Help for Complex Scoliosis Patient

Sixteen-year-old Rishee Ray is making history at Cedars-Sinai as the first pediatric patient to undergo halo-gravity traction ahead of spinal surgery.

Rishee has spent most of his life in a wheelchair due to a condition known as spinal muscular atrophy, a group of inherited diseases that affect the muscles responsible for voluntary movement in the body. 

The condition caused Rishee to develop severe scoliosis, with a 135-degree curve in his spine that was compressing vital organs and impairing his ability to sit upright. Additionally, he developed severe kyphosis, another dramatic curve from the side of his spine.

“When we looked at the right side of the chest, we could see his ribs literally stacked on top of each other, causing severe restrictive lung disease,” said Kenneth Illingworth, MD, pediatric spine surgeon at Cedars-Sinai Guerin Children’s. “Not only that, but there was also severe shoulder imbalance and coronal imbalance when he was sitting down.”

Illingworth said that to correct the extreme curvature in Rishee’s spine, spinal fusion surgery was the best option. However, because the curvature was so severe, surgery would have to wait while Rishee underwent a different treatment.  

“When you have curves that are that large, it makes it extremely challenging to operate on,” said Illingworth. “It also makes it extremely dangerous to the spinal cord.”

As a prelude to surgery, Illingworth recommended halo-gravity traction, a method that gently stretches and straightens the spine using a lightweight metal ring or halo that is attached to the skull with small pins.

Once the halo is in place around the head, it is attached to a pulley system, and weights are gradually added to slowly straighten the curved or compressed spine.

Most halo-gravity traction procedures on children last between three and eight weeks. For Rishee, it was a five-week process.

“At first it was difficult; it was this new thing on my head, but I got used to it,” said Rishee.

Pooja Ray, Rishee's mother, provided constant support, staying by Rishee’s side day and night, sleeping alongside him at Cedars-Sinai Guerin Children’s.

“We’ve been in the hospital for 40 days, but we have a purpose, so I don’t give my comfort that much of a thought, my goal was more important,” Pooja said.

The process ultimately yielded remarkable results.

Halo-gravity traction reduced Rishee’s curvature by half, decreasing it from 135 to approximately 70 degrees. And the straightening gave Rishee an additional three inches in height.

“I know it looks barbaric, but trust me, it’s one of the best procedures when you have to do corrective scoliosis treatment,” said Pooja.

After the halo traction device proved successful, Illingworth proceeded with the spinal fusion surgery, providing Rishee with relief from the severe lung compression he had been enduring and improving his daily comfort in his wheelchair—a critical element of his everyday life.

With the successful surgery behind him, Rishee can now sit upright, igniting a newfound sense of hope and optimism for his future.

“I feel more confident,” said Rishee. “I am able to control my neck and body better and can hold my head up and sit up straight without any external support.”

Rishee, who divides his time between India and Los Angeles, is back to his hobbies of swimming and painting and is pursuing higher education. He feels tremendous gratitude to his care team at Cedars-Sinai and to his mother.

“My mom was a great support, both emotionally and physically,” said Rishee. “Without her, this couldn’t have been possible.”

Read more on the Cedars-Sinai Blog: Seeking a Second Opinion for a Spine Condition