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Megan E. Johnson, M.D., Appointed Program Director for Pediatric Orthopedic Surgery Fellowship

Megan E. Johnson, M.D., Appointed Program Director for Pediatric Orthopedic Surgery Fellowship

by | Oct 24, 2023 | Scoliosis & Spine

We are honored to announce the appointment of Megan E. Johnson, M.D., as program director for the Dorothy & Bryant Edwards Fellowship in Pediatric Orthopedics and Scoliosis at Scottish Rite for Children. The Edwards fellowship is one of the oldest and largest fellowships in the country and has an alumni of nearly 200 surgeons.  
 
With this new appointment, Dr. Johnson will be responsible for attracting outstanding candidates from diverse backgrounds and training them to be skilled clinicians and surgeons. Dr. Johnson will ensure ongoing maintenance of a high-quality educational curriculum for our fellows and provide leadership and direction to our orthopedic faculty who take part in education. She will have a key role in ensuring our curriculum is undergoing needed innovation through regular program evaluation and quality improvement.
 
Dr. Johnson received her medical degree and completed residency training at Vanderbilt University in Nashville, Tennessee. She completed her pediatric orthopedic fellowship at Scottish Rite for Children in 2015, and following her fellowship, she returned to Vanderbilt University Medical Center. She joined the Scottish Rite for Children staff in 2020 as a pediatric orthopedic surgeon. Her clinical practice focuses on spine deformity in the pediatric population. She also treats patients with spina bifida, not only for their spine conditions but also for lower extremity issues. Dr. Johnson also serves as the Medical Director of Ambulatory Care and is an assistant professor of Orthopaedic Surgery at UT Southwestern Medical Center. 
 
“Dr. Johnson is an excellent clinician in the outpatient, inpatient and surgical setting and is an extremely talented surgeon who takes on both the straightforward as well as the complex deformities,” says Chief of Staff Daniel J. Sucato, M.D., M.S. “Not only is she a great leader, but she also has a natural ability to educate and is one of the favorites of our fellows to work with in the operating room and clinics.”
 
Dr. Johnson succeeds Dr. Sucato, who has served as program director of the Pediatric Orthopedic Surgery Fellowship program for the past 10 years. Dr. Sucato will remain Chief of Staff of Scottish Rite for Children as well as the director of Scottish Rite for Children’s Center for Excellence in Spine.

Share Your Story: Cookies and Castles Connection

Share Your Story: Cookies and Castles Connection

by | Dec 2, 2022 | Scoliosis & Spine

Meet Henley, a patient who was seen by our team of scoliosis and spine experts. Learn more about her journey below.

Blog written by Henley’s mom, Lauren.

In January 2022, Henley saw a new pediatrician for her annual well child appointment. At that appointment, she was screened for scoliosis. The pediatrician noticed a curvature in her spine and referred us to a specialist. Unfortunately (or really, fortunately!), the specialist wasn’t taking new patients, and a good friend of ours urged us to visit Scottish Rite for Children.

As a parent, I felt lost, overwhelmed and a little fearful of this new and unknown venture. From the second we stepped in the door at Scottish Rite, we felt like we were at the Ritz-Carlton of hospitals. Everyone was so kind, helpful and accommodating to Henley (and to me, too!). Henley had X-rays and an MRI done, which could be very scary for an 8-year-old, but the staff were incredibly patient and understanding. 

Once Henley was diagnosed with scoliosis, she was sent to the Orthotics and Prosthetics department, where she was fitted for a brace. She picked out a pattern for the brace and has been very diligent about wearing it. Henley will continue wearing her brace until she is done growing, so we have many years of care at Scottish Rite in our future! In a time that can be daunting and stressful for families, Scottish Rite has alleviated so much pressure from our family by their kind hearts and helping hands. 

Coincidentally, a close friend of ours was a Tri Delta at SMU and throughout the years, has invited us to participate in the annual Cookies & Castles event. This wonderful event directly benefits the Orthotics and Prosthetics department at Scottish Rite. We have decorated many gingerbread houses and as we attend Cookies and Castles this year, we will be doing so with an even greater appreciation.

Scottish Rite shifted our experience from stressful and daunting to something where we feel confident and supported on our scoliosis journey. When we have appointments, I have nothing to stress about. I know that we will find all the support we need at Scottish Rite with smiling faces. Not only does Henley gets excited to come to her appointments with Dr. Johnson, but also she loves learning about the progress being made from wearing her brace. She loves checking out the fish and getting popcorn, too.

Henley is currently a third grade cheerleader and a Girl Scout Brownie. She is on the UIL Storytelling team and in Junior FFA. In the spring, she’ll play volleyball and join a tumbling class. She adores animals, including her cat Kiki and her labradoodle Tito. In her free time, she loves playing with her little sister Presley and her friends. She also loves reading, drawing and baking!

Cookies & Castles Dallas and Cookies & Castles Frisco have been long-time supporters of Scottish Rite for Children. Both events take place at our campuses in Dallas and Frisco, where friends, families and patients can decorate gingerbread houses while supporting our organization. These events have raised nearly $1 million total for Scottish Rite throughout the years! We’re grateful to the unwavering support of Cookies & Castles, the Dallas Alumnae Chapter of Tri Delta and the North Texas Area Alumnae Chapter of Tri Delta. 

DO YOU HAVE A STORY? WE WANT TO HEAR IT! SHARE YOUR STORY WITH US.

Share Your Story: Oh, the Places You’ll Go!

Share Your Story: Oh, the Places You’ll Go!

by | Jul 19, 2022 | Scoliosis & Spine

Meet Beau, a patient who is seen by our team of multidisciplinary experts. Learn more about his journey below.

Blogs written by Beau and his mom, Courtney.

When Beau was 6 months old, he was placed in the Chinese orphanage system, and our family adopted him in 2017, when he was 4 years old. We did not know much about his history, as he lived in a very large orphanage and information was not passed along. We did know he would be somewhat of a medical mystery and booked his appointment with our pediatrician before we even left China.

Beau is a complex patient, and after a variety of appointments and tests, he was eventually diagnosed with a form of dwarfism called spondyloepiphyseal dysplasia congenita (SEDc) and a monoallelic mutation of COL2A1 gene. This is a rare genetic disorder that impacts different parts and systems of his body, including his eyes, hearing, spine and more.

In May 2021, Beau’s spinal curve rapidly started to increase, and that is when our orthopedic surgeon in Houston referred us to Scottish Rite for Children. We really love and trust our doctor in Houston, so it was very comforting to hear him say, ‘If my kid needed this done, where I’m sending you is where I would go. They are my number one choice.’ My anxiety as a mom went away, and I immediately started to research everything I could. We took the first available appointment and met Dr. Johnson for the first time at the end of June. She gave us a game plan for surgery, and we left with a sense of peace about the journey we were about to take with Beau at Scottish Rite.

In January 2022, Beau had spinal surgery and was in halo decompression for the next five weeks. Halo-gravity traction is the process of using a metal ring, or halo, attached to a child’s skull that applies traction to the spine, gently stretching and straightening out the spine to correct curvatures. – Courtney

I had so much fun in my halo, and my mom decorated my equipment, which made it even more fun! My walker was Mardi Gras-themed the entire time. I always had beads to hand out, and sometimes I even had a speaker playing Mardi Gras music!

My wheelchair was first decorated as the emperor’s throne, because of Chinese New Year, and I handed out handmade fortune cookies. I created all the sayings, and my mom made paper cookies. I even painted my face like a tiger, because we are in The Year of the Tiger.

For Valentine’s Day, my decorations were full of hearts, lights and sparkles. I had a cool shirt that said, ‘Just call me Cupid’ and wore an awesome red top hat with heart glasses. My mom and I made over 350 valentines, and we handed them out around the hospital. I know that there are a lot of people that are needed to make hospitals run smoothly, and I tried to meet all of them. I wanted to remind them that they are important, and I was thankful for all they did during my stay.

After surgery, I went home in a wheelchair. My farewell theme decorations were Oh, the Places You’ll Go! My mom said that this was a perfect theme to represent moving from China to the United States. Not only did I have to learn and adapt to a new world, but because of my spine surgery at Scottish Rite, I also have a new level of life, and nothing is going to hold me back!

I feel like I will be able to do anything I set my sights on, thanks to different people at Scottish Rite. The Therapeutic Recreation department allowed me to participate in sports and games that I never thought I would be able to do. My size can make sports hard, but they showed me how I could fully participate with just minor modifications.

When I was an inpatient, Ms. Dana gave me my very own Learn to Golf set of golf clubs, and we had a special visitor during therapeutic recreation – Mr. Carlos. He taught me how to play golf, plus he had a huge smile, was super nice, and has a special leg. We live near a golf course, and I have always wanted to learn how to play, but because of my size and my back, I never thought I would be able to participate. Mr. Carlos worked with me, and I learned how to make adjustments and was able to swing a golf club and hit the ball. After my big surgery, he even came to check on me. Learn to Golf will allow me to keep playing the sport and has connected me with special coaches, just like Mr. Carlos.

I am now back home in Houston and feeling good. I will always remember Scottish Rite for Children, and I look forward to my checkups because I can visit my friends all around the hospital, and they always remember my name!! – Beau

DO YOU HAVE A STORY? WE WANT TO HEAR IT! SHARE YOUR STORY WITH US.

Detecting and Treating Scoliosis

Detecting and Treating Scoliosis

by | Jun 3, 2021 | Scoliosis & Spine

Content included below was previously presented at the 2021 Pediatric Orthopedic Education Symposium by pediatric orthopedic surgeon Megan E. Johnson, M.D.

People hear the term scoliosis often, but they may not know what it means. Pediatric orthopedic surgeon Megan E. Johnson, M.D., walked through each phase of detecting and treating scoliosis in a recent lecture. This summary provides health care professionals with a succinct summary and language to navigate the steps and conversations with patients presenting with suspected scoliosis.

Watch the full lecture or download this summary

Defining scoliosis
Scoliosis is a structural lateral rotated curvature of the spine. For a condition to qualify as scoliosis, the Cobb angle, or the measurement of the degree of side-to-side spinal curvature, must be a minimum of 10 degrees. If the Cobb angle is less than 10 degrees, it is considered a spinal asymmetry, not scoliosis.

What are the types of scoliosis? 

  • Idiopathic scoliosis: The most common type of scoliosis. Idiopathic means that all other causes of scoliosis have been ruled out.
  • Congenital scoliosis: When vertebral malformations cause a curvature of the spine. The vertebrae weren’t formed correctly or haven’t separated from the other surrounding vertebrae correctly.
  • Neuromuscular and syndromic scoliosis: Occurs in patients with underlying neurologic disorders like cerebral palsy, spina bifida and other genetic conditions.

What age is scoliosis diagnosed?
Scoliosis may be diagnosed at any age, but earlier recognition often improves treatment options and outcomes. A patient’s age also helps to define the type of scoliosis that they may have.

  • Infantile idiopathic scoliosis: patient is between 0 and 3 years old at the time of diagnosis.
  • Juvenile idiopathic scoliosis: patient is between 4 and 9 years old at the time of diagnosis.
  • Adolescent idiopathic scoliosis: patient is 10 years or older at the time of diagnosis.

The most common type is adolescent idiopathic scoliosis (AIS). The patient’s curve typically goes to the right and can include either the thoracic or lumbar spine or both.

What history and physical exam findings are important with scoliosis?
In order to evaluate patients, it is important to learn if patients have had back pain, headaches, other neurologic symptoms or a family history of scoliosis. For girls, it is also necessary to know their menstrual history to gauge where they are in their growth cycle.

The physical exam is focused on identifying asymmetries in static posture. This includes:

  • Differences in shoulder height.
  • Scapular asymmetry – scapulae are at different heights or one is more retracted.
  • Pelvic obliquity – iliac crests are at different heights.
  • Trunk shift – drawing an imaginary line from the patient’s head to their waist and seeing if the head is centered over their waist.
  • Waist asymmetry – a visible bulge (typically on left) on the convex side of a lumbar curve, and crease on the concave side of the curve.

Special test
A very common test for scoliosis that most people are familiar with is the Adams forward bend test. Patients bend forward at the waist, and the examiner looks for signs of rotational deformities. Curves in the coronal plane cause rotation in the axial plane, which are visible in the Adams test. For example, a left midline lumbar prominence and the prominence of the right ribs are evident with a right thoracic curve.

Neurologic exam
A thorough neurologic exam assesses for asymmetries and changes in sensation, reflexes and motor function in the trunk and lower extremities. The patellar tendon, the Achilles tendon and the abdomen are tested to look for symmetry in reflexes. Being hyper-reflexive is fine when it is present on both sides. If there are reflexes on one side and not the other, it is an abnormal finding. Foot abnormalities, like a cavovarus foot or a significant flat foot on just one side, may indicate an underlying neurologic concern.

What radiologic imaging is used to diagnose scoliosis?
Plain film radiology (X-rays)
X-rays are essential to assess the patient’s scoliosis. Full-length X-rays of the spine, including the pelvis and the top parts of the hips and femurs, will give physicians all the information that they need to determine what the curve looks like, how big the curves are and how much growth the patient has left. Full-length X-rays are necessary for final diagnosis and treatment planning. Scottish Rite for Children uses advanced imaging technology called EOS, which utilizes a very-low-dose radiation for efficient and effective full-length images. To avoid unnecessarily repeating X-rays, images are not required for referrals for suspected scoliosis.

Advanced imaging
An MRI is indicated with these findings:

  • Curve abnormalities like a left-sided curve, a back that is rounder than expected or an abnormal appearing curve.
  • Short and sharp curves and kyphosis are red flags requiring further evaluation with an MRI.
  • Abnormal neurologic exam or other neurologic symptoms, like daily headaches.
  • Significant progression in the patient’s curve between follow-up appointments.

What factors are considered in planning treatment for scoliosis?
The goal of scoliosis treatment is to keep the spinal curve(s) as small as possible and prevent progression to surgery. The following are considered:

  • Age of the patient.
  • How skeletally mature they are.
  • Size of the scoliosis curve(s).

Bracing
Bracing is recommended for patients with curves between 20-25 and 40 degrees if they have at least two years of growth remaining. Thoracic lumbar sacral orthosis (TLSO) braces are worn 18 to 20 hours a day and are typically used for curves in the thoracic spine or both the thoracic and lumbar spine. If the patient only has a lumbar curve that is flexible, nighttime bracing may be recommended.

Surgery
Surgery is recommended when the patient’s curve has a Cobb angle of 50 degrees or more to prevent the curve from progressing into adulthood. Surgery is generally not recommended until the patient is at least 10 years old because if the fusion is done too early, the growth of the patient’s spine can cause some secondary issues.

When should a patient with suspected scoliosis see a pediatric orthopedic specialist?
Patients should be referred to Scottish Rite for Children:

  • If they have a scoliosis curve and are still skeletally immature.
  • If they are fully grown with a significant deformity that is visible in the clinical exam.
  • If they have a scoliosis curve with an abnormal neurological exam, chronic back pain, daily headaches, an asymmetric foot deformity or any other unusual symptoms.

Many patients evaluated at Scottish Rite for Children do not have scoliosis, but our team provides reassurance and recommendations for monitoring over time. Annual or six-month observation visits are indicated for some patients since curves change as the patient grows.

Are you interested in learning more? Visit our on-demand page for more educational opportunities including scoliosis and orthopedic topics.

Megan E. Johnson, M.D., Joins Scottish Rite for Children’s Surgical Team

Megan E. Johnson, M.D., Joins Scottish Rite for Children’s Surgical Team

by | Sep 24, 2020 | General News

(DALLAS – September 24, 2020) – Megan E. Johnson, M.D.,has joined the pediatric orthopedic surgical staff at Scottish Rite for Children. Johnson completed her fellowship at Scottish Rite for Children in 2015 and will see general pediatric orthopedic surgery patients, with a focus on spine, primarily at the Dallas facility. 

“We feel very fortunate to be able to recruit Dr. Johnson from Vanderbilt as we know she is a superstar who will be a great addition to our team and to the organization,” says Scottish Rite Chief of Staff Daniel J. Sucato, M.D., M.S. “She is someone I would call “talent-plus” as she has all of the hard skills of being a great clinician and surgeon along with the soft skills of being a great individual who will enrich the lives of the children and families we are privileged to treat and will continue to help us deliver the greatest care to our patients.”  

Before completing Scottish Rite for Children’s Dorothy & Bryant Edwards Fellowship in Orthopedics and Scoliosis in 2015, Johnson attended medical school at Vanderbilt University, where she earned her Doctor of Medicine. She completed her orthopedic surgical residency at Vanderbilt University Medical Center in Nashville, Tennessee.  Johnson previously served as an assistant professor of orthopedics at Monroe Carrell Jr. Children’s Hospital of Vanderbilt. 

“I am so excited and grateful to have the opportunity to come back to Scottish Rite and practice orthopedic surgery,” says Johnson. “Scottish Rite is an internationally recognized leader in pediatric orthopedics, and I love that the organization is full of people who share my passion for helping children.”

“Dr. Johnson’s expertise ensures that Scottish Rite continues to be committed to providing exceptional and innovative care to all who enter our doors,” says President/CEO Robert L. Walker. “We are excited to have her back on our team.”

Johnson is board certified by the American Board of Pediatrics in Orthopedic Surgery. She is an Assistant Professor at The University of Texas Southwestern Medical Center Department of Orthopedic Surgery, a member of the American Academy of Orthopaedic Surgeons (AAOS) and the Ruth Jackson Orthopedic Society, as well as a candidate member of the Pediatric Orthopedic Society of North America (POSNA) and the Scoliosis Research Society.