a ladder upside-down, being stepped on, or being squashed by someone falling on you. None of these sound appealing to me!
  •  Hippocrates Scoliosis Traction Machine  
  • 33 (?) BC, Jesus is described healing a woman who has been "bent over and could not straighten up at all." Luke 13:10-17. Of all the 'treatments' I found, this would be the only one I'd like to try!
Pare's Brace
  • During the Renaissance Ambroise Pare is the first doctor to treat scoliosis with a brace. He was also the first person to realize that when a person has finished growing, bracing does nothing to treat scoliosis. His brace is actually a metal corset forged by an armorer, and looks pretty uncomfortable! 

  • By the 1800's  Lewis Sayre begins popularizing the use of the plaster jacket, another way of bracing scoliosis. This photo to the left shows how they would string the patient up and twist them and pull them into a "straight" spine, after which they would plaster the patient holding them in the corrected position. 
1910 Brace made to look like a corset
  • Also during the 1800's, surgeons began attempting correcting scoliosis through surgery. They would only cut muscles and tendons to shorten them and pull the crooked spine straight. (Yikes.) After the invention of radiology in 1895, the x-ray became an integral part of trying to treat scoliosis. 
  • 1911 Fred Albee performs the first fusion surgery. He is the first person to use bone grafting techniques.
  • 1920 Wreden presents the first surgical scoliosis treatment that uses metal implants to stabilize the spine.
  • 1951 Lange uses Gerhard Kuntscher nails to stabilize the corrected spine. Yes. I said NAILS. If I had had surgery back in the 50's here is what my experience would have entailed:
  1. Preoperative time spent in the hospital in traction
  2. Preoperative casting, a full body cast meant to train the muscles for how they would be post-op.
  3. Non-Instrumented fusion. I.E. no rods or screws to hold the spine straight through the healing post-op.
  4. 2 weeks of bedrest for wound healing.
  5. Full body plaster traction cast for 6-12 MONTHS, most often in the hospital.
Understandably, those months laying flat and immobile left the patient extremely weak. The patient would have to learn how to walk again and wear a 24 hour brace even after surgery. They were very concerned with keeping the spine immobile while healing, and post-op patients were not allowed to do any form of exercise. Sadly, many patients would go back to their pre-op curves because the early fusion technique was not strong enough to hold the spine straight.
  • 1962 Paul R. Harrington develops and introduces the Harrington rod system. This was a major advancement for scoliosis surgery. The rods enabled the spine to remain straight while the fusion between the vertebrae solidified. His rods used hooks to hold on to the spine, as screws were not developed and used until 1990.
It's amazing how far the technology has come even in the last 10 years. I'm grateful for a surgeon who is continually participating in studies focused on learning new techniques. We've had several conversations about how they are always trying to find ways to make this surgery and recovery better and shorter. I was only in the hospital for 4 days compared to the 6 months to a year that I would have faced back in the 50's. I also benefited from cutting edge technology, instrumentation, and techniques. 

While there is no perfect solution for treating scoliosis, I am glad we have come so far!


3 Response to "it's come a long way..."

  1. n Says:

    I am 67 years old. My scoliosis was secondary to polio. I was one of the first children in New Orleans, LA to have the Harrington procedure. When I was 13 years old I had the first surgery to take bone from hips, then the instrumentation was placed in a second surgery. The kids who had the same surgery at the same time were subjected to a variety of pre-surgical measures to see which had a better outcome. Among the pre-surgical measures? One boy had holes drilled into his skull so he could be stretched out on a stryker frame before surgery; I was hospitalized (as we all were) and made to lie on my side with head down on a bed that positioned my spine in a curve opposite to the scoliotic curve. (confusing? sorry.) Anyway our recovery time after instrumentation was about 8-9 months flat on our backs IN BED and in the hospital until the bone could knit. Whew. Eventually, over the years, the rods had to be removed, one at a time, as they failed. I could stand and walk normally for about 20 years. My body is now very bent over and I walk bent forward looking at the ground. Interesting to me that the fusion is still solid (T4-T11) but its like my muscles and un-fused bones have fallen down around the spinal fusion. Chronic pain. I am delighted that I could contribute to an improved technique for those people who came after me. Thanks for the photos, etc. This is the first "blog" I have read.---nancy

  2. Rebecca Says:

    Hi Nancy, thanks so much for sharing your story! I can't imagine how difficult your surgery/recovery were, and I'm sorry to hear that you are still having so much difficulty now. I am so grateful to have been able to benefit from the advances that you and your generation no doubt contributed to my health now. Without you I know that I would have had a much more difficult experience. If you ever want to chat, I'd love to hear from you, my email is mytroubledbones@yahoo.com
    God bless! ~Rebecca

  3. Wong Chor Mun Says:

    Hi Rebecca,
    I like this post of yours particularly. I am also a scoliosis sufferer. I was 64 degree a big C curve before ops. I just had my spinal fusion for scoliosis on 17/2/2014. Yes this surgery has benefited me. My spine curve was corrected to 25 degree. I have a balance shoulder now. My gravity line restored. My right pelvic bone pains that I had over many years has gone.. God beside used the surgeons hands to restore my spine this surgery also has restore my being.. I am a happy person now..low self-image up-lifted. I no longer ask all the why me.. how ... what (regarding life).
    In my country there are many who are having serious scoliosis curve are still trying to avoid surgery. It is very sad many are still mislead and still think that spinal fusion is prone to failures.. They seems to unaware that spine surgery techniques over the years improve and advance just like computer and hand-phone.
    May I link this post of yours back to my blog?

    Regards,
    chor mun, Wong

Post a Comment