Pediatric spine surgery — Big trends and concepts for the future from Dr. Richard Schwend


Richard Schwend, MD, director of the orthopedic research program at Children's Mercy Kansas City (Mo.), past chair of AAP section on Orthopaedics, and President of POSNA- Pediatric Orthopaedic Society of North America, discusses how the pediatric spine field is changing and what to expect in technology development for the future.

Question: What emerging technology or technique do you think will have the biggest impact on the spine field five years from now?

Dr. Richard Schwend: Three key emerging technologies include:

• Growth modulation, tethers in the front, back or combination to guide growth of the spine, maintain flexibility
• Minimally invasive growing rod systems that are flexible and allow continued growth but also flexibility
• Smart braces that apply corrective forces during motion, in the correct location, direction and pressure, avoiding casting

Q: What do you think will fade or disappear from the spine field over the next few years?

RS: Three technologies that I think will disappear are:

• Intraoperative casting
• Current generation of magnetic rods
• Vertical expandable prosthetic titanium ribs

Q: Where do you see the biggest room for innovation in spine? What do you need to provide better care that doesn't currently exist?

RS: Here are four areas to watch:

1. Registries and shared data to better understand natural history, what does and does not work with different treatments.

2. Shared controlled trials to really see what works versus what does not work.

3. Need better understanding of how the pediatric spine and chest grows and moves.

4. What currently does not exist are spine implants that allow normal spine motion while guiding growth and restoring normal balance.

To participate in future Becker's Q&As, contact Laura Dyrda at

For a deeper dive into the future of spine, attend the Becker's 17th Annual Future of Spine + Spine, Orthopedic & Pain Management-Driven ASC in Chicago, June 13-5, 2019. Click here to learn more and register.

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