SPMLs & EtOH

open were not compromised by SPMLs also done at the same time – though that was not our thrust of interest. Basically, SPML never increased the larger open surgery time in any measurable way but it did reduce actual operating time frequently from preoperative projected time estimates. 100% of parents (of SPML) reported, by questionnaire, that they would do it again, knowing what they now knew, if sent back in time to re-decide. Over the following years that affirming opinion did not change. Aside from internal review and local orthopedic meeting presentations of specific aspects, the entirety was presented to the Canadian Orthopedic Research Society Annual Meeting, June 3, 1997 in Hamilton, Ontario, Canada by S. Walsh, APN. That session was overseen and the details reviewed by Dr. Robert Salter who stated that he liked the underlying concept and praised the depth of the study itself. It was thoroughly questioned and discussed by an audience of pediatric orthopedic attendees with overall positive regard. Since that time, adding oddball case observations and laboratory volunteer studies to try to pin down just what was happening, our methods evolved. What was small by necessity for cardiac patients became even smaller once we discovered ophthalmology tools. It became smaller not because we needed to be small anymore but because small was all that was needed once the underpinnings of success emerged – grudgingly. Range of motion isn’t it. Nice to have it, but that is not the target. This was not an easy belief to shed. Here is the important core of understanding: walking is a beautiful tune played on a masterfully built instrument. We tune that instrument in the way it can be played. Making the instrument taller, or straighter, or with more keys to press or holes to plug is irrelevant. The tune matters, only the tune. Know what is there, probe and test (stimulate) to see what makes what else spring forth - where and how much. THAT is the target. SPML is the overall gross tuning method, including focal ethanol to allow more precision and less REQUIREMENT to cut more places more extensively.