The best hospitals/clinics/centers/doctors that specialize in scoliosis treatment

[eljamo17]

I am seeking treatment for my 50 degree lumbar ideopathic curve.
I wish to know the best places and doctors I can go to to seek treatment.
I want to know the best in the country and the best in the East Coast ( i live in VA).

I am currently scheduling appointments and the Kluge center at UVa(University of VA) and at Baylor University in Texas. I have told these places are as good as any in the US, is this true?

[kennedy]

that mainly not ture the best in the county are the orthopedic shriners hospitals because they treat orthopedic problems also free of chrage. They the top learders in treating scoliosis and other orthopedic problems.
There a shriners hospital in Philadelphia or greenville on the eastcoast.

[eljamo17]

that sounds interesting, free surgery hmmm...

[mariaf]

I agree with Kennedy - if you are in Virginia, you might want to try the Shriners Hospital in Philadelphia. It's one of the best. Their toll-free number is 1-800-281-4050. I assume you are under 18 (they treat children up to the age of 18) and even though it is free, the care is EXCELLENT.

If you cannot get there, they will drive you. I actually know someone who was driven, free of charge, by the Shriners from Virginia to Philadelphia just a couple of weeks ago. Unbelievable, but true :-)

[eljamo17]

ok i was told about shriners earlier.
Well i would be having a fusion surgery, so they would be good for that?Vertabrae L1-L4 i beleive.
thanks for the reply.
I'll check them out.

[mariaf]

Yes, fusion (and anything related to scoliosis) is one of their specialties. My knowledge is mostly with regard to the Philadephia Shriners hospital and they are TOPS in all facets of scoliosis treatment, including fusion. Many parents, whose children require fusion, actually seek out an opinion at Shriners Philly because of their excellent reputation.

Good luck!

[eljamo17]

wow Ms.
Thank you so much again.
I'll totally check them out and make an appointment.
Plus its a good excuse to go to Philly! :)
and you said they use BMP in fusion surgery which is awesome!

[eljamo17]

They do use BMP don't they?
ANyone know?

[mariaf]

Sorry, I don't know the answer to that question about BMP. My son had VBS, not fusion. Also, I don't know if hospitals use different material on a case-by-case basis or if they use one material all the time, so best to ask someone at Shriners.

The physician's assistant to the spine team there is Janet Cerrone. She'd be your contact person. Her e-mail is janetcerrone@comcast.net. Or call the toll free number and ask for her. She usually returns voicemails and e-mails within a day or two.

Again, best of luck!

[gardenjen]

Quick note. Shriners treats up to 21 yrs. old. My daughter was offered
minimally invasive thoracoscopic fusion surgery at age ~20 by Dr. Betz. He requires a year window for follow-up after surgery. Great experience.

[mariaf]

Hi Gardenjen,

I had heard they treat patients up to age 21 - but I thought the caveat was that the child had to be in the Shriners Hospital system arleady. Was your daughter already a patient there?

Thanks for clarifying - I just want to be sure I have my facts straight :-)

[WNCmom]

When we spoke to Dr. Cahill earlier this month, I think he said they do not use BMP--they use donor bone. I don't remember the exact reason, but there was one. In any case, you would want to check this out to be sure.

[skybonus]

I asked the same question about the BMP if they used it in fusion surgery for my 13 years old son. His surgeon mentioned that the insurance company might not cover the cost by using BMP. And the FDA has not approval for the use of spine surgery for children. They only granted approval in specific types of spine surgery.

[txmarinemom]

Skybonus,

Most insurance companies won't cover rhBMP-2 for ADULT fusion, and it's debatable among surgeons whether it's effective for kids/adolescents.

Anyway, mine didn't cover it. Hanson knew going in they were going to kick it back, but I know I got it (because I have pictures of them laying the the absorbable collagen sponges).

Sherie, isn't Lenke one of the few in the US who will use BMP on kids? Just another way that doctors vary, Hanson did his fellowship under Lenke and won't.

And, no, skybonus ... the FDA only approves rhBMP-2 for instrumentation surrounded by titanium PEEK cages. Bullsh** when the studies prove its efficacy in cutting fusion time by 1/3 or more for scoliosis.

Regards,
Pam

[txmarinemom]

When we spoke to Dr. Cahill earlier this month, I think he said they do not use BMP--they use donor bone. I don't remember the exact reason, but there was one. In any case, you would want to check this out to be sure.

WNCmom, on adults they combine allograft (cadaver bone) or autograft (patient harvested bone) with BMP. Again, I think it's rare to find a surgeon who'll use rhBMP-2 on kids at *all*.

I know I've read of limited cases where only BMP is used (on adults), but normally it's combined with some type of bone graft material. They lay the sponges soaked in BMP, and the pack with bone graft.

Regards,
Pam

[skybonus]

I found that is interesting. It said the cost of implants in patients with rhBMP-2 was more than three times the cost of allograft.

http://www.ncbi.nlm.nih.gov/pubmed/17387522

[HaleyMom]

WNCmom, on adults they combine allograft (cadaver bone) or autograft (patient harvested bone) with BMP. Again, I think it's rare to find a surgeon who'll use rhBMP-2 on kids at *all*.

Pam

I'm a medical researcher for a drug company and briefly worked with BMP2 many years ago - though, I was looking at it from an oncology point of view.

The consequences of BMP2 in children, woman who may eventually become pregnant and patients recovering from cancer is still unclear. BMP2 acts as a potent growth stimulator. The rhBMP2 leaches out of the sponges and can promote abnormal growth at other sites - therefore not appropriate for growing children or patients harboring undetected metastesis. The issue for young woman is that they develop antibodies to the rhBMP that have the potential to cross the placenta. It's still not clear what effect these may have on a developing fetus or how long-lived the antibodies might be.

One needs to think carefully before chosing this option.

[txmarinemom]

Skybonus, I'm sure it is easily more expensive ... as I said, they don't use BMP2 alone (they combine it with either autograft or allograft), so you're paying for graft material PLUS rhBMP-2, and it is *not* cheap.

However, you can't compare the surgery they're describing (with the PEEK cages - the only FDA approved use of BMP2) to the way they use it in posterior fusion and instrumentation (which is NOT FDA approved). This isn't the same surgery ... this article you cited is about anterior cervical fusion.

BTW, if anyone wants to see how they place the absorbable collagen sponges (ACS) and then pack with graft material, there are a few slides in surgery photos that clearly demonstrate it.

I don't regret it at ALL - especially when it can cut fusion time by 2/3rds or more. I, personally, had no interest in waiting a year to resume my life.

HaleyMom, interesting info I had not seen ... thanks for posting that: I'll have to see what else I can dig up on the topic.

Luckily I fall into none of the "at risk" groups. (most certainly not young - nor planning to become pregnant ... barring some immaculate intervention!)

That IS really good information for people who DO, however :).

Regards,
Pam

[leahdragonfly]

Hi everyone,

interesting topic above. I will have to have a revision at some point of a failed fusion at L4-5. The surgeon I liked best (at OHSU) told me he would use a bone dowel placed through a TLIF, then he would extract some of my bone marrow and mix it with BMP and place this in the fusion bed. I have not heard of this before--has anyone else? My failed fusion was using autograft from my iliac crest (24 years ago, w/o instrumentation).

[eljamo17]

ok. I keep hearing about shriners.
But could someone please give me Dr. Lenke's contact info so that I might be able to contact him for an appointment or something.

[mariaf]

The phone number to the St. Louis Shriners Hospital, where Lenke practices, is 314-432-2930. I got the number from their website, btw.

Good luck.