Suiting Up For the Future
Tags: 3D Printing, Surgery, Technology, Orthopedic Surgery

“My advice, I think, would be that sometimes you may wish to be something, but it may not happen. Because life is never completely predictable.”

Nestled among the numerous buildings in the famed Queen Mary Hospital, the unassuming appearances of the Department of Orthopaedics and Traumatology of HKUMed would resemble any normal office with fluorescent lights, conference rooms, and cubicles.

But hidden behind the façade of a normal office, the department is where some of the best of technology crosses over with medicine, housing some of the latest in 3D printing for surgery, and researchers exploring the latest advancement tech can bring to orthopaedics.

“In the future, hopefully, we can really build an Iron Man for people who are paralyzed, to allow them to get up and move normally,” said Professor Kenneth Cheung, the Jessie Ho Professor in Spine Surgery and the head of the Department of Orthopaedics and Traumatology.

Recognized as one of the world’s top experts in surgery in scoliosis, Professor Cheung has been leading the department since 2012. In addition to running the department, he is a familiar face to those who follow the latest technological advancements in medicine and surgery.

Professor Kenneth Cheung explains how 3D printing is being used by surgeons to be more accurate during procedures.

“Technology that many of us are familiar with are actually making a difference now in medicine, and of course, in my field, in orthopedics, in particular. Things like computer vision, machine learning, big data use, this is now making changes to the things that we do,” said Professor Cheung.

No stranger to the impact of technology on medicine, Professor Cheung sees the changes technology is making on medicine, surgery, and orthopaedics.

“I think as a surgeon, I’m interested in helping patients. And what I see as a surgeon, is that what we are doing now is not perfect. There is room for improvement.”

In 2019, a surgical team led by the department performed the first non-fusion scoliosis surgery by vertebral body tethering in Hong Kong, a minimally invasive procedure to correct scoliosis, a spinal deformity when a patient’s vertebrae grow sideways causing a lifetime of discomfort and pain.

‟This new technique is the beginning of a new era in the surgical treatment of scoliosis. Children can look forward to normal activities without the psychological burden of bracing or effects of a long fusion surgery,” said Professor Cheung in 2019 at a press conference held at HKUMed.

(From left) Dr Kenneth Wong (Clinical Associate Professor and Chief of Division of Paediatric Surgery of Department of Surgery), patient’s mother Mrs Cho, Professor Kenneth Cheung (Head of Department of Orthopaedics and Traumatology) and Dr Kenny Kwan (Clinical Assistant Professor of Department of Orthopaedics and Traumatology).

Approximately 3.5% of the people in Hong Kong suffer from scoliosis, and 0.1% are diagnosed with severe scoliosis. In traditional fusion spine surgery, a surgeon will make long incisions in the back, cutting through muscle and tissues in order to insert rods and screws. Despite a correction from the procedure, a patient’s spine will become stiff and restrict the patient’s range of movement and mobility.

Through the vertebral body tethering (VBT), a minimally invasive procedure which screws are inserted into the vertebrae of a patient and then connected together by a tether where tension is applied, scoliosis patients can retain greater mobility by utilizing the patient’s growth potential to gradually correct the sideway curvature.

“Patients recover faster, there’s no need to use external braces or invasive fusion surgery, no need to leave large wounds, and the spine remains mobile,” said Professor Cheung.

The first Hong Kong VBT surgery was performed on a 9-year-old in 2019, and the patient has since recovered and returned to full activities.

A member of three generations of doctors in the Cheung family, Professor Cheung chose to specialize in orthopaedics because of his enjoyment for handicrafts. He also found the immediate improvements and results from a surgery gratifying.

However, his dream is to create an Iron Man suit for patients such as Christopher Reeve, the famed actor who portrayed Superman in the iconic 70’s and 80’s movie. In 1995 Reeve became quadriplegic, losing mobility from the neck down after a horse-riding accident.

Professor Kenneth Cheung has spent time thinking about the solution and the role of exoskeletons for patients such as Christopher Reeves.

“We now have assistive technology whereby we can help people who are paralyzed to walk again, these are what we call exoskeletons. These are in essence robotic legs that they can put on, and allows them to get up and walk. They are a little bit cumbersome at this moment.”

And with improvements in battery technology and the engine that drives the leg movements, Professor Cheung sees this as the first step to his plan for an Iron Man suit.

The second part of his Iron Man plan is the human brain-computer interface, an area researchers in his department along with the engineering department are working to translate signals from the human brain into movements.

“If you are to get the legs to move properly, the computer has to be able to interpret what we are thinking into signals. And those signals drive the motors to propel the person forward in a coordinated manner. And that is actually not that far away, either.”

After 15 patents, 16 personal research awards, and 37 team awards, Professor Cheung appreciates the impact inventions can make for patients.

“In my career as a surgeon, how many patients can I personally operate on? It may be a thousand, 10 thousand, whatever. But if one of my invention can be translated into a product, and that product is used globally, how many more patients can I actually benefit?”

The road to inventions can be arduous and winding. Failures and roadblocks can easily overwhelm those who dare to dream and be brave enough to innovate.

For other surgeons with the urge to invent, Professor Cheung has this to say.

“My advice, I think, would be that sometimes you may wish to be something, but it may not happen. Because life is never completely predictable.”