SCOLIOSIS

The LESS Institute Fosters Adolescent Scoliosis Care With the Best in LES

By Abagail Sullivan

Written by Fabio Pencle & Garianne Bowen

Compiled & edited by Abagail Sullivan

Adolescent idiopathic scoliosis (AIS) is the most common form of pediatric scoliosis in individuals between the ages of 10 and 18,1 found in as many as 4 in 100 adolescents.2 By definition, idiopathic scoliosis implies the cause is unknown or not related to a specific syndromic, congenital or neuromuscular condition. Treatment options include conservative management, bracing or operative intervention.

Marketing Intern Garianne Bowen is no stranger to a life with adolescent scoliosis, although she may not have known it at first.

“Looking back, though I had the signs of scoliosis growing up, my family wasn’t aware of the potential for this diagnosis. We all thought nothing could be done of it – and though I tried to accept it, I somehow could not,” she said. Bowen spent years settling for a life that held so much more potential, in the physical and emotional space. In a world where lives are hyper visual with social media exposure, “I always felt uncomfortable in my own body. It sometimes felt like I didn’t know how to walk correctly, and that eyes were always on me. My breasts were two different sizes, my stride wasn’t straight, clothes fit awkwardly and I experienced occasional annoying back pain. My shoulder was damaged by birth and my parents attributed that to me being ‘different,'” said Bowen.

Eventually Bowen’s parents discovered an article on scoliosis – and as they read, realized she fit the mold so entirely. Because of this, they scheduled an X-ray to be read by an orthopedic surgeon, witnessing first hand their daughter’s 40 degree spinal curvature.

A proper adolescent scoliosis evaluation includes X-ray imaging from various angles.  Generally speaking, those with curves of 10 to 25 degrees are monitored for surveillance with serial X-rays. This is usually at three, six or 12 month intervals. Those with curves greater than 25 degrees but less than 40 to 45 degrees are candidates for bracing. And those with curves of over 40 to 45 degrees who are skeletally immature are considered operative candidates.3

Bowen’s 40 degree spinal curvature seen through X-ray

Bowen’s 40 degree spinal curvature seen through X-ray

During her preliminary orthopedic visit, her doctor at the time being highly encouraged Bowen to undergo a spinal fusion from the neck down, a more major procedure for an adolescent scoliosis case that would limit Bowen’s flexibility and motion. But Bowen was not so on board. She became determined not to undergo surgery, adapting to a life of covering her curvature and accepting pain as the norm.

Three years post scoliosis discovery, Bowen’s mother met Orthopedic Surgeon Dr. Kingsley R. Chin at a conference. Impressed by his profile as a successful Jamaican-born, Harvard-trained spinal surgeon, she brought her daughter to him straightaway to determine a second opinion regarding treatment options. Dr. Chin assured Bowen he would not be completing a full spinal fusion, introducing a Less Exposure Surgery procedure in its place – and clarifying her every concern regarding maintaining motion post-procedure.

Dr. Chin pioneered this LES procedure, a short segment scoliosis surgery with a focus on the apical curve, gearing treatment to the levels above and below – limiting fusion levels.

“As he reassured me, my perceptions of the procedure were altered for the positive,” she said, and after further personal research and consideration, she ultimately trusted Dr. Chin to perform the surgery. “I am so grateful to have gotten to that place,” attests Bowen.

We know it’s vital to prioritize our health, but we must also expose ourselves to our options that lie ahead. Explore your varying avenues of recovery and choose the most appropriate healing method for you.

I can personally vouch for Dr. Chin as a top orthopedic surgeon, as I begin enjoying my young years to my utmost potential – confident and free of pain.
— Garianne Bowen

And just like that, from curvature to confidence, Bowen leads a life of health, happiness and pain-free motion.

The Less Exposure Surgery Advantage

In advancing Less Exposure Surgery, The LESS Institute aims to reduce operative time, minimize blood loss and decrease instrumentation, while improving overall outcomes. For more on adolescent scoliosis cases with The LESS Institute, see the Jamaica Gleaner article and our post titled 15-Year-Old Jamaican Girl Appreciates Life Changing Scoliosis Surgery in Jamaica by Dr. Kingsley R. Chin.

About Dr. Kingsley R. Chin

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Dr. Kingsley R. Chin is a board certified Harvard-trained orthopedic spine surgeon and professor with copious business and information technology exposure. He sees a niche opportunity where medicine, business and info. tech meet – and is uniquely educated at the intersection of these three professions. He has experience as Professor of Clinical Biomedical Sciences & Admissions Committee Member at the Charles E. Schmidt College of Medicine at Florida Atlantic University, Professor of Clinical Orthopedic Surgery at the Herbert Wertheim College of Medicine at Florida International University, Assistant Professor of Orthopaedics at the University of Pennsylvania Medical School, Visiting Spine Surgeon & Professor at the University of the West Indies, Mona, and Adjunct Professor of Clinical Biomedical Studies at the University of Technology, Jamaica.

  1. , 3. https://www.ncbi.nlm.nih.gov/pubmed/29763083

  2. https://www.srs.org/patients-and-families/conditions-and-treatments/parents/scoliosis/adolescent-idiopathic-scoliosis 


15-Year-Old Jamaican Girl Appreciates Life Changing Scoliosis Surgery in Jamaica by Dr. Kingsley R. Chin

By Caitlin Lubinski

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On a late Saturday night in May, an unlikely group of people’s paths crossed in a small operating room in the University Hospital of the West Indies. It was hot, and beads of sweat formed on the doctors’ foreheads above their surgical masks. Outside the O.R., the windows in the hallways were open to catch the breeze that filtered through the open slats. The hallway was quiet, filled only with an empty gurney with a canvas stretcher and wood handles. A clock on the wall covered in a metal casing methodically tracked the passing moments.

Inside the O.R., Dr. Kingsley R. Chin, an orthopaedic surgeon and founder of Less Exposure Surgery Specialists (LESS) Institute in Florida, and Dr. Carl A. Bruce, a consultant neurosurgeon at the University of the West Indies at Mona Jamaica, operated on a fifteen year old young woman. Around them stood Kevin Chappuis, a medical technology engineer from SpineFrontier, Inc, Harisha Buggam, a medical device distributor in the West Indies, and the University’s Chief of Anesthesiology, Dr. Harding. The operation, a high level, scoliosis case, required that surgeons correct a deformity in the patient’s spine.

Shinel Binns, the patient lying on the operating table, was fit and healthy -a normal young woman in every way, except for the severe curve in her spine. Standing up, Shinel’s legs were perpendicular to the ground, but at her waist, her torso and head angled sharply to the left, as if she had to fight gravity from pulling her left shoulder and head to the ground. A lifetime of trying to hold her head and torso upright to counterbalance her lumbar spine’s deformity had begun to create a curve in her thoracic spine.

Shinel lived in Saint Elizabeth Parish –a two hour journey from the hospital she was now being treated at in Kingston, Jamaica. She and her family had waited a long time for this moment. She would never have been able to afford an operation, but the donated time from the doctors, and over $500,000 in donated technology and personnel from SpineFrontier, as well as her community’s donation of $5,000, was making her operation possible.

Dr. Kingsley R. Chin had flown in earlier that day from the United States. Born and raised in Jamaica, he often returned to perform surgeries for people in need. As a pioneer in the Less Exposure Surgery (LES®) approach, Chin has devoted his life to refining and training others in a revolutionary approach to back surgery. The LES Philosophy of surgery pinpoints the problem, fixes it without collateral damage to surrounding tissues, and lets patients go home the same day.

A patient examination and X-Rays had confirmed to the doctors that Shinel’s original spinal deformity was in the lumbar spine. Because the thoracic curve was compensatory to keep her upright, Dr. Chin and Dr. Bruce operated on the most pronounced section of the curve (L1-L4). Dr. Chin used a Less Exposure Surgery (LES) approach, addressing the most pronounced section of the spinal curve (L1-L4) by inserting SpineFrontier’s S-LIFT® Lateral Interbody through a single, three inch incision at those levels to straighten out the spine. The surgeons then placed unilateral MISquito® Percutaneous Pedicle Screws to hold the straightened position.

The LES approach through the small incision on the side of the abdomen was low impact and saved Shinel the trauma of an incision through her stabilizing back muscles that could disrupt her strength. It also minimized the surgical trauma and maximized its effectiveness for a rapid and less painful recovery. This approach was especially important because it would allow a teenage girl to resume her daily activities more quickly. The surgeons expected that the thoracic curve would straighten itself over time. After the operation, Shinel already felt straighter and only had minimal superficial pain.

Harisha Buggum, the medical device distributor, had observed several other scoliosis corrections before through the Scotiabank Scoliosis Programme that provided implants at a greatly reduced cost to teenagers with scoliosis. But she had a renewed sense of excitement when talking about Shinel’s operation.

In this surgery, you could see the technology changing the deformity and you could see the spine literally straightening up through the fluoro imaging. It’s good to know technology has turned in the direction so that someone with scoliosis can actually get a correction from Less Exposure Surgery.”

“I’ve never seen that kind of procedure done,” Harisha said, leaning forward and talking energetically, “This was different for us than our day-to-day [procedures]. In this surgery, you could see the technology changing the deformity and you could see the spine literally straightening up through the fluoro imaging. It’s good to know technology has turned in the direction so that someone with scoliosis can actually get a correction from Less Exposure Surgery.”     

Harisha’s excitement over what she observed in the O.R. was just a small window into the many cases that Dr. Chin and his colleagues at the LESS Institute perform on a daily basis in the United States.

“This case is a perfect example of how Less Exposure Surgery can transform a patient’s life,” Chin commented.

Learn More About Less Exposure Surgery and connect with Dr. Kingsley R. Chin.