March 2022

Historian Corner

Jay Shapiro, MD

Four years ago, we lost one of the innovators in spinal deformity surgery, and my friend of nearly 30 years Robert M. Campbell Jr. As we get ready for IMAST its important to remember what it takes to innovate and implement change in spinal surgery.

Best known for his development of the Vertical Expandable Prosthetic Titanium Rib, Bob Campbell changed the way spine surgeons think of early onset scoliosis. No longer is the focus solely on the spine and cobb angle (the corner of the room as Bob would describe it), but on the entire thorax, and lungs (the rest of the room).

In 1989 in response to a ventilator dependent dying 8-month-old patient with a congenital chest wall deformity, Dr Campbell thought outside the box and turned an early construct of steinmann pins into the VEPTR device. Bob used his engineering background and help from Mel Smith, MD, his collaborating pediatric surgeon, to design the instrument system and surgical procedure. He more importantly changed how we approach these children with no treatment options.

Along the way we learned of thoracic insufficiency syndrome, the thumb excursion test, space available for the lung and, posterior hemithoracic ratio (JBJS Am 2003;85(3):399-408). Bob tirelessly fought through the difficult FDA device regulatory process (1991- 2004 leading the FDA feasibility study IDE #G900179) to get this life saving procedure available to these patients which is now performed in over 25 countries around the world. He helped to dramatically change the FDA’s process for development and approval of new pediatric devices and was named by the agency one of the 30 “Heroes of the FDA”.

When I see a new EOS patient thanks to Bob, I don’t only check the spine and Cobb angle, but evaluate the entire thorax along with the whole child.

Bob said, “Don’t be afraid to take a chance. It takes someone who can start a marathon without a finish line. If it’s for a child, it’s worth it. Don’t be afraid. You can succeed.”