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Mount Sinai Spine Center
5 East 98th Street, 4th floor
New York, NY 10029

Mount Sinai Doctors Manhasset
1155 Northern Boulevard,
3rd Floor, Suite 300
Manhasset, NY 11030

Posts by scoliosisass3

Surgeon Paves the Way for Non-Fusion Correction of Scoliosis

https://reports.mountsinai.org/article/ortho2021-02-mount-sinai-surgeon-paves-the-way-for-non-fusion-correction-of

 

Mount Sinai orthopedic surgeon Baron S. Lonner, MD, is leading the charge to add vertebral body tethering to the spine surgeon’s toolbox. Dr. Lonner has performed more procedures using the device than any other surgeon worldwide.

In August 2019, vertebral body tethering (VBT) was approved by the U.S. Food and Drug Administration, joining spinal fusion and rigid bracing as time-tested options to treat adolescents with abnormal lateral or side curvature of the spine whose bones have not fully matured. The approval marked an exciting new era in corrective surgery for idiopathic scoliosis and Mount Sinai orthopedic surgeon Baron S. Lonner, MD, is leading the charge to add the procedure to the spine surgeon’s toolbox. Having performed nearly 350 VBT procedures in recent years—more than any other surgeon worldwide with the approved device—Dr. Lonner is well positioned to lead the pack.

Currently, two surgical non-fusion devices have been approved by regulators in the United States. The Tether™ Vertebral Body Tethering System, which was developed by Dr. Lonner and other surgeons as well as a group of engineers, and the ApiFix System (ApiFix Ltd., Israel) for motion-sparing scoliosis correction. Dr. Lonner played an advisory role in the latter device.

“Spinal fusion has performed well traditionally for people with severe spinal deformity, and remains the gold standard,” says Dr. Lonner, who is Chief of Minimally Invasive Scoliosis Surgery and Professor of Orthopedics, and Pediatrics at the Icahn School of Medicine at Mount Sinai. “But if the curvature is moderate and more flexible, then the Tether can deliver excellent outcomes. In fact, we have seen correction of a 50-degree curve down to about 15 degrees or less, for example, while preserving spinal flexibility and function over time. And, patients are able to return to sports and other activities soon after surgery.”

Surgical Differences in the Approved Devices

Dr. Lonner continues to work with industry partners and their engineering and manufacturing arms to nurture the next generation of high-performance, non-fusion technologies and devices for spinal correction. For now, Tether and ApiFix are underscoring the surgical possibilities.

During the Tether procedure, the surgeon places an anchor and bone screws made of a titanium alloy into the patient’s spine on the convex (outwardly curved) side of the spinal curve through an anterior approach. With the help of thoracoscopic visualization and very small incisions, a flexible cord made of a polyethylene-terephthalate polymer is secured to the bone screws, and the surgeon applies tension to the cord to partially straighten the spine. After surgery, the cord continues to straighten the spine while the patient grows.

Dr. Lonner discusses the Mount Sinai Health System’s Non-Fusion Scoliosis Correction Program.

The ApiFix System is somewhat different, attaching to the spine on the concave side of the curve and maintaining a good deal of the patient’s natural flexibility through a self-adjusting rod mechanism that allows for additional post-operative correction. This procedure is performed from a posterior or back approach. The device can even be removed if the curve remains straight after a corrective period of three or more years. “ApiFix works well for children who have failed with an external brace—either their curve is getting worse or they cannot tolerate it emotionally or psychologically,” notes Dr. Lonner.

The Path Ahead for VBT

Dr. Lonner acknowledges there is a steep learning curve for vertebral body tethering, which might detract from quick and widespread adoption by the orthopedic field. Nonetheless, he has seen a good deal of enthusiasm among colleagues around the world for the now-approved technology, as evidenced by the numbers of surgeons undergoing training to become certified in the use of the technique for their patients. “There will always be a role for fusion surgery because of its ability to address larger curves,” Dr. Lonner allows, “but VBT and ApiFix have shown they can produce dramatic corrections in children with remaining growth. Just as importantly, having these tools available will allow surgeons, together with patients and their families, to be more proactive in addressing spinal curvature earlier on—before it becomes severe and requires fusion correction.”

Concludes Dr. Lonner, “Given the various options I can now offer my patients, this is a truly inspiring time to be a spine surgeon.”

Featured

Baron S. Lonner, MD

Baron S. Lonner, MD

Professor Orthopedic Surgery and Pediatrics

Keegan undergoes VBT

Thrown For A Curve – full from Sheryl Matthys on Vimeo.

Source – https://keegancares.com/scoliosis/

For years I’ve taken dance classes, gymnastics, and performed in musicals.  Because of my activities, I thought my back was ‘tight’.  I’ve been to the doctor for colds, concussions, and other things, but we didn’t know to ask ‘to get checked’ for scoliosis.

My diagnosis went unnoticed until one day at the age of 13 while at Wittler Orthodontics, the office manager Julie Downs spotted my shoulder blade sticking out.  She called my mom later that day after talking to her boss as to whether she should say something.  We’re so grateful she spoke up.

Upon consulting with several doctors in various states, my diagnosis of a 48º curve was too late for bracing to be effective.  My best option was surgery.  I underwent VBT (vertebral body tethering of T5-T12) which is a newly FDA approved surgery that uses a rope to maintain spine flexibility instead of fusion with two steel rods.

In my state, our legislature decided scoliosis screening was not necessary for schools and that pediatricians could handle it.

I’m an example that doesn’t work.
Had my school screened for scoliosis, had my doctor done the Adams Forward Bend test or used a scoliometer at any of my ‘sick’ visits, it may have been caught sooner.  Doctors may only screen on a designated ‘wellness’ visit or possibly at a sports physical.

This leaves too many kids left unchecked.
And, it’s such a fast and simple thing to do.

It’s my mission to speak with schools and youth groups of the signs of scoliosis and to have schools annually check kids grades 5 to 8 via the Adams Forward Bend Test.  I share my ‘before’ photo as a flyer so you can spot the signs of scoliosis too.

I have a speech, a talk, and flyers.  Contact me if you’d like the flyer on the right sent to you and/or to speak to your organization or if you’d like to support this not-for-profit cause.

Keegan Cares, Inc is a 501(c)(3) organization.

scoliosis_flyer_front_back

COVID-19 Update May 2020

Dear Patients and Your Families,

Finally, we are getting the team back together after we have been separated in order to be mobilized to care for patients in the fight against COVID-19. My team and I will be proceeding with patient care. We have been doing many Telemedicine visits with pre-operative and post-operative patients as well as for non-surgical patients. We will start seeing patients in the practice on May 19th. Our first surgery will be on May 27th and we are fully booked for June and most of July, part of August. We can readily find additional surgical slots for families in need.

The following are some of the protocols put in place. I can assure you that our team and the entire Mount Sinai organization are and will do everything possible to prevent exposure to COVID-19.  During office hours, there will only be one patient seen at a time, we will not have multiple patients in exam rooms at any given time. Patients and their families will be asked about symptoms of COVID and if they are symptomatic, they will be tested and not be seen. Only one parent can come in with the patient in order to minimize exposure for anyone. We can do FaceTime for a second parent who might want to be part of the discussion. I have done that frequently throughout my career. All patients and family members and staff will wear a mask at all times. The rooms and facilities are frequently being cleaned over and over and over again. Telemedicine or E-consults will remain a good option for all families before and after surgery but we will need to see preoperative patients at least one time prior to surgery.

All surgical patients will be tested at Mount Sinai within two days prior to surgery, only one parent will be allowed to stay at the hospital and with their child after surgery at a time. The parent will have to wear a mask throughout the hospital stay. The facilities have been cleaned, sterilized, inspected and are constantly being cleaned. Patients will not be roomed anywhere near a COVID + patient. 

I can very much appreciate the families’ and patients’ concerns. Let me assure all that Mount Sinai Hospital is a world-class institution. I was personally involved in the care of COVID patients several weeks ago, the hospital teams have amongst the most experience with this disease than any other hospital in the United States. The protocols have been developed and refined with the highest level of expertise. I am proud to say, thousands of lives were saved at Mount Sinai Hospital during this pandemic. My patients and their families will, as always, be the highest priority of my team and I and the hospital staff are looking forward to welcoming and caring for them. We will be available 24-7 to ensure a safe and comfortable experience.

Stay well, be healthy, and let us all have a renewed appreciation for all the blessings we have in life.

My best to all,

Baron Lonner. M.D. 

Chief of Minimally Invasive Scoliosis Surgery

Mount Sinai Hospital

Coronavirus Disease 2020 (COVID-19)

Dear Patient and Family,

Our Team at Scoliosis Associates and Mount Sinai Hospital Spine understand that you and your family may be experiencing personal hardships or concerns related to the COVID-19 Coronavirus outbreak and pandemic. We also understand that you would like your child or other family member to receive care, recommendations and counseling about their spinal condition. 

My team and I are here for you, we will be available via email, Telemedicine and E-Consults and look forward to resuming standard practice as soon as this current event passes.

In the meantime, we ask that you reach out to us with any questions or to arrange an E-consult. Please reach out to Patricia Permaul, 212-241-8312, or by email, patricia.permaul@mountsinai.org. Future office visits in the weeks and months ahead can be arranged through our appointment line, 212-241-8947.

Stay well, my very best to you, your family, and friends,

 

Baron Lonner, MD

Chief of Minimally Invasive Scoliosis Surgery

Mount Sinai Hospital 

Professor of Orthopaedic Surgery

Icahn School of Medicine

 

Mount Sinai Spine Center

5 East 98th St, 4th floor, Box 1188

New York, NY 10029

Office: 212-241-8312

Appointments: 212-241-8947

Fax: 646-537-9449

www.scoliosisassociates.com

June Is Scoliosis Awareness Month

As a member of the Scoliosis Research Society, Dr. Baron Lonner is happy to announce that June is Scoliosis Awareness Month. All over the United States of America, the Society will be raising awareness about scoliosis and its treatment.

Origins.

It was in 2008 that the National Scoliosis Foundation received the first official public proclamation from the US House of Representatives. Congresswoman Allyson Schwartz (PA) declared that each June would be a month of education and awareness about patient care, screening, privacy, and protection.

In 2009, the Scoliosis Research Society joined forces with the NSF to engage in a coordinated national program reaching across institutions, including schools, hospitals, clinics and private practices.

NSF and SRS are now joined by the International Research Society for Spinal Deformity and the Society on Scoliosis Orthopedic and Rehabilitative Treatment. Scoliosis Awareness month is an annual event which provides professionals in the field with a forum for raising the profile of scoliosis.

Campaign objectives.

Based on the statement: “The sooner detected, the better corrected”, Scoliosis Awareness Month hopes to diffuse the importance of early detection and the effectiveness of the therapeutic intervention with bracing.

To that end and in the service of greater public awareness, we wish to see every state, commonwealth, and district officially declare and observe June as Scoliosis Awareness Month to further educational efforts all over the USA.

At the community level, we encourage and support local advocacy and events which highlight scoliosis and its treatment. Part of this effort involves bringing together stakeholders like patients and their families, physicians and clinicians, to collaborate for enhanced care, screening, privacy and protection for those living with scoliosis.

By building communicative, collaborative networks, we hope to bring more public attention to the work we’re doing in the field and to the challenges of people with scoliosis.

What you can do.

While our goal to have June officially declared Scoliosis Awareness Month in every corner of the USA is becoming more reality than dream every year, we’re still not there. This year, SRS will contact Governors in all states who’ve not yet proclaimed, to respectfully request that they join the rising movement supporting scoliosis awareness across the country.

That’s why we’re calling on you to join us and do your part to raise awareness about scoliosis, by writing to your state Governor. Speak from the heart, simply stating why you believe scoliosis to be an important public health concern that deserves greater awareness.

Your voice is important, this June. Dr. Lonner and the team at Scoliosis & Spine look forward to bringing more information about this condition into the public square, particularly focusing on early intervention with conservative therapies that can help patients avoid surgery.

At Scoliosis & Spine, we celebrate the victories recent years have brought to advances in scoliosis care and treatment, but we know that more can be done. By reaching out to your state Governors, you’re joining in the fight to educate the public and empower patients and their families.

Dr. Lonner and the Scoliosis & Spine team invite you to join us, this June.

How to Tell If Your Child Has a Curved Spine

Scoliosis is a serious condition, predominantly affecting children between ages 10 to 16. Presenting as a curved spine, the condition can also be seen in younger children and adults.

If you suspect your child may have this condition, there are some simple ways to discern if there’s a curvature in play. How to tell if your child has a curved spine is a matter of observation on your part.

Things to look for.

When your child’s spine has a curve, the effect can be rotation of the ribs. To discern whether this is the case, ask your child to bend forward. If there’s a curvature, it will be indicated by an elevated portion of the ribcage when looking at your child’s back.

Scoliosis may also cause children to habitually lean to one side or the other, or for one shoulder to sit higher than the other. Some children will have one shoulder blade that protrudes. A lump or hump on one side of the back is another sign your child has a curved spine.

Timely diagnosis is key.

While children are still growing, spinal curvatures will become more pronounced. If you see any of the foregoing symptoms in your child, it’s, therefore, crucial that you seek a diagnosis as soon as possible, so remedial treatment can be applied.

Infantile scoliosis is not as simple to detect as scoliosis in older children and occurs in toddlers and infants under the age of three. Sometimes, a spinal curvature in children of this age group will improve. Once an infant can sit up, though, a curve can be more easily discerned.

Young children should undergo diagnostics like x-rays to determine if a curve is present. A scoliosis diagnosis in the early years of a child’s life can mean more severe problems later in life, like pulmonary issues. As the spine continues to twist, breathing may become difficult.

With timely diagnosis, scoliosis in very young children can be ameliorated with the use of a plastic brace to slow the curvature.

Scoliosis and pain.

Approximately 1/3 of children with scoliosis experience pain, but you can help your child relieve this with targeted stretching and strengthening exercises for the core.

I advise that you pursue a clinically directed program, in addition to your own efforts, as these have seen amazing results in children with curved spines. The Scroth Method and scoliosis-specific Yoga are two examples of therapeutic exercise that can contribute to better health and wellness, as well as pain relief.

Scoliosis and Spine Associates.

As I said earlier, the first thing you should do once you’ve determined that your child has a curved spine is to seek diagnosis. Depending on the severity of the condition, Scoliosis and Spine can then proceed with appropriate treatment.

At Scoliosis and Spine, we favor a conservative therapeutic approach. We’re on the leading edge of innovation and state-of-the-art treatments to serve our patients with spine care that puts their needs first.

Contact the Scoliosis and Spine Associates team. Let us help.

Adolescent Idiopathic Scoliosis – Staying Ahead of the Curve

This variety of scoliosis is a challenge for both patient and doctor, but it’s a challenge that can be met with the right approach.

Adolescents go through growth spurts and during those times, curvatures caused by scoliosis can progress rapidly. That said, there are also periods during which progression is extremely slow. Adolescent idiopathic scoliosis (AIS) treatment and care require vigilance and pro-active approaches to stay ahead of the curve.

New research offers hope.

Scoliosis & Spine Associates is fortunate to benefit from the work of our lead specialist, Dr. Baron Lonner. His role as a leader in scoliosis research brings our patients leading-edge care derived from ongoing research into treatment and prevention of scoliosis.

A study by the Chinese University of Hong Kong recently revealed that supplements can play a role in the treatment of AIS. Combining Vitamin D with calcium is being identified as a therapy capable of preventing the progression of scoliosis curvature in girls between the ages of 11 and 14.

Subjects in the study with a Cobb angle of 15 degrees who were also suffering from reduced bone mass, responded favorably to supplementation. The supplements were blind-tested against a group of study participants receiving a placebo, in two groups with different dosage levels.

After two years, the combination of Vitamin D and calcium showed significant improvement in the groups who’d received the supplements. There is hope that this therapeutic approach will revolutionize the treatment of AIS.

Ongoing study.

Research continues into the role of supplementation in the prevention and treatment of AIS. Researchers are also exploring the role of nutrition in staying ahead of the curve and supporting patients with the condition.

The future for young people suffering from AIS is brighter, as physicians begin to see the value of the Hong Kong research as an ongoing practice in the treatment of their AIS patients.

But with Adolescent idiopathic scoliosis, staying ahead of the curve demands a sensitive partnership between physicians and patients that maintains vigilance over progression. Every patient is different.

While supplementation is a hopeful addition to the arsenal in the war on scoliosis, other therapeutic approaches are deployed for maximum effect.

A comprehensive approach.

A comprehensive approach to AIS implicates a variety of therapies working together to stay ahead of the curve. Bracing and physical therapy are part of that.

Bracing serves to stabilize curvatures, particularly during periods of rapid growth. Physical therapy, which may come in the form of scoliosis-specific Yoga, stretching and strengthening, works to build the patient up physically, also promoting patient physical awareness.

It’s our belief at Scoliosis & Spine that a plan for treatment should be developed between the caregiver and the patient, resulting in a coordinated and pro-active program in which the two parties to treatment work together closely.

At the root of a comprehensive approach to AIS is the relationship between doctor and patient that’s built on trust and common purpose – staying ahead of the curve.

Contact us for more information about Adolescent idiopathic scoliosis and staying ahead of the curve.

Scoliosis awareness logo

June Is Scoliosis Awareness Month

As a member of the Scoliosis Research Society, Dr. Baron Lonner is happy to announce that June is Scoliosis Awareness Month.  All over the United States of America, the Society will be raising awareness about scoliosis and its treatment.

Origins.

It was in 2008 that the National Scoliosis Foundation received the first official public proclamation from the US House of Representatives.  Congresswoman Allyson Schwartz (PA) declared that each June would be a month of education and awareness about patient care, screening, privacy, and protection.

In 2009, the Scoliosis Research Society joined forces with the NSF to engage in a coordinated national program reaching across institutions, including schools, hospitals, clinics and private practices.

NSF and SRS are now joined by the International Research Society for Spinal Deformity and the Society on Scoliosis Orthopedic and Rehabilitative Treatment.  Scoliosis Awareness month is an annual event which provides professionals in the field with a forum for raising the profile of scoliosis.

Campaign objectives.

Based on the statement: “The sooner detected, the better corrected”, Scoliosis Awareness Month hopes to diffuse the importance of early detection and the effectiveness of the therapeutic intervention with bracing.

To that end and in the service of greater public awareness, we wish to see every state, commonwealth, and district officially declare and observe June as Scoliosis Awareness Month to further educational efforts all over the USA.

At the community level, we encourage and support local advocacy and events which highlight scoliosis and its treatment.  Part of this effort involves bringing together stakeholders like patients and their families, physicians and clinicians, to collaborate for enhanced care, screening, privacy and protection for those living with scoliosis.

By building communicative, collaborative networks, we hope to bring more public attention to the work we’re doing in the field and to the challenges of people with scoliosis.

What you can do.

While our goal to have June officially declared Scoliosis Awareness Month in every corner of the USA is becoming more reality than dream every year, we’re still not there.  This year, SRS will contact Governors in all states who’ve not yet proclaimed, to respectfully request that they join the rising movement supporting scoliosis awareness across the country.

That’s why we’re calling on you to join us and do your part to raise awareness about scoliosis, by writing to your state Governor.  Speak from the heart, simply stating why you believe scoliosis to be an important public health concern that deserves greater awareness.

Your voice is important, this June.  Dr. Lonner and the team at Scoliosis & Spine look forward to bringing more information about this condition into the public square, particularly focusing on early intervention with conservative therapies that can help patients avoid surgery.

At Scoliosis & Spine, we celebrate the victories recent years have brought to advances in scoliosis care and treatment, but we know that more can be done.  By reaching out to your state Governors, you’re joining in the fight to educate the public and empower patients and their families.

Dr. Lonner and the Scoliosis & Spine team invite you to join us, this June.

a smiling young boy from the front and from behind

How to Tell If Your Child Has a Curved Spine

Scoliosis is a serious condition, predominantly affecting children between ages 10 to 16.  Presenting as a curved spine, the condition can also be seen in younger children and adults.

If you suspect your child may have this condition, there are some simple ways to discern if there’s a curvature in play.  How to tell if your child has a curved spine is a matter of observation on your part.

Things to look for.

When your child’s spine has a curve, the effect can be rotation of the ribs.  To discern whether this is the case, ask your child to bend forward.  If there’s a curvature, it will be indicated by an elevated portion of the ribcage when looking at your child’s back.

Scoliosis may also cause children to habitually lean to one side or the other, or for one shoulder to sit higher than the other.  Some children will have one shoulder blade that protrudes.  A lump or hump on one side of the back is another sign your child has a curved spine.

Timely diagnosis is key.

While children are still growing, spinal curvatures will become more pronounced.  If you see any of the foregoing symptoms in your child, it’s, therefore, crucial that you seek a diagnosis as soon as possible, so remedial treatment can be applied.

Infantile scoliosis is not as simple to detect as scoliosis in older children and occurs in toddlers and infants under the age of three.  Sometimes, a spinal curvature in children of this age group will improve.  Once an infant can sit up, though, a curve can be more easily discerned.

Young children should undergo diagnostics like x-rays to determine if a curve is present.  A scoliosis diagnosis in the early years of a child’s life can mean more severe problems later in life, like pulmonary issues.  As the spine continues to twist, breathing may become difficult.

With timely diagnosis, scoliosis in very young children can be ameliorated with the use of a plastic brace to slow the curvature.

Scoliosis and pain.

Approximately 1/3 of children with scoliosis experience pain, but you can help your child relieve this with targeted stretching and strengthening exercises for the core.

I advise that you pursue a clinically directed program, in addition to your own efforts, as these have seen amazing results in children with curved spines.  The Scroth Method and scoliosis-specific Yoga are two examples of therapeutic exercise that can contribute to better health and wellness, as well as pain relief.

Scoliosis and Spine Associates.

As I said earlier, the first thing you should do once you’ve determined that your child has a curved spine is to seek diagnosis.  Depending on the severity of the condition, Scoliosis and Spine can then proceed with appropriate treatment.

At Scoliosis and Spine, we favor a conservative therapeutic approach.  We’re on the leading edge of innovation and state-of-the-art treatments to serve our patients with spine care that puts their needs first.

Contact the Scoliosis and Spine Associates team.  Let us help.

young girl with scoliosis standing at the meadow and looking at the distance

Adolescent Idiopathic Scoliosis – Staying Ahead of the Curve

This variety of scoliosis is a challenge for both patient and doctor, but it’s a challenge that can be met with the right approach.

Adolescents go through growth spurts and during those times, curvatures caused by scoliosis can progress rapidly.  That said, there are also periods during which progression is extremely slow.  Adolescent idiopathic scoliosis (AIS) treatment and care require vigilance and pro-active approaches to stay ahead of the curve.

New research offers hope.

Scoliosis & Spine Associates is fortunate to benefit from the work of our lead specialist, Dr. Baron Lonner.  His role as a leader in scoliosis research brings our patients leading-edge care derived from ongoing research into treatment and prevention of scoliosis.

A study by the Chinese University of Hong Kong recently revealed that supplements can play a role in the treatment of AIS.  Combining Vitamin D with calcium is being identified as a therapy capable of preventing the progression of scoliosis curvature in girls between the ages of 11 and 14.

Subjects in the study with a Cobb angle of 15 degrees who were also suffering from reduced bone mass, responded favorably to supplementation.  The supplements were blind-tested against a group of study participants receiving a placebo, in two groups with different dosage levels.

After two years, the combination of Vitamin D and calcium showed significant improvement in the groups who’d received the supplements.  There is hope that this therapeutic approach will revolutionize the treatment of AIS.

Ongoing study.

Research continues into the role of supplementation in the prevention and treatment of AIS.  Researchers are also exploring the role of nutrition in staying ahead of the curve and supporting patients with the condition.

The future for young people suffering from AIS is brighter, as physicians begin to see the value of the Hong Kong research as an ongoing practice in the treatment of their AIS patients.

But with Adolescent idiopathic scoliosis, staying ahead of the curve demands a sensitive partnership between physicians and patients that maintains vigilance over progression.  Every patient is different.

While supplementation is a hopeful addition to the arsenal in the war on scoliosis, other therapeutic approaches are deployed for maximum effect.

A comprehensive approach.

A comprehensive approach to AIS implicates a variety of therapies working together to stay ahead of the curve.  Bracing and physical therapy are part of that.

Bracing serves to stabilize curvatures, particularly during periods of rapid growth.  Physical therapy, which may come in the form of scoliosis-specific Yoga, stretching and strengthening, works to build the patient up physically, also promoting patient physical awareness.

It’s our belief at Scoliosis & Spine that a plan for treatment should be developed between the caregiver and the patient, resulting in a coordinated and pro-active program in which the two parties to treatment work together closely.

At the root of a comprehensive approach to AIS is the relationship between doctor and patient that’s built on trust and common purpose – staying ahead of the curve.

Contact us for more information about Adolescent idiopathic scoliosis and staying ahead of the curve.