Early Onset Scoliosis. Guidelines for Management in Resource-Limited Settings

Chapter 1: Introduction
Alaaeldin Azmi Ahmad

Chapter 2: Economical and organizational problems

• Chapter 2a Economics and Implementing Early Onset Scoliosis in Limited Resources Facilities
  Ahmed Shawky Abdelgawaad
• Chapter 2b: Mismatch in Expectation between Industry & The Countries with Limited Resources
  Aakash Agarwal PhD
• Chapter 2c: Organizational Deficiencies in Developing Countries and The Role of Global Surgery
  Amal Ahmad 

Chapter 3: Education and Research

• Chapter 3a: Blended learning in Training Pediatric Deformity Surgeons
  Emre Acaroglu and Alpaslan Senkoylu
• Chapter 3b: Evidence based Medicine in Low Middle Income Countries
  Patrick Thornley, Devin Peterson and Mohit Bhandari

Chapter 4: Growth of the Spine
Federico Canavese, François Bonnel and Alain Dimeglio

Chapter 5: Pulmonary Evaluation and Management
Laura Ellington, Mary Crocker and Gregory Redding

Chapter 6: Non-surgical management
Muhammad Tariq Sohail and Shahid Ali

Chapter 7: Anesthesia Management
Damarla Haritha and Souvik Maitra
 
Chapter 8: Surgery

• Chapter 8a: Biomechanics of Surgical Intervention
  Aakash Agarwal 
• Chapter 8b: Principles of Surgical Management
  Michael Grevitt
• Chapter 8c: Principles of Preoperative management
  Mohamed Fawzy Khattab
• Chapter 8d: Principles of Intraoperative Management
  Ashok N. Johari, Rashid Anjum and Vrushali Ponde
• Chapter 8e: Principles of Post-Operative management
  Kaustubh Ahuja and Bhavuk Garg
• Chapter 8f: Principles of Management of Long-Term Complications
  Meric Enercan and Azmi Hamzaoglu
• Chapter 8g: Management of Spinal Tuberculosis in Young Children
  S Rajasekaran, Sri Vijay Anand K S, Ajoy Prasad Shetty and Rishi Mugesh Kanna  

Chapter 9 Global Experience in EOS Management

• Chapter 9a: Experience of EOS management in Pakistan
  Amer Aziz and Abdullah Shah
• Chapter 9b: Experience of EOS Management in China
  Yong Hai and Aixing Pan
• Chapter 9c: Experience of EOS Management in Egypt
  Mohammad M. El-Sharkawi and Amer Alkot
• Chapter 9d: Experience of EOS management in Mozambique
  Alaaeldin Azmi Ahmad
• Chapter 9e: Experience of EOS Management in Chile
  Samuel Pantoja
• Chapter 9f: Experience of EOS management in 2 worlds
  Ujjwal Kanti Debnath
• Chapter 9g: Experience of EOS Management in 2 worlds-II
  Fernando Rios, Behrooz A. Akbarnia and Gregory M. Mundis, Jr
• Chapter 9h: Cross Border Spine Surgical Treatment: Issues to Consider
  Harwant Singh

Chapter 10 Future consideration
Alaaeldin Azmi Ahmad

This book follows a context-based approach to management of early-onset scoliosis (EOS) in countries with limited resources in education, finance, and research. Due to the great variety in etiology, onset age, progression rate, and severity associated with EOS, it calls for a unique treatment plan. This book enumerates the optimal provision of surgical and non-surgical services, from education/training of local surgeons, to effective teamwork, to implementing an effective data collection system; helping the surgeon to gain a hands-on experience. It also illustrates the successful execution of deformity correction using real life experiences from countries in Asia, Africa, and Latin America.

• Discusses biomedical principles that will help to get universally standard implants that are credible and affordable for countries with limited resources.
• Specific surgical Guidelines and the ability to develop evidence-based practice for this service would be an interesting read for surgeons working in global organizations as well as to local surgeons.
• First book to focus on countries with limited resources for the management of early onset scoliosis.

Dr. Alaaeldin Azmi Ahmad M.D

A Pediatric Orthopedic Surgeon by training, Dr. Ahmad entered the field of pediatric orthopedic surgery eighteen years ago following a one-year fellowship at Shriner’s Hospital in Los Angeles. Since then, he has initiated pediatric spine surgery and education services in Palestine as well as other countries with limited resources. In his role as a surgeon as well as professor, he holds the position of Professor in Annajah Medical School, Head Of The Pediatric Orthopedic And Spine Unit in Annajah University Hospital, Consultant Pediatric Orthopedic Surgeon in Saint Joseph Hospital – Palestine, and Visiting Consultant Pediatric Spinal Surgeon in Abdali hospital -Jordan. He also holds an adjunct faculty appointment at the orthopedic department in University of South Carolina in Charleston and in the biomedical engineering department at the University of Toledo in Ohio-USA.

As a Pediatric Orthopedic Surgeon, Dr. Ahmad possesses extensive experience in the management of children with spine deformity, with a special interest in early onset scoliosis cases. He invented a new surgical technique that is more affordable than prevailing techniques, and that avoids current surgeries for the growing spine through posterior tethering called Active Apex Correction (APC). Dr Ahmad has presented this technique in numerous international congresses and has published papers in peer reviewed journals discussing its efficiency in the surgical management for children with Early Onset Scoliosis. Currently, this technique is being used in Palestine, Jordan, India, and Mozambique with positive results. Overall, Dr. Ahmad has over than 35 publications in international journals and books, most of them related to early onset scoliosis management. He shares editorial responsibilities as editorial board member in JPO B and as reviewer board member in GSJ, SICOT J, Journal of clinical orthopedic and trauma

Dr. Ahmad has been active in spinal orthopedic education initiatives, both locally and globally. In Palestine he has trained residents in the orthopedic residency program beside being a member of the orthopedic committee of the Palestinian Board for 9 years. He also became head of the orthopedic program at the Palestine International Cooperation Agency (PICA), in charge of developing a Pediatric Spine Surgery Program in Mozambique and Nicaragua as well as pediatric spine missions in Pakistan and Rwanda. Globally, he is a member in the growing spine committee- (SRS), International Outreach Work Group- (NASS), education strategy task force- (AO Spine), spine committee chair and secretary general of World Orthopedic Concern (WOC)- (SICOT), COSECSA international fellow. In addition, he is involved in Weil Cornell Spine education program in Tanzania. He possesses a global vision and the ability and drive to collaborate with colleagues toward the development of education and training programs that can improve spine surgery services in countries with limited resources.

Dr. Aakash Agarwal

Aakash Agarwal, PhD, is the Director of Research at Spinal Balance Inc. (Toledo, USA) and an Adjunct Professor of Bioengineering at University of Toledo (Toledo, USA). Dr. Agarwal is a prolific researcher in the field of preventive and predictive science of spinal pathology and postoperative complications, such as spinal deformity, surgical site infection, hardware failure, and spino-pelvic imbalance. Dr. Agarwal’s primary expertise lies in new preventative measures to combat spinal surgery complications, including surgical site infection, and implant failures associated with early onset scoliosis. His major interests include translational research with immediate bench-to-bedside applicability. He has been a major contributor to several important projects that have been recognized as majorly significant. He uses combinatory knowledge of biomedical engineering, clinical medicine, mechanical engineering, and biomechanics to study surgical failures and new treatments to mitigate the risk of complications and infections. He is the inventor of a "two-step asepsis" process involving providing spinal implants in an individual-sterile tube, and a preloaded intraoperative sheath allowing implants to be handled hygienically, aimed at reducing surgical site infection and biofilm formation. Dr. Agarwal also have extensively explored the mechanism behind scoliosis spinal implants failure in children. Through human trial studies and biomechanical simulations, he identified the high failure rate of certain distraction-based rods and growth-guided systems and also provided guidelines on how to reduce such failure modes. Dr. Agarwal holds several national and international patents. He is an Editorial Board member for the journals Clinical Spine Surgery and Spine by Lippincott Williams & Wilkins. Dr. Agarwal also is an Advisory Board member for Center for the Disruptive Musculoskeletal Innovation (CDMI) under the aegis of the National Science Foundation (NSF).