Areas of Research
Researchers at Texas Scottish Rite Hospital for Children are dedicated to providing research that will benefit the children served by the hospital. The Sarah M. and Charles E. Seay/Martha and Pat Beard Center for Excellence in Spine Research focuses on six main areas of research.
New Spinal System Implant Design and Modification
In the mid-1980s, TSRHC researchers developed the TSRH® Spinal System, a segmental spinal instrumentation that became the number one implant system used throughout the world for spinal deformity and adult degenerative conditions. The team of TSRHC surgeons expanded on the concepts of French physicians Cotrel and Dubousset to develop an instrumentation with improved connector mechanisms that was easy to use, provided three-dimensional correction and used a connector for the two rods. The system was used at TSRHC and throughout the world for many years. In October 2006, the hospital launched the TSRH® SILO™ 5.5 Spinal System. a modified design of the TSRH® Spinal System, which is lower profile, much easier to use and allows for greater correction and stabilization of the spine. Due to its versatility, the implant system can be used for spinal deformity, tumor, degenerative spine trauma and other spine conditions. TSRHC surgeons continue to develop modifications to improve the system for the benefit of our patients.
Understanding Spinal Deformity and Spinal Growth
The growth and development of the spine and its potential progression are important concepts to understand when treating children with spinal deformities. TSRHC has contributed important studies in this area of research, including how to prevent continued anterior spine (front of spine) growth in young patients who have had an anterior or posterior spinal fusion; the association of scoliosis with an underlying neural axis abnormality and lateral radiographic findings; and the characterization of spinal growth. TSRHC researchers have made exciting advances in understanding the role of one of the major growth centers of the spine. Modulation of this growth center has been used to create a scoliosis model at TSRHC and continued study is being done to apply these concepts to the treatment of patients.
Outcome Studies Following Operative and Nonoperative Treatment
Scoliosis treatment falls into two categories: operative and nonoperative. Researchers at TSRHC have focused on determining both radiographic and clinical outcomes of both types of treatment. TSRHC has studied the effectiveness of traction and bracing as nonoperative treatment methods and the radiographic and functional outcomes of surgical treatment using a variety of methods.
Defining Adverse Outcomes and Complications
Although results following surgical treatment for idiopathic scoliosis are generally outstanding, there are some potential adverse outcomes. TSRHC researchers have characterized complications such as delayed infection and risk factors for developing pseudoarthrosis, a condition in which the spine does not fuse. These identifications have allowed surgeons to take steps to manage and limit the number of complications that occur.
Investigation of Minimal Access Surgical Techniques
Thoracoscopic techniques have taken on a greater role in the treatment of spinal deformity in children. Beginning in the 1990s with anterior release, these techniques now include anterior instrumentation and fusion. TSRHC’s extensive research efforts analyze improved ways to perform thoracoscopy, ranging from the patient’s position to sparing segmental blood vessels to the position of the screws relative to the important anatomy in the chest. Thoracoscopic techniques are currently being tested to modulate the growth of the spine to correct scoliosis without fusion.