The brace was originally designed by Drs. Blount and Schmidt for post-operative care. It was then used to help control scoliosis in a growing child until the child achieved sufficient spine growth to undergo spine fusion. It was observed that some children actually improved their scoliosis and no longer needed surgery. The brace was then used to prevent progression of scoliosis. The brace acted by passive correction while the patient was sleeping and through active correction while awake by pulling away from the chin and occipital supports.
Dr. John H. Moe established the Scoliosis Service at Gillette State Hospital for Crippled Children in response to a need to fill the void in the field of spine deformity care.
Harrington’s Operation, First Steps
Responsible for the care of hundreds of polio victims in Houston, Dr. Paul Harrington was convinced that an internal mechanical solution was needed to prevent small scoliosis curvatures from becoming severe. He began by attempting to stabilize the facet joints with the spine bent into a corrected position with trans-facet screws, an operation that failed. But Harrington was convinced that internal fixation of the spine was the key to solving the problem of post-polio scoliosis. Over the next 5 years he developed a new approach using hooks and threaded rods, initially instrumenting the convexity, but then adding a distraction system on the concavity. Harrington reported 35 design modifications during those first 5 years. In 1954 he began working with Thorkild Engin, an Orthotist and Machinist. Together they manufactured the hooks and rods for each case the night before surgery. A grant from the National Foundation for Infantile Paralysis supported this work. In March of 1955, Harrington conceived of the ratchet mechanism for the distraction rod and he began to develop the system that was ultimately made available to other surgeons beginning in 1960. Although Harrington originally conceived of his operation as a dynamic one, he ultimately realized that fusion was required in addition to instrumentation in order to achieve a lasting correction of deformity.