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Keith Bridwell, MD
Orthopaedic Surgeon
The Asa C. and Dorothy W. Jones Professor Dr. Keith Bridwell is Professor of Orthopaedic Surgery at Washington University School of Medicine. He is the founder and Director of the Washington University (St. Louis) Spine Fellowship program, which was initiated in 1991 and to-date has trained 24 fellows, with 3 currently in training. Dr. Bridwell is Chief of Spine Surgery in the Department of Orthopaedic Surgery at Washington University School of Medicine, St. Louis, and is the Asa C. and Dorothy W. Jones Professor of Orthopaedic Surgery. He holds hospital appointments at Barnes-Jewish Hospital, St. Louis Children's Hospital, and St. Louis Shriners Hospital for Children. Following a medical degree at Washington University Medical School in 1977, Dr. Bridwell did his orthopaedic internship and orthopaedic surgery residency at Washington University School of Medicine. In 1982, he completed a spinal deformity research fellowship at Rush Medical College, the University of Illinois, and Chicago Shriners Hospital for Children. Since that time, Dr. Bridwell has limited his practice to spinal surgery, mostly complex spinal disorders and spinal deformity surgery. In 1985, Dr. Bridwell received board certification from the American Board of Orthopaedic Surgery. Dr. Bridwell is an active member of the American Academy of Orthopaedic Surgeons, the North American Spine Society, the Scoliosis Research Society and the American Orthopaedic Association. He was the local host for the Scoliosis Research Society meeting in St. Louis in 1997. He has been the Chairman of the Program and the Membership Committees for the Scoliosis Research Society and has served on its Board of Directors. He is the immediate Past President of the Scoliosis Research Society. The Scoliosis Research Society is the leading international society for the study of spinal deformity and the oldest orthopaedic specialty society in North America. Since 1982, Dr. Bridwell has been an active researcher in the spine field. He has contributed >40 chapters to medical textbooks, >130 articles to scientific peer-reviewed journals, and >200 scientific abstracts/ presentations. He is a deputy editor for Spine. Dr. Bridwell is co-editor-in-chief with Ronald L. DeWald, M.D. of The Textbook of Spinal Surgery, editions 1 and 2. The third edition of The Textbook of Spinal Surgery is currently under development. Dr. Bridwell's clinical practice includes all aspects of spinal surgery, both pediatric and adult. However, the emphasis has been spinal deformity, in particular idiopathic adolescent scoliosis and adult idiopathic scoliosis with superimposed degenerative changes, fixed sagittal and coronal imbalance syndromes and high-grade spondylolisthesis. Dr. Bridwell is listed in The Best Doctors in America. Keith Bridwell, MD is on the Spine Universe Editorial Board. SpineUniverse articles from Keith Bridwell, MDAdult Spinal Deformity: Scoliosis, Kyphosis, Spondylolisthesis Scoliosis, kyphosis, and sagittal imbalance are types of spinal deformity. Scoliosis is a three-dimensional deformity that affects the coronal, sagittal, and axial planes. Anatomical Planes of the Body Medical professionals often refer to sections of the body in terms of anatomical planes (flat surfaces). These planes are imaginary lines – vertical or horizontal – drawn through an upright body. Anatomy Lesson: Spinal or Vertebral Column The spine starts just below the back of the head and travels down to the pelvis; the hip area. Aprotinin Decreases Blood Loss in Complex Adult Spinal Deformity but Increases the Risk of Acute Renal Failure This study examined the efficacy of Aprotinin to reduce operative blood loss in adult spinal deformity patients. Basic Bone Structure Bones are organs composed of hard living tissue providing structural support to the body – it’s scaffolding. It is a hard matrix of calcium salts deposited around protein fibers. Circumferential Resection and Shortening Procedure for Congenital Kyphosis and Scoliosis in a Skeletally Immature Male A case narrative of a 13-year-old boy presented for evaluation of congenital scoliosis and kyphosis. Columna vertebral La columna vertebral (o espina dorsal) se extiende desde el cráneo hasta la pelvis y se compone de 33 huesos individuales que se denominan vértebras. Comparison of Smith-Petersen Osteotomies versus Pedicle Subtraction Osteotomies for the Treatment of Fixed Sagittal Imbalance (71 Patients with Minimum 2-Year Followup) An abstract from the SRS 2004 Annual Meeting on the comparison of Smith-Petersen osteotomies vs pedicle subtraction osteotomies for the treatment of fixed sagittal imbalance. Complications (Pseudarthrosis, Neurologic Deficit) of Pedicle Subtraction Osteotomies for Fixed Sagittal Imbalance An abstract from the 2002 SRS Annual Meeting reporting on the complications of lumbar pedicle subtraction osteotomy plus the anticipated 2-5 yr follow-up result. Decisions and Expectations with Osteotomy Surgery for Fixed Sagittal Imbalance Syndromes: Smith-Petersen vs Pedicle Subtraction Decisions and Expectations with Osteotomy Surgery for Fixed Sagittal Imbalance Syndromes Dowel Fibular Strut Grafts for High-Grade Dysplastic Isthmic Spondylolisthesis Fibular strut grafting is a useful surgical adjunct in high-grade spondylolisthesis that is partially reduced. Estructuras nerviosas de la columna Los nervios controlan las funciones del cuerpo, incluyendo los órganos vitales, las sensaciones y el movimiento. Facet Joints of the Spine Anatomy A joint is where two or more bones are joined. Joints allow motion (articulation). The joints in the spine are commonly called Facet Joints. Other names for these joints are Zygapophyseal or Apophyseal Joints. Fixed Sagittal Imbalance in a Very Young Adult Female Created by Settling of Cages at L4/L5 and L5/S1, Treated by Pedicle Subtraction Osteotomy Case narrative about a young female who prresents for surgical treatment at age 16 with a combination of back and leg pain. Idiopathic Scoliosis: Options of Fixation and Fusion of Thoracic Curves The development of new techniques along with new technology has allowed for enormous changes in the treatment of idiopathic scoliosis and has given surgeons and patients a wide variety of options. Intervertebral Discs Intervertebral discs are the pillow-like cushions in between your vertebrae. They are your spine’s shock-absorbing system, helping you move more easily. See illustrations of what your discs look like and learn more about what they do for your spine. Is the SRS-22 Instrument Responsive to Change (Surgical Treatment) in Adult Scoliosis Patients Having Primary Spinal Deformity Surgery? The purpose of this study is to prospectively analyze responsiveness of SRS-22 to change (surgical treatment) at one and two years following surgery. Is the T9, T11, or L1 Proximal Level the More Stable Following Lumbar/Lumbosacral Fusions from the Thoracolumbar Junction to L5-S1? Study compares the postoperative proximal junctional change, thoracic kyphosis progression and saggital vertical axis change following fusion and instrumentation L5-S1. Is There an Optimal Patient Stance for Obtaining a Lateral 36" X-Ray? A Critical Comparison of Three Techniques An abstract from the SRS 2003 Annual Meeting on optimal patient stance for obtaining a lateral 36" x-ray. Late Complications of Adult Idiopathic Scoliosis Primary Fusions to L4 and Above – The Effect of Age and Distal Fusion Level An abstract from the 2002 SRS Annual Meeting analysing adult IS treated with long instrumented fusions from the to L4 and above by two surgeons between 1985 to 1999. Ligaments Ligaments are fibrous bands or sheets of connective tissue linking two or more bones, cartilages, or structures together. One or more ligaments provide stability to a joint during rest and movement. Long Adult Deformity Fusions: Is it Better to Stop at L5 or the Sacrum? An abstract from the SRS 2003 Annual Meeting comparing the outcomes of long adult deformity fusions to either L5 or the sacrum in the presence of ahealthy 5-1 disk. Lumbar Spinal Stenosis - Overview Spinal stenosis is most common in the last three levels of the lumbar spine namely L3-4, L4-5 and L5-S1. It is diagnosed and confirmed by an MRI or CAT scan/myelogram. Lumbosacral Fixation Techniques and Indications Indications for a fusion to the sacrum in primary patients include lumbar curves with substantial disc degeneration. Minimum 5-Year Analysis of L5-S1 Fusion Using Sacropelvic Fixation (Bilateral S1 and Iliac Screws) For Spinal Deformity An abstract from the SRS 2004 Annual Meeting on outcomes for lumbosacral fusion in spinal deformity patients using a combination of bilateral sacral and iliac screws. Muscles of The Spine Muscles are named according to their shape, location, or a combination. They are further categorized according function such as flexion, extension, or rotation. Nerve Structures of The Spine Nerves follow tracts and cross over junctions called Synapses. Simplified, it is a complex communicative process between nerves conducted by chemical and/or electrical changes. Neurologic Complications of Pedicle Subtraction Osteotomy: a Ten-Year Assessment This study evaluated neurologic deficits following pedicle substraction osteotomy. Neurological Deficit From a Purely Vascular Etiology After Unilateral Vessel Ligation of Segmental Arteries During Anterior Thoracolumbar Fusion of the Spine An abstract from the SRS 2003 Annual Meeting designed report to on neurological deficit from a purely vascular insult to the spinal cord. Options of Thoracic Idiopathic Scoliosis Fixation and Fusion Options of Thoracic Idiopathic Scoliosis Fixation and Fusion Proximal Junctional Kyphosis Following Adult Spinal Deformity Long Posterior Segmental Instrumentation and Fusion: Minimum 5 Years Follow-Up Study anaylzes the time-dependent chance, prevalence and rsik factors for proximal junctional kyphosis in adult spinal deformity. Proximal Junctional Kyphosis in Adolescent Idiopathic Scoliosis Following Segmental Posterior Spinal Instrumentation and Fusion: Minimum 5 Years Follow Up An abstract from the SRS 2004 Annual Meeting on the long term proximal junctional change in AIS following segmental posterior spinal instrumentation and fusion. Proximal Junctional Kyphosis in Adult Spinal Deformity Following Long Instrumented Posterior Spinal Fusion: Incidence, Outcomes and Risk Factors Analysis An abstract from the SRS 2003 Annual Meeting designed analyze patient outcomes and risk factors associated with proximal junctional kyphosis undergoing long instrumented posterior spinal fusion. Proximal Junctional Kyphosis in Adult Spinal Deformity:Comparison of Hook versus Pedicle Screw Constructs Study analyzed intermediate follow-up of matched groups in adult deformity patients (pedicle screws vs. hooks). Pseudarthrosis in Adult Idiopathic Scoliosis Primary Fusions An abstract from the SRS 2003 Annual Meeting on the characteristics of adult idiopathic scoliosis pseudarthrosis sites. Pseudarthrosis in Long Adult Spinal Deformity Instrumentation and Fusions to the Sacrum: Incidence and Risk Factor Analysis of 149 Cases An abstract from the SRS 2005 Annaul Meeting designed to analyze the incidence of and risk factors for pseudarthrosis in long adult spinal instrumentation and fusion to S1. Pseudarthrosis in Long Adult Spinal Deformity Instrumentation and Fusions: Risk factor and Clinical Outcome Analysis of 228 cases An abstract from the SRS 2004 Annual Meeting on the incidence of and risk factors for pseudarthrosis in adult long spinal deformity instrumentation and fusions. Results of Lumbar Pedicle Subtraction Osteotomies for Fixed Sagittal Imbalance: A Minimum 5-Years Follow-Up Study This study reports on results compiled after 5 years about pedical subtraction osteotomies for iatrogenic sagittal imbalance. Risk Factors for Adjacent Segment Degeneration Following Lumbar/Thoracolumbar Fusion with Pedicle Screw Instrumentation: A Minimum 5-Year Follow-Up The authors discuss three hypotheses about adjacent segment degeneration following lumbar/thoracolumbar fusion with pedicle screw instrumentation. Sagittal Thoracic Decompensation (STD) Following Adult Lumbar Spinal Instrumentation and Fusion to L5 or S1: Causes, Incidence, and Risk Factors Analysis An abstract from the SRS 2005 Annual Meeting looking at the causes, incidence of and risk factors for sagittal thoracic decompensation (STD) in adult lumbar deformity spinal instrumentation and fusion to L5 or S1. Scheuermann's Kyphosis (Scheuermann's Disease): Abnormal Curvature of the Spine Scheuermann's kyphosis develops during times of bone growth (e.g., puberty). Researchers are still trying to figure out what causes this type of kyphosis, but it may run in families. In this article, learn about symptoms and treatments. Scheuermann's Kyphosis: Non-Operative and Surgical Treatment Treatment for Scheuermann's kyphosis depends on the patient's age, severity of the curve, and the presence of neurological problems. Spinal Curvature Problems: Fixed Sagittal Imbalance Fixed sagittal imbalance simply means that the spine is curved in a way that prevents someone from standing up straight. An educational article that includes before and after surgery x-rays and photos so that you can see the difference in posture. Spinal Curves Spinal curves are either kyphotic or lordotic. In a normal spine there are four types of spinal curvatures important to balance, flexibility, and stress absorption and distribution. Spinal Deformity in Adults and Surgical Treatment Advances Keith Bridwell, M.D. discusses the types of spine surgery used to treat idiopathic and degenerative adult spinal deformities. Included is information about recent surgical advancements that includes BMP. Spinal Deformity in Adults: Common Types of Idiopathic and Degenerative Disorders Scoliosis, kyphosis, and sagittal imbalance are types of spinal deformity. In this article, Dr. Keith Bridwell provides his expertise on these disorders and their treatment. Staged Posterior Surgery for Severe Adult Deformity An abstract from the 2002 SRS Annual Meeting looking at staged posterior surgery for severe adult deformity Surgical Treatment of Fixed, Unbalanced Adult Spinal Deformities Case Study: Surgical Treatment of Fixed, Unbalanced Adult Spinal Deformities. K.H. Bridwell, M.D. Surgical Treatment: Fixed Sagittal Imbalance in a Very Young Female Created by Settling of Cages at L4/L5 and L5/S1, Terated by Pedicle Subtraction Osteotomy Summary of surgical revision and outcome. This case illustrates how easy it is to produce a sagittal imbalance problem when fusing segment in the distal lumbar spine. The Impact of Positive Sagittal Balance in Adult Spinal Deformity An abstract from the SRS 2004 Annual Meeting designed to investigate adult deformity patients with positive sagittal balance. The Morbidity of Anterior Exposure for Spinal Deformity in Adults: An Analysis of Patient-Based Outcomes and Complications in 112 Consecutive Cases An abstract from the SRS 2005 Annual Meeting designed to determine the impact of anterior exposures on pain, function, and self-image; and the prevalence of approach-related complications. The Validity of the SRS-22 Instrument in an Adult Spinal Deformity Population Compared to the Oswestry and SF-12 An abstract from the SRS 2003 Annual Meeting on the validity of the SRS-22 instrument in an adult spinal deformity population. Thoracolumbar Deformity Arthrodesis Stopping at L5: Fate of the L5-S1 Disc with a Minimum 5-Year Follow-Up Study evaluated the fate of L5-S1 disc analyzing subsequent disc degeneration and associated risk factors for degeneration. Thoracolumbar Deformity Arthrodesis to L5 in Adult Scoliotics: The Fate of the L5-S1 Disk: Is it Protected by a Deep-Seated L5? An abstract from the 2002 SRS Annual Meeting that looks at the incidence and sequella of L5-S1 DDD in adult scoliotics. Vascular System of the Spine The function of the vascular system is to nourish each cell in the body. This includes the vertebral column, spinal cord, neural elements, muscles, and other related structures. Vertebral Column The vertebrae are composed of many elements that are critical to the overall function of the spine, which include the intervertebral discs and facet joints. What Causes Adult Spinal Deformity? The causes of spinal deformity are mutlifold as some deformities are idiopathic (cause unknown) with superimposed degenerative changes. When Fusing from the Thoracolumbar Junction to L5-S1, How Much Lordosis is Ideal? An abstract from the SRS 2005 Annual Meeting designed to determine the optimal time dependent sagittal spinal balance following adult lumbar deformity instrumentation and fusion.
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