Meet the Halifax doctor changing how scoliosis is treated in North America
As children develop, their bodies change and their bones grow.
For some children they’re able to enjoy sports — but some aren’t.
For the roughly three per cent of children who develop scoliosis, their range of motion becomes restricted and their spine begins to curve or rotate
One doctor at the IWK Health Centre’s children’s hospital in Halifax, though, is trying to change how doctors treat the disorder.
Dr. Ron El-Hawary, chief of orthopedics at the IWK, is the first and only surgeon in North America to perform a new and less-invasive surgery that gives children suffering from scoliosis a new lease on life.
The unique and innovative procedure, known as ApiFix, has been used and developed over the past six years in Europe and Israel.
Compared to the procedures being carried out elsewhere on the continent, ApiFix allows a patient to have more mobility.
According to Dr. El-Hawary, the new surgery is half as long as other methods, allowing for a shorter recovery time.
“In the medium term we can see that patients have more flexibility, meaning that it’s likely they will have better participation in sports and perform at the same level, or higher than they did previously,” he said.
The procedure won’t necessarily make the patient’s scoliosis disappear, Dr. El-Hawary said, but it can reduce the curving of the spine by at least half.
Jessica Robb, 14, was first diagnosed with adolescent idiopathic scoliosis when she was seven years old.
“At first we didn’t truly believe it was something as serious as it was, because we didn’t know a whole lot about it,” Jessica’s mother, Tracy-Aikema-Robb, told Global News from the family’s home in Westover, Ontario.
“We thought it was something that would fix on its own.”
But it didn’t.
After consulting with a specialist, Robb began wearing a brace on her back everyday, 20 hours a day, for the past seven years.
“It got annoying wearing a brace everyday and all night,” Robb said.
And the bracing didn’t stop the scoliosis from curving her spine further. By the time of her surgery, she would be suffering from 50-degree curvature of the spine that caused a twisting of her rib cage, restricting her breathing.
Eventually, doctors told the family that she would need surgery to help correct the curve of her spine and stop the scoliosis.
The typical method, referred to as fusion surgery, has required the insertion of two metal rods along the spine, fusing the vertabrae so the spine cannot continue to bend.
While it is helpful for many patients and Dr. El-Hawary still performs the procedure, he says that it can cause patients to develop arthritis into adulthood. The procedure also causes the spine to lose its range of motion — causing a loss of flexibility for the patient.
Aikema-Robb says that when she was informed that her daughter would have to undergo the fusion surgery — the only option being offered in Ontario — she spent hours searching for other options.
“It was such a blow, such a shock that I was almost in tears,” she said.
That’s when she came across the new procedure being done by Dr. El-Hawary.
Within eight months they were on the way to Halifax to prepare for the procedure.
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“Rather than using two rods, we use one rod,” said Dr. El-Hawary, “and rather than using 15 to 20 screws we use between two and four.”
“It’s not as robust as the fusion-type operation, but the advantage is that there are lots of joints within the rod that allow for motion.”
Along with stopping the curvature of the spine, ApiFix allows patient’s to further increase their flexibility and motion over time.
The unique rod used in the procedure has a ratcheting system built into it. As the patient begins to build strength and recover the system will lengthen and help to continue to strengthen their spine.
Robb, along with her mother and members of her family, flew out to Halifax in late 2017 to undergo the procedure.
Both mother and daughter say the results are more than they could have dreamed of.
“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,” said Aikema-Robb.
Robb wholeheartedly endorses the procedure, saying that she is happy she no longer wear a brace and that she can once again enjoy sports.
“They should do it,” Robb said.
“It’s really worth it.”
The good news is that this procedure will likely become more common.
Dr. El-Hawary says that he knows of at least six surgeons throughout the country that are looking at performing the procedure within the next year.
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