18 August 2020, Singapore – As the complete paediatric scoliosis and spine care specialist, the Musculoskeletal Centre (MSC) at KK Women’s and Children’s Hospital (KKH) now delivers intraoperative spinal procedures with an advanced navigation system that is radiation-free. In under two weeks, KKH has performed Asia’s first four successful surgeries on paediatric scoliosis patients using the 7D Machine-vision Image Guided Surgery (MvIGS) system.

Scoliosis, a lateral curvature of the spine, sees the highest incidence among adolescents aged 10 to 16, representing close to 80 percent of newly diagnosed cases at KKH. With increased awareness, there are more cases being presented with early onset of scoliosis in younger children, including those under three years old. Surgical treatment would be recommended for cases with severe1 scoliosis, or even to arrest the progression of the condition.

Guided by machine vision technology with real-time positioning and guidance, paediatric spinal surgeons at KKH can perform intricate procedures with greater clarity and certainty, resulting in
  • Improved workflow productivity in the operating theatre, with time for patient spinal identifier registration reduced from 30 minutes to mere seconds. This translates to shorter, more efficient surgery, with very minimal blood loss;
  • Even more accurate screw placement under direct vision, further reducing the already very low incidence of nerve and spinal cord injuries; and
  • Elimination of x-ray use during surgical navigation, taking radiation safety of patients and healthcare teams to a new level in contrast to current conventional surgery methods. The operating theatre no longer needs to be outfitted with expensive lead insulation.

Associate Professor Kevin Lim, Chairman, Division of Surgery and Senior Consultant at the Department of Orthopaedic Surgery, KKH said, “Our Musculoskeletal Centre has been transforming paediatric patient care to become the one-stop provider for orthopaedic treatment, management and orthotic services. The Centre also offers evidence-based care dedicated to paediatric sports and exercise medicine. To foster and enable active lifestyles and improve quality of life for our paediatric patients, the Centre embraces a holistic approach toward muscle and bone development with pre-emptive, prescriptive, pre- and post- operative care management.”

Holistic paediatric back and spine care
Through its Musculoskeletal Centre (MSC) and Paediatric Orthotic Centre (POC), KKH offers complete treatment and day-to-day management of bone deformities, fractures, scoliosis and neuromuscular diseases in persons up to 18 years of age. Adolescents and children can look forward to many years of developmental growth and greatly benefit from an improved quality of life.

With a dedicated sports and exercise medicine practice, and the use of orthopaedic imaging with low-dose radiation (known as EOS), these make the MSC a true end-to-end, patient-centric musculoskeletal specialist service in Singapore.

For over 20 years, KKH has been providing paediatric orthotic services as part of multidisciplinary treatment for children with conditions like scoliosis, cerebral palsy, flat feet and complex congenital deformities. Locally, the POC is the only facility with in-house prosthetists and orthotists, and an onsite orthosis fabrication workshop to fulfil demands for timely, personalised needs of patients with lower limb and spine conditions.

Patient experience at the MSC
Based on treatment outcomes and experience, a recent teenage patient study revealed scores from KKH MSC are
  • on par with global counterparts – in patients’ ability to perform routine and social activities, pain, self-image, mental health, and satisfaction with case management, and
  • close to perfect score (on a scale of 4) - in satisfaction and care from nurses, doctors and cross-discipline clinical team.

S. Ariffin, parent of an in-patient at MSC in June 2020, said, “This is my first experience with KKH - for me and my child who has scoliosis. As a first time parent with a child who needs to go through a surgery, every detail is important. The thoughts of whether I’m making the right decision for my child is crucial at any point.”

Beyond patient safety and the best possible outcomes, KKH is guided by transforming patient care and experience. “My big thanks also goes to the team that helped with my child’s pain management. With all the positive support she gets, my child is able to walk confidently within a short period of time. Thank-you to all,” added the parent, on the child’s post-operative experience.

1 Exceeding a Cobb angle of 45 degrees, an indication of curvature in vertebral column disorders.