1950's

The Risser Cast utilized a lighter contoured cast applied in traction on a stabilizer frame (Risser frame). Traction through chin and pelvic straps, localized lateral pressure at apices of coronal deformity (Risser localizer cast) also described posterolateral pressure localized to rib hump. (Instr. Course Lect. 1955; 12:255-9) He also described the Risser sign for iliac crest that is still used today to indicate maturity.

In 1951, Mr. Francis Allan commenced instrumented operative correction of fixed curves and published a series of 11 cases in 1955. No plaster casts were used and a variety of etiologies were represented. All patients had a simultaneous spinal fusion. The corrective instrument was a “jack” of his own design. Initially this was manufactured in the Royal Orthopaedic Hospital workshop and later fabricated by in stainless steel “SMo”. Later, titanium was used but this was never reported.

This implant consisted of a barrel and two forks attached at either end with left and right threaded splines and locking nuts. Thus, when the barrel was rotated with the bar distraction was achieved. The forks gained purchase on the transverse processes or the pedicles of the spine. The fork design varied. The barrel was manufactured in various lengths, the longest being 4 inches. The device was first implanted in 1951.

Dr. John R. Cobb from New York reported on the results of surgery in 363 patients with a variety of bone graft types. Patients were kept in bed with a turnbuckle cast for 6-7 months. However, the pseudarthrosis rate was dramatically lower than his contemporaries (4.1%). John Cobb also introduced the Cobb Angle, still used today as a tool in the evaluation of spinal deformity

Prof. Arthur R. Hodgson popularized anterior spine surgery in Hong Kong, initially for tuberculosis of the spine.

H.H. Boucher described the use of pedicle screws as “a method of spinal fixation” in JBJS 41B: 1959