LEXINGTON Time and time again in recent months, Shriners Hospitals for Children-Lexington has demonstrated its commitment to being a leader in orthopedic care by incorporating cutting-edge technology to increase the quality and safety of the care provided to patients of the hospital.
MAGEC Growing Rods
Last September, Vishwas Talwalkar, MD, pediatric orthopedic surgeon, completed the hospital’s first implantation of the state-of-the-art Magnetic Expansion Control (MAGEC) Spinal Bracing and Distraction System on Noah, an eight-year-old boy with scoliosis.
Growing rod surgery is used to treat scoliosis, a sideways curvature of the spine, in children with curves at high risk of worsening. Traditional growing rod surgery involves the implantation of growing rods on either side of the spine. The rods are attached to the vertebrae with hooks or screws. The initial surgery corrects the scoliosis as much as possible, and then the child returns every six to eight months to undergo lengthening surgery as the child grows.
MAGEC rods, approved by the FDA for use in the United States in 2014, are changing treatment plans for scoliosis because they do not require surgical intervention to perform the lengthening procedures. After the initial surgery to insert the MAGEC rods, lengthenings take place in the outpatient clinic. “There’s a mechanism inside the rod that is controlled by an external magnetic device,” Talwalkar explains.
Noah returned for his first lengthening procedure post-surgery in January. Rather than undergo the lengthening surgery that traditional growing rods require, Noah lay on an exam table and watched Star Wars videos while Talwalkar used an External Remote Controller to communicate with the magnets in Noah’s back and perform the lengthening.
“This new technology is one more tool that allows us to provide high quality healthcare,” says Anna Gayle Parke, RN. “Not only is it painless and quick, it also eliminates multiple episodes of anesthesia, therefore reducing the risk of complication.”
Not all spinal curves can be treated with the MAGEC system; there must be a section of the spine straight enough to line up with the magnets. “This is a great option for some of our patients who require growth instrumentation,” says Talwalkar. “It remains to be seen if we will use this on a regular basis.”
Computer-Aided Design
Shriners Hospitals for Children-Lexington’s Pediatric Orthotic and Prosthetic Services (POPS) department offers a full range of care, including upper and lower extremity prosthetic care, scoliosis bracing, and a wide spectrum of pediatric orthotic services.
In March, POPS introduced 3-D scanning technology and incorporated computer-aided design (CAD) to assist staff in the design of orthotic and prosthetic devices. These technologies offer a high degree of accuracy and reproducibility to accentuate the current clinical skills needed for the intricate pediatric orthotic and prosthetic designs.
“Using our Vorum computer-assisted design program, we can either scan our patients in real time or scan a fiberglass cast taken during assessment. We then modify the scanned images and digitally send these files to our Twin Cities fabrication center for production,” says Eric Miller, CPO-L, Orthotics & Prosthetics manager.
“The most noticeable benefit is for our patients with scoliosis,” Miller continues. “The ability to scan allows us to capture a detailed image of the patient without any hands-on contact. The majority of our scoliosis patients are young females, and the scanning process makes it less awkward for that patient population.”
EOS Imaging System
In January, Dale Wallenius, director of Development, announced that he had secured funding to purchase an EOS Imaging System for the Shriners Hospitals for Children Medical Center (SHCMC) scheduled to open in 2017 on the UK HealthCare campus. EOS® is a unique, ultra-low dose X-ray system that utilizes Nobel Prize–winning technology to reduce the amount of radiation received during an X-ray procedure. The EOS system at SHCMC will be the first in Kentucky.
Radiation exposure to patients is 50 to 85 percent lower than standard digital radiography, and 95 percent lower than a computed tomography (CT) scan. This reduced radiation is an important benefit for patients with progressive conditions, such as scoliosis and other spinal deformities that require frequent X-rays to monitor disease progression. “EOS will primarily be used on patients with spine conditions and lower extremity conditions, affecting nearly 43 percent of our patients,” says Peggy Myers, director of Radiology.
Reducing a patient’s exposure to radiation from X-rays has been a top priority of the medical imaging industry, which has resulted in a best practice standard known as “ALARA.” This standard states that technology should use radiation doses that are “as low as reasonably achievable” (ALARA) without sacrificing the high-quality images needed to make medical decisions.
EOS captures full-size, whole body images of a standing or seated patient in a single scan. Images are taken from multiple angles at the same time, reducing the number of X-rays and improving the surgeon’s ability to diagnose and plan for surgery based on three-dimensional views. Frontal and lateral images of any length can be acquired simultaneously. Physicians are able to view all areas of the body with one image, rather than piecing together multiple images, as is done with digital radiology.
“The vision of Shriners Hospitals for Children is to be the best at transforming children’s lives by providing exceptional healthcare,” says Tony Lewgood, administrator. “Incorporating proven state-of-the-art technologies in a compassionate, patient-centered environment helps us provide the highest quality care to our patients.”