Two to four out of 100
people are affected by
scoliosis, a sideways
curvature of the spine.
It occurs most often among
adolescents aged 10 to 16.
At KK Women’s and Children’s
Hospital (KKH), nearly eight out
of 10 newly diagnosed cases
belong to this group. With
increased health literacy, more
cases are also showing up with
early onset of scoliosis, including
those under three years old.
Having scoliosis can undermine
one’s quality of life as it can cause
chronic back pain, particularly
in more severe cases. It can also
cause noticeable differences in
one’s physical appearance, such
as uneven hips and shoulders or
prominent ribs. This can result
in some children becoming selfconscious
about their appearance
and affect their emotional
development, and more so as they
move toward their teenage years.
Milder scoliosis may be
controlled with less invasive or
non-surgical methods, including
orthoses such as a spinal brace.
In severe or late scoliosis where
the spinal curve is more than 45
degrees, surgery is recommended
to correct the condition and
prevent it from worsening.
<<Young patients with severe
scoliosis can benefit greatly from
an improved quality of life after
surgery, said Clinical Associate
Professor Kevin Lim.>>
“When early detection or
other means to correct the
condition is not possible, surgery
is encouraged as early as possible.
After surgery, young patients
can look forward to many years
of developmental growth and
greatly benefit from an improved
quality of life,” said Clinical
Associate Professor Kevin Lim,
Chairman, Division of Surgery and
Senior Consultant, Department of
Orthopaedic Surgery, KKH.
No radiation exposure
After acquiring new technology
in July 2020, KKH doctors have
been able to conduct spinal fusion
surgeries for scoliosis in a safer
and more efficient way without
the use of radiation.
In spinal fusion surgery, rods
and screws are implanted in the
spine to realign and fuse together
the vertebrae so that they heal
into one solid bone mass.
Previously, x-rays had to
be taken during the surgery to
guide surgeons in placing the
screws and implants accurately.
This exposes the patient and
healthcare team in the operating
theatre (OT) to radiation.
The new technology — the 7D
Machine-vision Image Guided
Surgery (MvIGS) system — uses
visible light in place of radiation.
With the system’s patented surgical
light placed above the patient,
built-in camera technology and light
sensors are linked to computing
resources in the OT to provide real-time 3D images. The system
is based on technology similar to
that used in self-driving cars.
KKH is the first hospital in
Asia to install the MvIGS system
developed by Toronto-based
7D Surgical. Within six months of
using the system, 30 patients have
been successfully treated.
“Like a Global Positioning
System (GPS) for surgery, the
MvIGS system, aided by machine
vision technology with real-time
positioning and guidance, helps
paediatric spinal surgeons
perform intricate procedures with
greater accuracy and certainty,”
said Prof Lim.
The technology is advantageous
for spinal deformity surgery
as it has the ability to quickly
and accurately navigate very
small, deformed, or even absent
anatomy. Doing away with x-rays
also elevates the safety of those
involved, and eliminates the need
for costly lead insulation in the OT.
Surgery now takes a shorter
time, with reduced blood loss and
improved workflow productivity
in the OT. Patient spinal identifier
registration is a process where
a patient’s scan images, taken
before the operation, are matched
with his or her anatomy in the OT.
This takes mere seconds, unlike
previously where manual imaging
had to be done and can take
up to 30 minutes.
Shorter surgeries translate
to lower complication rates and
faster postoperative recovery.
“As the placement of screws
is more accurate with the new
technique, it further reduces the
already very low incidence of
nerve and spinal cord injuries.
Many patients and caregivers
have also shared positive
experiences from pre-surgery to
recovery,” said Prof Lim.
What is scoliosis?
Scoliosis is a sideways curvature
of the spine. Often characterised
by an ‘S’ or ‘C’ shape, the
condition may present with
uneven shoulders, asymmetry of
the shoulder blades and waist,
and an apparent leg length
discrepancy. While there is no
known way to prevent scoliosis,
early detection can arrest its
progression. Managing a child or
teenager with scoliosis depends
on several factors, such as age,
skeletal maturity, and severity
of the condition. Visit a doctor if
you notice signs of scoliosis.