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Charles E. Johnston II, M.D.

The principles of posterior spinal fusion are: subperiosteal exposure of the vertebrae, decortication of the laminae and transverse processes, excision of the facet joints, and packing of each facet area with autologous bone.

Third generation spinal instrumentation systems give greater stabilization than earlier methods, obviating the need for external support. However, intraoperative complexity and difficulty with revision remain problematic.

Beginning in 1985, Charles E. Johnston II, M.D., of the Texas Scottish Rite Hospital in Dallas, participated in the development of a new system to address these issues.

In this segment of the VJO, Dr. Johnston performs posterior spinal surgery to correct a 51-degree single right thoracic curve on an 11 1/2-year-old female patient using the TSRH system.

References
1. Johnston CE, Ashman RB, Richards BS Texas Scottish Rite Hospital Posterior Spinal Instrumentation The Pediatric Spine, Principles and Practice Stuart L. Weinstein, editor Raven Press, New York 1994, pp 1585-1618
2. King HA, Moe JH, Bradford DS, Winter FB (1983): The selection of fusion levels in thoracic idiopathic scoliosis J Bone Joint Surg (AM) 65:1302-1313

• Total Run Time: 17:21 minutes
• Catalog Number: 8014
• Publication Date: June 1996

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