History of Scoliosis Surgery at HSS
This is the fourth in a series of blog posts celebrating the 150th anniversary of HSS. Throughout the year you’ll hear from varied departmental representatives on the evolution of their clinical service and the hospital overall. We hope you’ll enjoy this look back as we continue to lead musculoskeletal medicine into the future.
Dr. David B. Levine was chief of Scoliosis Surgery at HSS from 1967 to 1994 and is director of alumni affairs and chair of the HSS Archives Committee. Dr. Levine spoke to us about the history of scoliosis surgery at HSS. Visit the blog tomorrow for a perspective on emerging research in the prevention and treatment of scoliosis.
How did you become interested in scoliosis?
When I came to HSS in 1961 as a first year orthopedic resident, Dr. John Cobb, the long-time chief of Scoliosis and world famous expert in the field, was recovering from a stroke. Young surgeons-in-training had come to HSS from all over the world since the early 1950s to learn from Cobb. Dr. Philip D. Wilson, Jr., had temporarily taken over as chief of the scoliosis service, but there was a need for someone trained in the newer methods of treating scoliosis patients with associated pulmonary disorders. HSS arranged for me to train further at Ranchos Los Amigos Hospital in California, a county center for post-polio patients.
What was the standard of care when you began your practice?
Back in the days of Cobb, surgeons used a full body turnbuckle cast. The whole treatment process lasted about year, with the child unable to get out of bed. The patient first wore a cast from the head down to one thigh. We then cut the cast in half with a big tree saw and applied a metal screw-type lever called a turnbuckle on one side. Over a period of about five weeks, we turned the turnbuckle.
This turning motion corrected the curve. The patient had to lie down in this cast for five to six weeks. After the curve was corrected, surgeons cut a window in the cast, through which they performed surgery. Since anesthesia in the late 1950s and 60s was limited, surgeries could not last longer than two hours, so several surgeries on one patient were staged at two week intervals. Recovery from surgery was often nine months. Finally, the patient needed to learn how to walk again before going home.
Everything changed in 1963 when Dr. Wilson, Jr., and Dr. Konstantin Veliskakis performed the first Harrington rod procedure at HSS. The Harrington rod was attached to the spine with hooks. A wire was then used to pull the vertebrae together so the curve would straighten. The vertebrae were then fused together so they would stay straight. Once Harrington rods were developed, recovery became much easier for patients.
David B. Levine, M.D., is director of alumni affairs and chair of the HSS Archives Committee. He joined the staff of HSS in 1961 and served in many HSS leadership positions before retiring from HSS in 1995, including chief of the Scoliosis Service (1968-1994), director of the Department of Orthopedic Surgery (1987-1990) and chairman of the Orthopedic Residency Training Program (1987-1990). In 2002, HSS established the Annual David B. Levine Honorary Lecture in the field of scoliosis. In 2006, the David B. Levine, M.D., Chair was established in his honor. In 1988 Levine served as president of the HSS Alumni Association, a role that stimulated his interest in the history of HSS and medical history in general. Levine returned to HSS in his current roles with alumni affairs in 2003. He is author of the book “Anatomy of a Hospital,” on the history of HSS.