Birth of Fellowship Training
During the September 10, 1970 business meeting, Dr. William F. Donaldson, Jr. introduced Dr. John D. King to comment on the first fellowship he had completed which in essence was the beginning of fellowship training in spine surgery. The fellowship was expected to last 6 months and the fellows were required to spend a major portion of their time in one institution, but were urged and expected to make short visits to at least one or more institutions. At that time two fellowships were appointed, one outside the United States and Canada and one from within. Dr. King and Dr. Jen Fan Wang were the first SRS fellows in 1970. Dr. King reported “everywhere we went, I have never seen so many people who were so generous and so sincere…..It was certainly one of the most stimulating experiences of my life and I will remember it as long as I live”. This historic first year lead to the development of spine fellowships world-wide, as well as the SRS Traveling Fellowship.
Spinal Cord Monitoring
Dr. Clyde “Les” Nash presented a feasibility lab study on cats regarding the effects of blood pressure and evoked potentials whick subsequently lead to clinical use of spinal cord monitoring.
Stagnara Wake-up Test
Mme. Vauzelle and Dr. Pierre Stagnara first presented the results of the Stagnara’s Wake-up test at the 7th Annual Meeting in Wilmington, Deleware. This test was commonly used before the spinal cord monitoring became available.
Dr. John E. Hall and orthotist “Bill” Miller devised the Boston Brace System for the treatment of scoliosis. They used a prefabricated, symmetric, thoracolumbar-pelvic module that was available in multiple sizes and could be modified for each patient’s size and curvature. The orthosist corrected the deformity through lumbar antilordosis and a combination of voids and opposing pressure areas that were positioned according to the curvature characteristics. A coordinated exercise program was an integral part of the treatment plan. The Boston Brace’s low profile made it more acceptable than the Milwaukee Brace and it remains the “gold standard” for the orthotic treatment of scoliosis more than four decades after its introduction.
First Harrington Guest Lecture at the SRS Annual Meeting
Prof. Arthur R. Hodgson, a world-renown orthopaedic surgeon from Hong Kong, presented the first Harrington Lecture at the 10th Annual Meeting of the Scoliosis Research Society in Louisville, KY in 1975. This lectureship was established as a tribute to Dr. Paul R. Harrington (1911-1980), 1973 SRS President and designer of the Harrington Instrumentation, the gold standard of surgical care of spine deformities from the 1960s to the 1990s throughout the world.
Zielke Anterior Spinal Implant
With the shortcomings of the Dwyer instrumentation system and the increased understanding of the three dimensional deformity of scoliosis, Dr. Klaus Zielke developed an improvement over the Dwyer system that was used around the world for over twenty years starting in 1975. Known as the “Ventrale Derotations-Spondylodese” (VDS) system and it offered the ability not only to compress across the convexity of a scoliotic deformity but also the ability for derotation and “lordosation” of the scoliosis deformity.
Best known as a correction device for lumbar and thoracolumbar scoliosis allowing the ability to decrease the number of vertebrae fused compared to posterior spinal rods, it was also used in combination with posterior Harrington rods for large double curves. This combination of systems allowed scoliosis surgeons to take advantage of the improved derotation, lordosation, segmental fixation and decreased number of vertebrae fused than with Harrington rod fixation alone.
Dr. J. Resina, from Portugal first presented on this topic in 1963 and reported on the results of his first 100 patients in 1977 in JBJS. Dr. Eduardo R. Luque popularized segmental fixation and presented his first report at the SRS Annual Meeting in 1976. He worked closely with Dr. Charles (Jake) Heinig who taught him to do vertebral decancellations to correct rigid deformities, which he combined with his instrumentation. He worked closely with Dr. Al Sanders in his technique and the three of them organized courses in Latin America teaching the technique.
Further Development of Intraoperative Monitoring
Royal National Orthopaedic Hospital, Stanmore, UK reported development of a system for intraoperative spinal cord monitoring. Epidural or scalp Sensory Evoked Potenetials were recorded. A series of 111 cases of spinal deformity was reported in 1982 with three true positives. There were no permananet neorological injuries. The investigators were Dr. S. Jones, Mr. A. Ransford, Mr. M. Edgar & Mr. T. Morley. (British Scoliosis Society records.)