Dr. Juan C Rodriguez-Olaverri, Anterior Scoliosis Correction (ASC), interviewed Dr. Derek Lee
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- Опубліковано 6 сер 2024
- This interview is for educational purposes and covers information provided by Dr. Rodriguez-Olaverri regarding his opinions on Anterior Scoliosis Correction (ASC) Non-Fusion Scoliosis Surgery. This video is not an endorsement. Viewers should consult their physicians and treating team accordingly. See highlights via timestamps below.
Chapters:
0:00 Introduction
0:25 Dr. Rodriguez-Olaverri's personal scoliosis diagnosis. Age 12, 28 degree thoracolumbar curve.
2:39 Path to Spine Surgeon.
6:15 Initial exposure to non-fusion surgical option.
8:05 Waited for a non-fusion surgical system for scoliosis.
9:14 Quality of life is a top goal.
11:49 NYU is an opportunity to improve non-fusion research and surgical techniques.
14:09 Preference for ASC over VBT.
15:42 ASC offers the ability to both rotate and compress the spine to a greater degree.
16:15 Mini-open and a 2nd tether reduces tether breakage from 15-18% to less than 5%.
16:59 Similar surgical approach to Drs ABC.
18:20 Decision to do disc releases is based on x-rays and spine stiffness.
19:21 Prefers MRI to create 3D reconstruction of the spine.
20:24 Rib hump is a rotational, not a coronal deformity.
20:57 Anterior Vertebral Overgrowth drives scoliosis.
21:46 Has never seen over correction in curves over 55 degrees. Sees over correction in less than 30-40 degree curves with lots of growth remaining.
22:37 Need further research on curve flexibility and balancing curves for best correction.
23:34 Sees more bone overgrowth in the vertebrae of the most corrected curve.
24:56 ASC for mature curves may modulate both bone and muscle to stabilize curves after a broken tether.
25:58 Rotation is the first indication of tether breakage.
27:04 ASC allows greater spine de-rotation.
27:51 During scoliosis curve progression, rotation becomes before hypokyphosis.
28:26 Correcting rotation corrects hypokyphosis.
29:07 Fusion is all about de-rotating the spine.
31:25 Disc Release necessary to create kyphosis and rotation.
32:23 Disc release controversy.
33:03 Disc release details.
35:27 Practice is 90% paediatric and 10% adult.
37:31 Will there be availability in Spain for surgeries?
39:15 Youngest VBT patient is 5 years old.
41:47 Uses both Globus and Zimmer Biomet instrumentation.
43:19 Definite advancements in tether technology coming.
44:21 Needs to be different instrumentation systems for thoracoscopic and mini-open approaches.
45:45 Better screw purchase is important for top screw to allow better tensioning.
47:27 Any plans to tether higher than T4 for high thoracic curves?
48:41 VBT fusion hybrids.
49:46 Mature tethers.
58:44 BONUS INTERVIEW PART 2. Review of 2 Cases. Case 1: Immature Spine ASC. Case 2: Mature Spine ASC
58:54 Case 1 - 13 year old female, Risser 0, Sanders 2, Pre-menarche. Immature spine ASC.
1:04:31 Case 2 - 17 year old female, mature spine ASC.
/ 11982. .
drdereklee.com/
This interview is for educational purposes and covers information provided by Dr. Rodriguez-Olaverri regarding his opinions on Anterior Scoliosis Correction (ASC) Non-Fusion Scoliosis Surgery. This video is not an endorsement. Viewers should consult their physicians and treating team accordingly. See highlights via timestamps below.
Chapters:
0:00 Introduction
0:25 Dr. Rodriguez-Olaverri's personal scoliosis diagnosis. Age 12, 28 degree thoracolumbar curve.
2:39 Path to Spine Surgeon.
6:15 Initial exposure to non-fusion surgical option.
8:05 Waited for a non-fusion surgical system for scoliosis.
9:14 Quality of life is a top goal.
11:49 NYU is an opportunity to improve non-fusion research and surgical techniques.
14:09 Preference for ASC over VBT.
15:42 ASC offers the ability to both rotate and compress the spine to a greater degree.
16:15 Mini-open and a 2nd tether reduces tether breakage from 15-18% to less than 5%.
16:59 Similar surgical approach to Drs ABC.
18:20 Decision to do disc releases is based on x-rays and spine stiffness.
19:21 Prefers MRI to create 3D reconstruction of the spine.
20:24 Rib hump is a rotational, not a coronal deformity.
20:57 Anterior Vertebral Overgrowth drives scoliosis.
21:46 Has never seen over correction in curves over 55 degrees. Sees over correction in less than 30-40 degree curves with lots of growth remaining.
22:37 Need further research on curve flexibility and balancing curves for best correction.
23:34 Sees more bone overgrowth in the vertebrae of the most corrected curve.
24:56 ASC for mature curves may modulate both bone and muscle to stabilize curves after a broken tether.
25:58 Rotation is the first indication of tether breakage.
27:04 ASC allows greater spine de-rotation.
27:51 During scoliosis curve progression, rotation becomes before hypokyphosis.
28:26 Correcting rotation corrects hypokyphosis.
29:07 Fusion is all about de-rotating the spine.
31:25 Disc Release necessary to create kyphosis and rotation.
32:23 Disc release controversy.
33:03 Disc release details.
35:27 Practice is 90% paediatric and 10% adult.
37:31 Will there be availability in Spain for surgeries?
39:15 Youngest VBT patient is 5 years old.
41:47 Uses both Globus and Zimmer Biomet instrumentation.
43:19 Definite advancements in tether technology coming.
44:21 Needs to be different instrumentation systems for thoracoscopic and mini-open approaches.
45:45 Better screw purchase is important for top screw to allow better tensioning.
47:27 Any plans to tether higher than T4 for high thoracic curves?
48:41 VBT fusion hybrids.
49:46 Mature tethers.
58:44 BONUS INTERVIEW PART 2. Review of 2 Cases. Case 1: Immature Spine ASC. Case 2: Mature Spine ASC
58:54 Case 1 - 13 year old female, Risser 0, Sanders 2, Pre-menarche. Immature spine ASC.
1:04:31 Case 2 - 17 year old female, mature spine ASC.
facebook.com/groups/11982...
drdereklee.com/
He did my surgery on Friday, I feel a lot better now
What degree was ur curve? Do u have a mature spine?
Finally, back to real medicine. Glad to have found this video. Thank you.
Dr O is an awesome person and a great surgeon. He performed ASC on my daughter 6/12/20. Great interview! Thank you Dr. Lee for the interviews.
Thank you! My son had VBT 7 months ago. Just trying to provide good/accurate information so parents/patients can make informed decisions.
@@DerekLee Did Dr O perform the surgery?
@@houstonhandsome1 my son's surgery? His surgeon is Dr. Amer Samdani.
My daughter will be having VBT with Dr. Rodriguez in 1 week. Thanks for this interview.
In long run I.e. 20-30 years after surgery complications r in which surgery vbt or fusion
Thank you for this! I’m just now starting my research on this surgery, trying to avoid a fusion. Did he say he’s been doing his since 2007 or 2017?
I believe he started tethering in 2017. :)
Thanks Dr Lee. Great interview. Do any of the surgeons know why some severe curves are flexible whilst others are stiff, all other indications being equal? Do they have any suggestions on increasing flexibility seeing this is such an important criteria for VBT/ASC?
Good questions! In general, the spine stiffens as we age but overall flexibility is an individual trait. Some are hypermobile due to poor collagen quality while others are rigid early on. Consider scoliosis specific physiotherapy exercises by a qualified practitioner to increase flexibility. This is an interview that will give you more info:
ua-cam.com/video/DSBdNqgWYkQ/v-deo.html
@@DerekLee Thankyou Dr Lee
Hey! Thankyou so much for holding this interview! It was so informative! Can u please tell me the cost for VBT ? Or atleast the cost for the surgery of your son?
Consider joining these FB groups. They would be able to answer your specific questions.
Facebook VBT/ASC/Tethering Support Groups:
Canada: facebook.com/groups/60224...
USA: facebook.com/groups/Scoli...
UK: facebook.com/groups/12878...
@@DerekLee Thankyou so much!
Thank you for the video. I was wondering if this is available in India
Yes in Chennai. Here you go.
ua-cam.com/video/WhEuak4F4gw/v-deo.html
@@DerekLee thank you so much. Can this be done for a 22 year old man
@@uhtredsonofuhtred2867 it depends on each individual case. Just reach out to Dr. Hegde for his opinion.
Is asc surgery permanent? or will I need future revision surgeries every few years.
Good question! Unfortunately no one can answer that. There is never a guarantee with any form of surgery. Some curves might remain stable indefinitely while others might progress. Additionally there is no long-term data on ASC outcomes for mature spine scoliosis surgery.
hello legendario , im 29 years old man, its asc surgery posible for me ?
It depends on how flexible your spine is and if there is significant degeneration. Just reach out to Dr. Olaverri for his recommendations.
So it sounds like there is nearly no data on fully mature adult tethering? Where can I read the most up to date details on adult tethering?
Correct. There is some data on mature adolescents but not much on more mature adults.
esmed.org/MRA/mra/article/view/2632?fbclid=IwAR1czuXdYYil3fhXd4Fj3skQwwYTWVeCHFQZ4QbaAIm4ljnaMUba8iedyXQ
online.boneandjoint.org.uk/doi/abs/10.1302/1358-992X.2021.11.016?fbclid=IwAR3S4VouThtBqfqokEaOT_ALj5PDgz73TzmZFGXaWFmTEIE5vvObGAX-Tkw
My son was diagnosed with scoliosis yesterday and I was very shoked kindly assist
Just head over to my public FB group.
facebook.com/groups/1198200727630801/
In long run which is better
Fusion or vbt
Each case is unique. Consider talking to a surgeon who performs both fusion and VBT to get a balanced perspective.
Dr. Derek Lee -thanks dr.Lee please answer below question
How can I share my x-ray with u need u r expert advise on scoliosis
@@artninjapr8310 I'm not an expert. :)
It would be best to reach out to these surgeons directly as most are able to communicate via email and virtual consults.
Dr. Derek Lee -can I get Dr.Baron Lonner email I'd to consult
I am 20 years 43 curve how to not surgery?
Many patients live just fine with that degree of scoliosis without surgery. Of course scoliosis specific exercises might help to keep your spine and muscles flexible.
Here's a good interview you might like to watch regarding scoliosis exercises.
my son 3 year old . he have congenital scoliosis. what is right treatment?
12 degree curve after surgery is that visible from outside
It would be hard to see.
Dr. Derek Lee - if curve gets reduced from 40 to 10 degree
Will that result in a balanced posture atleast from outside
@@artninjapr8310 In many cases, even going from 40 to 20-25 will show a balanced posture.
Dr. Derek Lee - really
How to reduce posture pain due to scoliosis n muscle stiffness
@@artninjapr8310 scoliosis specific exercises. Here's a great place to start. ua-cam.com/video/DSBdNqgWYkQ/v-deo.html