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Dr. John H. Moe exhibit

Twin Cities Spine Center is proud of its heritage as a pioneer in orthopedic spine care. That legacy was founded by John H. Moe, MD. Dr. Moe dedicated his professional life to understanding and treating disorders of the spine, revolutionizing the field. This exhibit is a look back at the life of Dr. Moe and his many accomplishments—and a look at the history of scoliosis research and treatment.

Dr. John H. Moe: Pioneer

Dr. John H. MoeTwin Cities Spine Center (TCSC) is a specialized practice devoted to patient care, education and research. Internationally recognized for excellence in orthopedic spinal surgery, TCSC is dedicated to the comprehensive management of spinal diseases, deformities and disorders, focusing on the cervical, thoracic and lumbar spine. TCSC is also a leading international research and educational institution.

Twin Cities Spine Center is one of the outgrowths of the pioneering work of John H. Moe, MD—widely regarded as the founder of modern scoliosis research and treatment. In the 1940s, Dr. Moe helped create one of the first dedicated inpatient hospital spine units in the world. His work led to the development of the Scoliosis Research Society, with the first annual meetings held in Minneapolis in 1966 and 1967, as well as the first comprehensive textbook on spinal deformities.

In the 1980s, Dr. Moe's center evolved into two highly acclaimed spinal practices—the Minnesota Spine Center and the Twin Cities Scoliosis Spine Center. These two separate practices joined forces in April 1998 to form Twin Cities Spine Center, headquartered on the campus of Abbott Northwestern Hospital. In recent years, TCSC has emerged as one of the preeminent practices in the world. It now consists of 10 surgeons and over 80 professional and support staff, including a full research department. All staff surgeons are highly trained specialists, devoting their medical practice exclusively to spinal conditions. TCSC offers a complete array of spinal management resources, including outpatient evaluation and individualized treatment, and 24-hour on-call consultations.

TCSC treats thousands of patients for spine issues every year. The broad base of experience allows for comprehensive care for a large, variable patient population. Surgeons at TCSC utilize a combination of well-established and new, cutting-edge techniques, resulting in a broader spectrum of patient care options and high-quality treatment.

Early life

The youngest of six children, John Howard Moe was born on August 14, 1905, on a farm located a short distance from the town of Grafton, North Dakota. The child of Norwegian immigrants, his first exposure to English was the single-room schoolhouse that he entered at the age of 6. One of his sisters was his teacher, and most of his classmates were his cousins. He attended the country school until the 8th grade, when he transferred to the public school in Grafton. [2]

In 1923, unimpressed with farming, and urged by his mother and sister who was a nurse, he entered the University of North Dakota at Grand Forks with no particular plan, goal or career in mind. Reflecting on his education, he later wrote, "I am not certain why, but in my second year as a university student, I decided to take the remaining necessary requirements for what was known as 'pre-medicine.'" [3]

In 1927, he graduated from the University of North Dakota with a bachelor of science degree. That same year, he entered medical school at Northwestern University in Chicago, where he then received his bachelor of medicine degree in 1929 and his doctor of medicine degree in 1930, after completing an internship and orthopedic residency at the Illinois Research and Educational Hospital. [3–4] Dr. Moe later recollected, "Upon finishing my internship, I was in a quandary as to what to do...my roommate, Dr. Claude N. Lambert, who was in his final year of general surgery residency there, wanted to change into orthopedic surgery under Dr. Henry Bascom Thomas, chief and head of orthopedic surgery at the University of Illinois. He persuaded Dr. Thomas to let me fill in several months in order to hold the place open for him when he returned; it is this position as personal assistant to Dr. Thomas which led me into the field of orthopedic surgery." [3]

In 1931, Dr. Moe traveled to Minnesota for further orthopedic training in residence at the Gillette State Hospital for Crippled Children in St. Paul (the Minnesota State Legislature later changed the name to Gillette Children's Hospital in 1971). In 1934, he was named clinical assistant professor in the Division of Orthopaedic Surgery at the University of Minnesota and carried staff appointments at Gillette and Fairview Hospitals. In 1936, Dr. Moe was made head of orthopedics at Minneapolis General Hospital (now Hennepin County Medical Center). In 1957, he was appointed as clinical professor and director of the Division of Orthopaedic Surgery at the University of Minnesota (under his leadership, the division received departmental status in 1964), and the following year as chief of staff at Gillette. [2]

Scoliosis service at Gillette Hospital

Dr. Moe's greatest interest and academic contributions were in the area of spinal deformity. [4] In the fall of 1947, Dr. Moe was invited by Dr. Claude N. Lambert to join the Contemporary Orthopaedic Society, a group of outstanding orthopaedic surgeons from all around the United States. At its first meeting in Milwaukee that year, the topic was scoliosis, and Dr. Moe took lengthy notes. [3] From what he was learning, it became quite apparent to Dr. Moe that scoliosis was not treated at Gillette State Hospital as well as it was at the Hospital for the Ruptured and Crippled in New York by Dr. John R. Cobb or as it was at the Milwaukee Children's Hospital by Dr. Walter P. Blount. [5]

This meeting marked the beginning of Dr. Moe's deep interest in scoliosis, and he returned to Gillette determined to apply everything that he had learned. [2] He immediately contacted Dr. Carl C. Chatterton, chief of staff at Gillette Hospital, and asked for his permission to start a scoliosis service in an attempt "to get a more realistic and productive treatment to this much neglected subspecialty of orthopaedic surgery." [3] Dr. Chatterton agreed and, armed with his newfound knowledge, Dr. Moe went to work.

Scoliosis Research Society

Dr. Moe led the formation of the Scoliosis Research Society (SRS) and served as its president for the society's first three years. [4] In 1957, while serving as the director for the Division of Orthopaedic Surgery at the University of Minnesota, Dr. Moe made annual symposia in orthopedic surgery part of the curricula. The symposia, which typically lasted three days, were offered as a part of the continuing courses in medical education at the university. As the Scoliosis Service at Gillette Hospital developed and as his name became known, Dr. Moe set out to concentrate these symposia into courses on the treatment of scoliosis. [3]

As Dr. Moe later wrote, "the course was well received by a relatively large number of orthopaedic surgeons from all parts of the United States, all of whom were enthusiastic in their questions and discussion of scoliosis." [6]

Toward the end of the course, during a roundtable discussion of scoliosis moderated by Dr. Moe, it was proposed by Dr. David B. Levine that a group of orthopedic surgeons interested in scoliosis could benefit themselves and others if they were to form a national organization devoted to the study of the spinal deformity. [6]

From his position on the podium, Dr. Moe "heartily approved of this thoughtful suggestion" and asked Dr. Levine to draw up a preliminary constitution for such a club. [6] In turn, Dr. Harrington (SRS President, 1973) said he would personally donate $1,000.00 to help organize it.

Shortly thereafter, letters were sent from the University of Minnesota Division of Orthopaedic Surgery to a number of orthopedic surgeons throughout the country asking for their opinion and advice regarding the establishment of a "scoliosis club," a name which had been suggested by Dr. Philip D. Wilson, Sr., whose advice Dr. Levine had sought. The response was overwhelmingly favorable. [6] Through correspondence, it was then proposed that an organizational meeting be held on Jan. 22, 1966, at the Palmer House in Chicago, Illinois, during the 33rd Annual Meeting of the American Academy of Orthopaedic Surgeons. During this meeting, the constitution that Dr. Levine had drafted was reviewed and revisions were proposed. The following officers also were appointed:

President: John H. Moe, MD
Vice president: John E. Hall, MD
Secretary and treasurer: William J. Kane, MD
Executive Committee: William J. Kane, MD; William F. Donaldson, MD; Louis A. Goldstein, MD; Paul R. Harrington, MD; David B. Levine, MD; Jacqueline Perry, MD

The name "North American Scoliosis Association" was selected for the club. A meeting of the executive committee was then arranged for the following day, Jan. 23, 1966, during which further consideration was given to the constitution and the name was changed to the "Scoliosis Research Society" in order to:

  • Stimulate an interest in scoliosis within the medical profession.
  • Promote the exchange of ideas related to the causes and treatment of scoliosis.
  • Standardize scoliosis terminology.
  • Establish a foundation for clinical and investigational research in scoliosis. [6]

According to Dr. William J. Kane (SRS secretary and treasurer, 1966–1970), to become a "research society," in the truest sense of those words, rather than an exclusive club, was "the most important and crucial decision that the founders of the SRS ever made." [7]

The committee planned to have the revised constitution ratified by two-thirds of the members present at the first annual meeting of the society. [6] The date for this meeting was set for June 10 and 11, 1966.

The meeting was held in Minneapolis at Diehl Hall, located in the Bio-Medical Library at the University of Minnesota. Sessions on the constitution, scoliosis terminology and evaluation filled the morning of June 10. The afternoon was devoted to five technical presentations and a movie. [7]

Scoliosis Research Society 1st Annual Meeting

June 10 and 11, 1966
5th Floor, Diehl Hall, Bio-Medical Library

Presentations:
Historical Notes on Scoliosis; Perimetry in Scoliosis
J. William Hillman
Congenital Scoliosis
Robert B. Winter, John H. Moe
Scoliosis Data Selection, Storage and Retrieval
Paul R. Harrington
Evaluation of Treatment of Scoliosis by Harrington Instrumentation
James W. Valuska, John H. Moe
Barium Swallow Studies in Scoliosis
Allan M. McKelvie
Exercise in Scoliosis (Movie)
Walter P. Blount

On June 11, the day was consumed by business meetings and a continuation of the sessions from the day before. The meeting attracted 35 participants from all over North America.

Scoliosis fellowship

In 1971, Dr. Moe established a scoliosis fellowship for physicians who had completed their orthopedic residencies and wished to specialize in the care and treatment of scoliosis. [4] The fellowship was endowed by the Twin Cities Scoliosis Fund, which was established as a memorial to Dr. Moe's first wife, Marguerite, after her death in 1969. [3]

In 1961, he wrote, "Orthopaedic surgeons in many areas of the United States and in many other countries have in past years incorporated into their resident-training programs so meager an exposure to scoliosis that orthopaedists are being sent out into practice each year without fundamental knowledge or any concept of what can be done for the child with lateral curvature of the spine. The minds of many have been closed to the unbiased evaluation of the efforts being made in scattered areas to teach basic principles of treatment of scoliosis and to demonstrate the really excellent results which are constantly obtained when these principles are intelligently applied." [9]

Fellows

Since its inception, over 140 physicians from all over the United States and many parts of the world have been trained in the treatment of scoliosis through the John H. Moe scoliosis fellowship program: Dr. Claudio Pedras of Brazil and Dr. Edgar Dawson of Los Angeles, California, were the first two physicians to complete the training program. Many of these physicians bring badly needed scoliosis care to their countries through the establishment of scoliosis clinics. [10]

International outreach

Dr. Moe worked selflessly to promote the care and treatment of patients with spinal deformities not only at home, but abroad. [2] Throughout Europe, Asia, the Caribbean and, most notably, South and Central America—where his work has been officially recognized in Brazil, Venezuela, Chile, Peru and Columbia—Dr. Moe's travels established him as a pioneer in scoliosis research and education. [2, 11]

International outreach

Twin Cities Scoliosis Center

Twin Cities Scoliosis Center Founders

In 1974, Dr. Moe founded the Twin Cities Scoliosis Center. In 1973, he had obtained authority from the University of Minnesota School of Medicine to establish an affiliation with Fairview Hospital. The following year, he was named professor emeritus of the Department of Orthopaedic Surgery as he directed his effort toward establishing the Twin Cities Scoliosis Center at the Fairview-St. Mary's Medical Office Building, adjacent to both hospitals and connected to them by skyways. [3]

Under Dr. Moe's direction, the center grew to become one of the world's major resources of patient care, scoliosis research and physician training in the field of spinal deformity. Physicians from all over the world sought his advice and counsel and came to study with him. [4]

School screening

The start of screening for scoliosis began in 1963 in Aitken, a town with a population of about 10,000 in central Minnesota. [14] In 1973, the state of Minnesota pioneered spinal screening in the United States by implementing a centrally directed statewide but voluntary program based on clinical examination. [15] To help promote the program, Dr. Moe and Dr. Robert B. Winter wrote "A Plea for the Routine School Examination of Children for Spinal Deformity," which appeared in the state medical journal. [16] During the 1975–1976 school year, over 570,000 children were screened in Minnesota. [14]

School screenings

As of 2003, 21 of the United States had legislated school screening, 11 states had recommended school screening without legislation, and the remaining either had volunteer screenings or recommended not to conduct screening in the schools. [17]

Milwaukee brace

After their meeting in 1947, Dr. Moe started to collaborate closely with Dr. Walter P. Blount on the development of the Milwaukee brace. [18] Together, they changed it from, as Dr. Moe described it, "an unsightly and unsatisfactory brace to a closely fitting brace easily worn; complications have practically been eliminated." [3]

Milwaukee brace

Dr. Moe's textbook

In 1978, Dr. John Moe and his colleagues from the Twin Cities Scoliosis Center published the first edition of their textbook, Scoliosis and Other Spinal Deformities. Now in its third edition, many consider this book to be the first definitive work on spinal-related deformities.

In 1955, while presiding over the Southern Medical Society, Dr. George Eggers urged Dr. Moe to write a "much needed book on scoliosis treatment." Dr. Eggers had been impressed by a paper on scoliosis that he invited Dr. Moe to present to the society's orthopedic section; however, Dr. Moe did not feel that his experience at that time justified such an attempt. In his foreword to Scoliosis and Other Spinal Deformities, Dr. Moe later wrote: "Now, after 28 years of learning, we will do so. This book is written with the major assistance of men who have gained basic knowledge of scoliosis treatment from working with me at Gillette Children's Hospital in St. Paul, the University of Minnesota Hospitals and Fairview Hospital in Minneapolis. These men have advanced far beyond my early teaching and have attained national and international renown as authorities in all fields of scoliosis, kyphosis and other spine deformities." [20]

Textbooks

Family life

Scoliosis also played an important part in the personal life of Dr. Moe. He met his wife Mary Lou through her daughter Nancy Wood, who had a congenital cervicothoracic scoliosis and needed surgery. [21] In 1974, at the age of 13, the magnitude of Nancy's double curve necessitated that she undergo posterior fixation instrumentation and spinal fusion from C6 to T6. [22]

Prior to surgery, Dr. Moe placed her in halo traction to distract her spine. The halo was then attached to a plaster body cast during the operation. "My six-month follow-up was a wonderful day because I got the halo taken off...I felt like a new person because I didn't have that thing on my head anymore, even though I had to wear another cast for three months," said Nancy. [23]

The follow-up visits lasted for two years. During her final appointment with Dr. Moe, while saying their goodbyes, he asked Nancy if more of her father's art was available in Minnesota. Having limited financial resources, Bob Wood—a Western and Native American painter and sculptor—had arranged with Dr. Moe to pay for her surgical treatment with art. "Yes, we have a lot of art. You ought to come over some time...Mom, can't we have Dr. Moe over for lunch or brunch or something on Sunday...wouldn't that be nice, wouldn't that be fun?" replied Nancy. [23]

Family life

"Sitting at the other end of the examination room, horrified that I would invite someone to come over...my mom said, 'No way! No way are we going to have some famous doctor come over to our house!' Dr. Moe just sort of laughed. He was always very friendly and nice. He smiled and said, 'Well, maybe you'll write me a letter and let me know when it might be a good time to come by and see some of the art that you have.' So they left it at that." [23]

Despite her initial reaction, Nancy's mother spent the weekend gathering together some paintings that she thought Dr. Moe might like to see and writing him that letter. "Please call me at either of the numbers above and let us know which evening or afternoon would be open for you. The girls are excited about your and your wife's visit if she would wish to come," Mary Lou wrote. [24] She was single at the time, as was Dr. Moe, and according to him, "this was the beginning of the team of Moe and Moe who now travel worldwide working together spreading the gospel of scoliosis." [21]

"When John came over to the house, we talked about all the pictures that we had out of my dad's. It was really a nice time. So that's how my mom and John really got to know each other," said Nancy. "Being, as she was, a medical secretary trained in Rochester, Minnesota [at the Mayo Clinic], he offered her a job...So she started working for him, then they got engaged and then they got married." [23]

Acknowledgments

The John H. Moe Exhibit was made possible through the generosity of Mrs. Mary Lou Moe and her family, Twin Cities Spine Center, and the Museum of Modern Spinal Surgery.

Museum of Modern Spinal Surgery

The Moe family

Mary Lou Moe (wife)
Claudia (Wood) Fussle (stepdaughter)
Elizabeth (Moe) Olson (daughter)
Kathleen (Wood) Dean (stepdaughter)
Lawrence D. Moe (son)
Nancy (Wood) Wilson (stepdaughter)
Richard J. Wood (stepson)

Twin Cities Spine (Scoliosis) Center

David S. Bradford, MD (founding member)
Francis Denis, MD
Daryll C. Dykes, MD, PhD
Timothy A. Garvey, MD
John E. Lonstein, MD (founding and sustaining member)
Amir A. Mehbod, MD
Kevin J. Mullaney, MD
Joseph H. Perra, MD
Manuel R. Pinto, MD
James D. Schwender, MD
Ensor E. Transfeldt, MD
Robert R. Winter, MD (founding member)

References

1. Asher MA, Keller RB. The Moe-Harrington Connection. Presented at: 25th Annual Meeting Scoliosis Research Society; September 24–27, 1991; Minneapolis
2. Wood KB, ed. Selected Writings: John H. Moe, M.D. Minneapolis, Minn: Twin Cities Scoliosis Spine Center; 1993.
3. Moe JH. A Reference to background and childhood. Typescript, circa 1976.
4. Bradford DS. John H. Moe, M.D., 1905–1988. J Bone Joint Surg. 1988;70-A(10):1577.
5. The Staff of Gillette Children's Hospital. The Specialized Orthopedic Surgery Program at Gillette Children's Hospital. Minn Med. June 1972;55:563.
6. Moe JH. Memorandum to Robert B. Winter regarding origin of the SRS, 22 January 1973.
7. The First 20 Years [videotape]. Chicago: Scoliosis Research Society; 1986.
8. Winter RB, Kane WJ. John H. Moe: In Memoriam. Spine. April 1988;13(4):442.
9. Moe JH. Changing concepts of the scoliosis problem. J Bone Joint Surg. June 1961;43-A(4):471-473.
10. Twin Cities Scoliosis Center. 1981 Annual Report. Minneapolis, 1981.
11. Kane WJ. Newer knowledge of scoliosis: a tribute of John H. Moe, M.D. Clin Orthop Relat Res. July-August 1977;126:2–3.
12. Thompson SC. Interview of Dr. Robert B. Winter, 13 June 2006.
13. Twin Cities Spine Center. History. Available at http://www.tcspine.com/about-us/history. Accessed on April 17, 2006, and updated January 2009.
14. Lonstein JE. Screening for spinal deformities in Minnesota schools. Clin Orthop Relat Res. 1977:33–42.
15. Lonstein JE, Bjorklund S, Wanninger MH, Nelson RP. Voluntary school screening for scoliosis in Minnesota. J Bone Joint Surg Am. April 1982;64(4):481–488.
16. Winter RB, Moe JH. A plea for the routine school examination of children for spinal deformity. Minn Med. 1974;57:419.
17. Grivas TB, Wade MH, Negrini S, O'Brien JP, Maruyama T, Hawes MC, Rigo M, Weiss HR, Kotwicki T, Vasiliadis ES, Sulam LN, Neuhous T. SOSORT consensus paper: school screening for scoliosis. Where are we today? Scoliosis. November 2007;2(17). Available at: http://www.scoliosisjournal.com/content/2/1/17. Accessed on March 7, 2008.
18. Blount WP. Bracing for scoliosis. In: Orthotics. Vol. 9 of Physical Medicine Library. New Haven, Connecticut: Elizabeth Licht Publisher; 1966:306–331.
19. Blount WP, Moe JH. The Milwaukee Brace. Baltimore, Md: The Williams & Wilkins Company; 1973.
20. Moe JH, Winter RB, Bradford DS, Lonstein JE. Scoliosis and Other Spine Deformities. Philadelphia, Pa: W.B. Saunders Company; 1978.
21. Hennepin County Medical Society. Dr. Moe Named Bolles Bolles-Rogers Winner. The Bulletin. May-June 1980;51(3):9.
22. Wilson NL. Personal communication, 28 September 2007.
23. Thompson SC. Interview of Nancy Wilson, 25 September 2007.
24. Wood ML. Letter to Dr. John Moe, 19 January 1976.