By Nate Jones
Staff Writer
Miranda Panico, at 10 years old, has undergone a revolutionary new kind of surgery aimed at treating the spinal disease scoliosis.
The Cloukey family of Scarborough is no stranger to the disease. Both of Bonney Coukey’s two children, Sam and Miranda Panico, were diagnosed with scoliosis in November 2005 by Dr. Philip Ansen of Falmouth Orthopedics. Sam Panico, six years older than his sister, was diagnosed first. Cloukey said she thought nothing of Ansen requiring Miranda Panico to be checked for the disease. All that changed when Miranda Panico’s test came back positive.
“I was shocked,” Cloukey said.
Cloukey described the two years following their diagnoses as “a nightmare” as she spent much of that time aiding her son through wearing two different types of medical braces.
“Every day we’d have to fight about it” Cloukey said.
Cloukey described the position that most scoliosis patients suffer through: the forfeiture of privacy, keeping to a strict schedule of adjusting and donning the braces, the inability to be active in sports and other physical activities, in addition to the discomfort caused by the brace itself. Miranda Panico remembered and described the “red gashes dug into his skin” that she observed during her brother’s bracing period.
“Bracing is extremely effective,” Ansen said “The problem is compliance with patients who do not want to wear the brace.”
Despite their efforts with the bracing, Sam Panico’s spinal curve reached a critical 70 degrees and had to be corrected with spinal fusion surgery at Boston Children’s Hospital last April.
When it came to addressing Miranda Panico’s spinal curve, Ansen had a different solution.
“Kids with scoliosis under the age of 10 in the United States are extremely rare, and Miranda came to us at age 8,” Ansen said. “Miranda was a prime candidate for the surgery since she fit the criteria, which in itself is very uncommon.”
Ansen said it is not uncommon for a spinal curve under 40 degrees to be watched and monitored, and often does not require bracing or surgery.
It was by observing Sam Panico’s spinal problems that doctors were able to predict that her spinal curve, 32 degrees at age eight, would need medical attention.
With Miranda Panico’s family history and years of strong growth spurts ahead of her, Ansen said, she was one of a few patients he has ever seen who would have been eligible for the new procedure called Vertebral Body Stapling.
    The new procedure is a non-invasive surgery that Ansen described as “yet to be performed anywhere in Maine.”
Miranda Panico became the second patient to have the procedure performed in Massachusetts Dec. 10 at Boston Children’s Hospital. The procedure was performed by Randal R. Betz, the pioneer behind the procedure and his associate Michael T. Hresko, who are both practicing orthopedic surgeons at Boston Children’s Hospital.
“I thought it would go lower,” stated Miranda Panico, whose spinal curve was decreased from 32 to 25 degrees. Cloukey said that she also had high expectations after Nathan Winslow, another scoliosis sufferer, had the procedure performed early that day, resulting in an 18 degree reduction in his spinal curve.
Miranda Panico and her mother felt confident going into the experimental surgery thanks to the support from support groups such as the online based Vertebral Body Stapling Support group. The support group was founded by Amanda Pompa and Maria Follenius, both mothers of children who underwent the surgery at Shriner’s Hospital in Philadelphia, Pennsylvania. Pompa said that it could be “frustrating as a mother” to find information on such a new procedure.
“You really want the assurance of another parent,” Pompa said.
“I wasn’t really scared, just hoped it would work,” Miranda Panico said. She also admitted feeling relieved that she was able to avoid the frustration she witnessed her brother go through with the bracing technique.
“I know I wouldn’t like it,” she said.
Ansen said if not for the vertebral stapling technique, Miranda Panico would have been undergoing the same bracing method her brother experienced.
    While Ansen pointed out that it is an extreme rarity for patients to be eligible for vertebral stapling, Cloukey and Miranda Panico both expressed hope that in the future many more scoliosis patients may find themselves undergoing the treatment in lieu of enduring the struggle comes with bracing.