Posted by Orthopedic surgeon Dr. Ron El-Hawary is giving youth suffering from adolescent idiopathic scoliosis (AIS) a new lease on life. Dr. El-Hawary, chief orthopedics at the IWK, is the first, and currently, only doctor to perform the ApiFix procedure in North America. The revolutionary new system allows for a shorter, less invasive, less expensive surgery that preserves motion and function in patients while lessening the chance of back pain later in life.
“Posterior Dynamic Deformity Correction (PDDC or Apifix) is a novel treatment option for certain patterns of scoliosis,” says Dr. El-Hawary. “The technique has evolved and has been used for 6 years in Israel and Europe with over 200 surgeries performed to date. We have been fortunate at the IWK Health Centre to help develop this technique in a careful and responsible manner.”
Westover, Ontario’s Jessica Robb, 14, is one of only six patients to have received the ApiFix procedure in North America, all performed in Halifax, Nova Scotia. She was diagnosed with scoliosis at the age of seven and suffered a 50-degree curvature of the spine that caused a twisting of her rib cage, restricting her breathing. Six months after the surgery she is now able to breathe better and without the aid of a puffer. She also no longer has pain in her back and does not need to wear a brace.
“It felt as if the weight of the world was lifted off us when Dr. El-Hawary showed us that first x-ray after the surgery.”
“As Jessica’s parents we are so thankful for Dr. El-Hawary and the opportunity he gave her to have a normal life without worry about scoliosis or fear of fusion surgery,” says Tracy Aikema-Robb, Jessica’s mother. “It felt as if the weight of the world was lifted off us when Dr. El-Hawary showed us that first x-ray after the surgery.”
“The gold standard treatment for adolescent idiopathic scoliosis has been Posterior Spinal Fusion and Instrumentation surgery which has improved considerably since its earliest version (Harrington Rod),” says El-Hawary. “While this surgery is predictable and gives excellent short term results, there is some concern about its impact on spinal mobility and on the potential development of spinal arthritis. “Fusionless” surgeries such as PDDC and vertebral body tethering have been developed to try to keep scoliosis from worsening while allowing more physiological spine mobility. As these techniques are very new, we do not know the long term outcomes for these patients. Therefore, we are carefully selecting patients and are evaluating the effects of these treatments by using health related quality of life questionnaires, x-rays, and lung function testing as part of the Children’s Spine Study Group registry.”
Scoliosis is an abnormal curvature of the spine that involves a twisting or rotation of the bones of the spine either to the left or right. AIS is the most common form of scoliosis and affects two to three per cent of children between the ages of ten and 18, a time when the human body is growing at its most rapid pace. While the cause of AIS is unknown it is thought to be a genetic disorder and it is more common among females than males.