. : When did you arrive at ?

. : October 6th, 1948. I carried out a training course of making function of intern in obstetrics in a maternity in Neuilly-sur-Seine and an evening a colleague saw me and tells me: “Can you repair my father? He directs in a hospital which will be closed if he did not find in the next days a doctor to reside at it. You would go for a short stay, one month for example, time that it finds you a stable substitute. ” His/her father, it was Joseph , the nephew of François Calot. I had never heard of before. The day of my arrival, it made a terrible storm and the old landing gear which took me along advanced painfully. I had the impression to go at the end of the world. Fortunately that Doctor awaited me the station.

 

. : How was this, ?

. : There was sand everywhere. It formed in the streets of true snow-drifts. Curved “pushers” tried to cross them, pushing carriages on which patients under their hedgings were lengthened. Two thousand patients reached of osseous diseases were then neat in , the majority in the four large specialized hospitals. The displacement of the patients involved in the streets an important traffic of flat carriages called “cable routing channels” on which they remained lengthened night and day. In the middle of the street I had noticed from the start a gathering of “cable routing channels” and . “It is here that the patients come to rent where to make repair their carriage”, tells me Doctor . It was the workshop of Mr whom I will attend so much thereafter.

 

. : Which was your assignment?

. : The Institute Stone-block then accommodated nearly 300 patients, primarily reached tuberculosis of the bones: badly of , coxalgia, tumors white, etc At the sides of there was an assistant, a former military surgeon, who had settled in like ENT SPECIALIST, and it is all! But were the processing reduced to what? Primarily with the puncture of the abscesses and the plasters of immobilization of the sick hinges. The evils of caused abscesses which by the in the triangle from and which went down sometimes had then to be punctured regularly. The dents required large bandages. Every morning, the nuns which made the nursing care collected buckets of greenish pus. But there was celebrates it cure . I.e., while waiting for the cure, the patients remained lengthened on their cable routing channel vis-a-vis the sea which got clear very far. In fact the specific virtues of the marine climate had been development since the beginning of the century. “Thanks to his particularly tonic microclimate, one told, in one winter is worth two summers! ”

 

. : No medicines?

. : There were no anti-tuberculous antibiotics at this time. I supported my thesis on the tuberculosis treatment ostéo-articular by the . When I arrived, pulmonary tuberculoses thus successfully were discussed. It was necessary to test in thearticular ones. One had entrusted to the instructor Etienne the responsibility to organize, on the whole of the hospitals of , the evaluation of the tuberculosis treatment by the .

 

. : What did you make at your beginnings?

. : At the beginning I had almost time to go to the fisheries to shrimps. As for the care, I made the punctures and the plasters. For the children who had or rachitics, one carried out in cutaneous osteotomies/. The consolidation was done very quickly in the plaster of correction. No cicatrice was visible, which made the admiration of the parents. I was permanently in the middle of the patients. The evening, as I was unmarried, I remained with them on the terrace and they posed heaps of questions to me which I did not can answer. The establishment was at the same time a hospital and a school. One passed the certificate of studies on the spot. The families came well to see the children, when they could it, but the majority lived far. Despite everything there was an good atmosphere and they were supported between them. Then, I told myself that I could not drop all these people-there. Such an amount of worse I will remain still a little with them. I thought of remaining there perhaps nths more. I remained 30 years there.

. : How were the deformations discussed?

. : With terrible plasters of rectification. The children reached of thoracic scolioses had the elevated arm on the concave side with the head and the trunk in position of permanent kyphosis. Kyphosis, had one says me, it was for the thorax. The cannot if the rachis are in dorsal lordosis. Why? Because the articular posterior ones are geared. Thus if is wanted, it is necessary that one has a little play between the posterior hinges, and for this reason it is necessary to put the patient in kyphosis and to then only push on the . It was said that it was necessary to discuss a scoliosis like a clubfoot by successive handling. I did that during two years. I learned how to do what Calot did formerly, i.e. to put a plaster of and to interpose under the plaster each week of the increasing quantities of felt-tip pen plates to accentuate the correction. Then at the end of nths, I reported myself that had many disadvantages, that the thorax was crushed, that lordosis was increased and that one prevented the patient from breathing when one supported too extremely ahead, etc

 

. : How do you explain such an archaism?

. : Because there was no criticism. had come to the Institute Stone-block, the first place to Europe where it had forwarded its method, and Stone-block had been completely allured. had gone to the United States to learn this technique. And the things continued like that. We left the war… When I decided to make amendments, one let me make. I had to amend the framework which was used for the realization of the collars. I placed a traction which did not exist in the plaster of . The correction was done by a system of tapes and specific smugglings to each case, without former thoracic pressure. The plaster was made over. In addition I started to involve the patients with the sport on the beach and the years of respiratory rehabilitation so that they can improve their musculation and their vital capacity. But of course, all that did not arrive the day at the following day.

 

. : You made yourself your experiment of the functional and csotcina.comedic processing of the scoliosis?

. : In 51, I went to see Pierre in Lyon. I knew that him also its side had organized a processing center of the scolioses, the Foundation. It brought together there patients with whom it made make csotcina.comedic gymnastics and processing. I went to inform me near him. We then often swapped unit our ideas and our techniques.

 

. : This moment you did not make surgery of the scoliosis?

. : At all. After the plasters, the patient was fitted with a collar of leather or celluloid. First surgery of the scoliosis, at the Institute Stone-block, arrival of Mr .

 

. : When Mr does it arrive on your premise?

. : In December 52. The management of the establishment had been entrusted to him. The team had packed itself and we were several doctors. Then when Mr arrives and that he discovers a team of young people he could have told them that it was not its level and have made come his Parisian assistants. On the contrary, he told: “I am not here for all to hustle, I am here to work and if you want we will work together. ” That obliged us to stir up us and one made with him an extraordinary team.

 

. : In practice, how that did it occur?

. : It came one day and half per month to see the patients and to make the main operations of csotcina.comedic surgery. It brought its own anesthetists. The tuberculous chambers were operated: direct accesses, evacuation of the abscesses, curetting of the lesions, arthrodesis of the large hinges. One operated also the deformations of the skeleton of the child: , or , pectus excavatum, inequality length of lower limbs etc and their after-effects in the adult. As I had practically not made general surgery, he asked me to regularly come to Paris in order to improve my formation. He was instructor charged with the Pulpit of operative procedure. So that at the end of my period of formation, I could receive in y qualification of general surgeon, in 1969 competence in csotcina.comedic surgery and 1975, during his creation, the qualification in csotcina.comedic surgery. Mr made this monthly voyage in during 25 years.

 

. : Spent a few years, which kind of interventions did you make?

. : I had specialized in the deviations of the spinal column. We made vertebral arthrodeses, sometimes for but especially for the scolioses. It was the only way maintain the corrections obtained. We had terrible cases of scolioses: the average of the was of 90°. Why? Because one sent to the worst cases. It was after the war, the children neither had been detected nor discussed.

 

. : What made them?

. : We endeavoured to rectify them gradually, and that often required much time, one year sometimes in plasters of progressive correction, while trying to improve their vital capacity, their muscular state, their psychological conditions. When the desired correction had been obtained, one removed the posterior party of the plaster and one grafted. The operation consisted in reviving the posterior party of the vertebrae on the whole of the curvature and depositing there cortico-spongy grafts which one took on the hip bone. The plaster was then closed again and operated remained lengthened on a cable routing channel harms and day during 12 to nth, until radiographic control shows an obvious osseous merger. But the losses of correction were not rare. It appeared necessary to fix a stay in the dishing to maintain the correction of the serious curvatures. As of 1954 we used a long cortical graft taken on the tibia of the patient to embed it between the thorny apophyses of the extreme vertebrae according to the technique of , and thereafter a heterogeneous graft of bone of calf or skid.

 

. : Did you have exchanges with other specialized centres?

Y.C.: Little, apart from those which directed to Lyon Pierre and Paris Pierre . Then I had the extraordinary chance to be able to make a long voyage of study in the United States. One day, I notice in the medical press that the Medical faculty of Paris proposes a six month old purse to a surgeon who would like to improve in a specific branch. I send a letter of candidature. A few weeks later, Faculty addresses a questionnaire to me which I answer. Then I forget. One year more, late I receive a letter of Medical faculty asking me to pass to the secretariat: “Sir, you are prize winner of the purse. ” This purse had a so large influence in my professional path which I wanted to know last year how I had been able to obtain it whereas I did not have any support. I wrote at the Medical faculty of Paris and I fell on an extremely pleasant secretary who is leaning on the files of 45 years ago. It found a box in which there was all the history.

 

. : And then?

. : Here the composition of the jury: Chairman Leon ; 4 instructors of clinical pulpits: Louis Pasteur-Valéry , Robert , Henri , Jean ; 4 instructors of scientific pulpits: Sirs , , Verne, and . Each one undoubtedly had a candidate but they were not able to agree. I was the only one that nobody knew. In his meeting of May 8th, 1958, the jury allotted the purse unanimously to me! At all events, the surprise passed, he was difficult for me to leave my service and my family. I was married and father of six children. But everyone encouraged me. My wife faced. The nuns who directed the Institute proposed to find me a temporary substitute and to continue to pour me my wages. I felt a little the disapproval of my colleagues, but Mr told me “It is the chance of your life; Go ahead! ”

 

. : Who did you visit?

. : I went initially to Cobb to New York then I made a whole circuit: Philadelphia, Baltimore, , Orleans News, Los Angeles, Iowa , Mineapolis, Milwaukee, Chicago, Boston and also Toronto, Montreal and Quebec.

 

. : What do you learn at Cobb?

. : There was in its service a great number of in processing, especially of the paralytic scolioses after poliomyelitis. I learn how there to examine thoroughly the patients and to measure the importance of the curvature to the radio: “the angle of Cobb”. It had improved the technique of the of which had become the “plaster of Cobb”. It was a very extensive plaster with hinge. It contained a , took all the trunk and the two thighs. It was divided transversely in its medium in such a way that the two parties could laterally tilt one on the other and open the curvature gradually. The interventions were carried out in the plaster by hulling and affixing of grafts as we did it in . When I left it, I thought of stopping me in Houston because a local surgeon had made to a presentation on an instrumentation which appeared interesting to me. Cobb dissuaded me while telling me; “It is insane, it puts metal in the vertebral column! ” I thus did not stop in Houston: this insane was called Paul

. : Which other memorable meetings?

. : That of to Los Angeles. I had already met it in France. I arrive at his place whereas its assistants had left all on vacation; he told me: “One will work together. ” It was very sympathetic nerve. It made fire the language with all its patients because it was convinced that the scoliosis was due to a Metabolic Disorder caused by the sweetened ice creams. He saw of it the sign in the of the language I learned how at his place to make the “localizer ” which he carried out on a special table, to locate the pressure on the by a metal push rod. This plaster immobilized the patient of the ring to the bottom of the buttocks. I found that it was much more constraining than than we made in . We discussed it often together. I helped it to operate. It could make three scolioses in the course of the day. It quickly approached the posterior party of the vertebrae and it raised a chip of thorny and blade which it left pedicle under the muscle. These chips were “” between them, i.e. higher chip against lower chip. He thus thought of obtaining a good merger without having to take bone on the iliac crests. To Mineapolis I passed to John and I saw how made him its hulling. He made neither like Cobb, nor like . After of thorny and blade, it opened interarticular spaces, removed the cartilage and stuffed the space thus open of small balls of cancellous bone packed to make arthrodesis. That seemed more judicious to me and its results were better. I then visited in Iowa and in Milwaukee. Finally, I practically went everywhere where it was done something of interesting. I posed with all the same questions and each evening I took notes which I piled up in four large books.

 

. : Did you have at this time the impression that these surgeons were very advances some on those of France?

. : Not always, but they all learned me much. I noted that they accommodated with cordiality and consideration the visitors, even if they did not have academic qualifications. The free access that they had opened to me with their files, their consultations, their methods and especially with their ideas, would I have found it in our hospital services?

 

. : With your return in France had you acquired a certain legitimacy?

. : Undoubtedly! I made several communications. I went a little everywhere where I was going to show what I knew and especially what I did not know; in any case I raised the questions which had to be raised. I was the only one to have made this tour.

 

. : In did your practice, what change?

. : In practice I improved my collar plastered while utilizing simultaneously the three forces of corrections which up to that point were used separately. Thus I developed the technique of EDF: Strain, , Bending. The plaster was made in the optimum position of correction and largely cut out to allow the muscular and respiratory years essential.

 

. : And for the surgery?

. : I endeavoured to carry out like John an interarticular arthrodesis and to deposit to the bed revived an large amount of osseous chips . The few rejections which one had had with the us had led to re-use an autogenous tibial graft. To avoid the possible fracture of thorny between which was embedded with force the graft, I made manufacture in of the stainless steel hooks, a little like the hooks of , between which I embedded the tibial rod after having carried out the strain of the curvature with a special dynamometric spreader. This progress allowed each time to reduce the times of immobilization. The next step was suggested to me by work of a Canadian, Armstrong, who referred to the interest of a third something to lean on at the top of the curvature. I found the idea good and I developed the . : Operative paragraph of Transverse Traction. It was to make it possible to bring closer to the line of centers the side vertebrae towards a stem of inserted on the concave side, and to thus relieve the supports on the level of the extreme vertebrae. This operative paragraph improved stabilization of the operated segment. The patients walked at the end of three months without plaster. The corrections were the best than we obtained until there. It is about this period that I am falls ill and that I very stopped. It was into 75.

 

. : What did it occur?

. : I carried out a life of insane; I operated five to six scolioses per week, I had many consultations, I slipped by on the right and on the left to make communications. I tried to write saturdays a little. One beautiful day, an assistant who left cardiology comes to tell me to slow down a little and to make a cardiologic balance-sheet. He finds with reason that I am tired more and more. He takes to me an appointment with a cardiologist of the Tenon hospital. The aforementioned tells me: “With electro there is nothing malicious good, but it would be good to make investigations, a test of effort in particular; one could do it in 10 days. ” I cannot return on this date, then one decides to do it immediately. One installs me in a room, one makes me go up on a bicycle in the presence of many students. I do not want to have the air of in front of the young people and I pedal to lose the breath. I start to perspire, they tell me: “That starts to be well, Mr…” I awake in reanimation. I tell: “I have my consultation at two hours” and one answers me, “you do not worry”. On the blow of three hours, new cardiac arrest. They reanimate me, but with difficulty, and the evening whereas I am in my bed that starts again. Three discomforts in only one day, that done much. they decide to put an intracardiac probe to me. I understand perfectly the conversations in the recovery room: “This type is nasty, three discomforts in the course of the day; if it has another this night of it, it will pass there. Did one warn his wife?” The , I am still there. A French cardiologist, Paul , former student of Power station had just developed an atomic pacemaker. After some adventures one established me in the abdomen an aircraft which ran on plutonium, called “ Alcatel. ” I was number 184.

 

. : How do you feel afterwards?

. : On the blow, taken by the events, I was happy to be still in life, therefore I was not desperate. I wanted to resume my work, . But I was not at all in form. I made a pericarditis, in short I did not leave myself there. A medical Commission classified me final invalid second category. There are three categories: the first where one can still do something, the second where one cannot exert any trade and the third where cannot “only leave a house on fire” had one says me. At 50 years, I felt from now on good with nothing; I had 8 dependant children, I did not have more future. I left , I went in my house of Brittany where I made . Every night, I operated in my sleep. The day I looked at salads pushing in the garden. Two years after my retreat in Brittany, while putting command in my office and while arranging cartons, a photograph fall. I recognize an young girl whom I lengthily looked after. I remember his history. I tell myself: “And if I looked with an eye all criticizes that I did? ” Indeed, for 20 years all the patients of the service had been photographed on their arrival and their departure. All these documents slept there, forgotten in a corner. I began with the play all to re-examine. Gradually, the day and the night in my sleep, it is with that I thought: “Of which instrumentation would it be necessary to lay out to carry out a three-dimensional correction and to abolish any plaster? ” It was for me a true therapy. I had installed in my Breton house a small workshop of do-it-yourself. I spent all my time there. Each day I drew prototypes.

 

. : How do you manufacture your prototypes?

. : For a long time, it is the workshop of Mr , that which repaired the “cable routing channels”, which me manufactured my instruments and my operative paragraphs. Thus it made me the framework of correction for scoliosis, a special table for spine surgery, the plantable metal hooks, first etc In 1973, the owner, without child, decides to close his workshop for lack of transferee. He proposes to me to take it again, but in my capacity as doctor in exercise, I tell him that it is not possible. He insists that I help it to find somebody. Finally, to render service to me, two members of my family agree to acquire the goodwill. A small firm is made up to ensure the survival of the firm and the continuation of the manufacture of the hardware. For ethical reasons, I refused to take part in it. Thus Society was born the first April 1973 from csotcina.comedic manufacture of Hardware, . It is it which, to render service to me, manufactured me my prototypes.

 

. : You wanted to obtain a correction?

. : Yes, it was necessary to reduce the side curvature, to correct vertebral rotation and to restore the sagittal physiological curvatures of the rachis. Work of had convinced me of the interest of a segmentary instrumentation but I feared the passage of wire in the spinal canal. I thus gradually improved the form of the vertebral hooks so that they can be superimposed on all the levels and fixed on a stem in reconciliation or spacing in any position of rotation. The two stems were identical concave side and side convex and joined together at their ends by a in order to produce a rectangular framework in which all the established elements were solidarized. The solidity and the stability of the assembly on the segment to be amalgamated were to make useless any post-operative external application in collar. I worked there from 79 to 82

 

. : How did you come from there to collaborate with ?

. : I thought of Jean , because I had forwarded with him twelve years earlier to the a conference of teaching on the congenital scolioses. I had been impressed by his quickness of mind, the safety of his judgment and his intellectual rigor. I knew work which it undertook on the three-dimensional character of the deviation. I told myself: “Here is a guy who will be able to tell me what is worth my instrumentation. ” Me, I did not have any more patients. I thus meet Jean who seems from the start interested. A few days later he writes to me to propose a case. The first operation took place at the hospital Saint Vincent of Paul on January 21st, 1983 on an young man reached of disease of .

 

. : They is curious which you did not begin “on your premise” in ?

. : When I developed this instrumentation, I initially went to show it with my successor, Daniel Chopin, who received me very nicely. But it did not seem interested because it had another instrumentation at the head. However thereafter, it took not only the landing gear goes from there but it was a genuine engine of CD.

 

. : How did your first installations occur?

. : Very well. We chose the most difficult cases intentionally. 25 cases are operated the first year including 17 in Saint Vincent of Paul, without specific problem. The patients are set up as of the first days which follow the operation, without plaster nor collar. In October ichel operated the first adult with Saint Joseph. It is with Jean and Michel that the operational strategy adaptable to each case is clarification. 137 cases were operated in 1984. The indications of the instrumentation extended then very quickly to all instabilities from the rachis: fractures, tumors, neurosurgery etc One beautiful day a surgeon of Quebec comes to visit me at the time of the . I had made knowledge with his father 25 years earlier. He asks me to see the instrumentation and on a radio in front of my window I explain to him: “Here I take a stem, I bend it to adapt it to the curvature. See this stem, it is twisted like that in this plan, but if I turn it of 90°, it becomes very right.” And there, illumination! I carry out that if one makes turn a bent stem, inserted concave side, one mobilizes all the vertebrae. One can at the same time reduce the curvature of face, apical rotation, and restore the physiological curvatures of the rachis of profile. It is indeed a three-dimensional correction. I propose the idea with Jean. One tested in the most flexible forms and the correction was done as wished.

 

. : International success was fast!

. : In September 1984, we went, Jean and me to operate in in Kentucky, on invitation of the instructor . In Brittany during my line of the desert, had come twice to see me. I had then shown him the prototypes on which I worked and that had interested it much. It returned to see me in Paris and invited us to come in to make a demonstration. To make operate in the United States an American citizen by foreign surgeons and with an instrumentation which does not have the approval of the FDA, it is not a small matter. Authorizations had had to be required in very high place. We operated in front of a panel impressing surgeons of the rachis of which . The correction was completely satisfactory. Eight days after there was a score of television channels which disseminated the event. The patients were obviously sensitized. Surgeons too.

 

. : Didn't you have from the start more success in the United States than in France?

. : The new instrumentation initially attracted curiosity, mistrust then the interest. It was almost simultaneous in the two countries, but on a different ladder. There was into 84 a hundred instrumentations ordered in the United States. I was anxious. It was necessary that we forward the gained experience, that we say the errors and the traps to be avoided. A paraplegia, it was the end of the instrumentation! I required that one send the hardware only to the surgeons who could attest that they had been formed there. Moreover, this precaution allowed the firm which manufactured the hardware not to be too quickly overflowed!

 

. : Which firm?

. : It was the small firm of which had become a large firm. That also had worried me. Would it have the capacity to answer an unceasingly increasing request? But I wanted to remain faithful to those which had worked with me and to keep an eye on manufacture. The hardware was baptized .

 

. : Thereafter CD was such a success that it did many followers…

. : It had many descendants. CD was sophisticated thanks to the contest of the surgeons who used it. We made Compact CD, because one found the instrumentation initial too bulky, in particular when he did not have much muscular hedging there, then CD Horizon. amalgamated into 93 with . Now, it is which ensures manufacture and marketing. They are leaving CD . Many surgeons brought their experiment, their reflections and their suggestions. It was a true team work, beyond the borders and through time. We opened a new route, much engaged there since. It is one of the things of which I am more to trust.

 

. : You created a Foundation?

. : I had taken patents for my hardware, and they were bought up by the firms. That gave me financial availabilities. I will not tell that I did not need any, one always needs money especially when one has eight children. But I considered that if I had had this extraordinary opportunity it was so that I do something of useful to all of it.

I wanted to create an Association Law 1901 for search in rachidian pathology. I even signed the agreement in front of notary. At the last time, the administration refused because the amount of money that I brought seemed him disproportionate with the aim indicated. Perhaps you one has believed that masked a business transaction? I was disappointed.

 

. : Why a Foundation?

. : To create a Foundation is a final instrument. It was told me that the Institute of France could can be to shelter that which I wished to constitute. I met Mr Pierre , Chancelier of the Institute. I informed him of my project. Complete records were submitted to the Advisory Members of the Commission of the Institute made up of the perpetual secretaries and representatives of the five academies. The Foundation for search in rachidian pathology was created by decree of October 27th, 1999. November 21st, 2000, an American subsidiary of the Foundation, Fondation was established in Tennessee.

. : Which kind of search encourage?

. : The search topic for 2140 2666 is the idiopathic scoliosis. I wanted to mobilize all those which can bring lights on top. One knows neither the cause nor the mechanism of development of the deformations which hide under the purely symptomatic name of idiopathic scoliosis.

 

. : How do you recruit?

. : By ad in the international press. The Foundation to date received 40 research projects coming from Canada, China, the United States, France, the United Kingdom, Japan, but also of Egypt and Yugoslavia. After study, the Scientific advice makes his selection with the blind man. Each board member receives the project without knowing his source. When the choice is stopped, he is proposed to the Board of directors which decides. At January 1st, 2004, 15 research projects will have been dealt with in the following fields: anatomo-pathology, biomechanics, biochemistry, endocrinology, genetics, neurology, otorhinolaryngology.

 

. : Are there French projects?

. : There is every year at least a French project. I hold to with it. But the disease does not have borders, search either. The Foundation wants to support the most promising programs where that they are and to bring closer all the research teams so that they enlarge their field of view and advance more quickly together.

Fifty five years after, questions of lengthened of “Why? How? ” resound still today in my head. The Foundation created at the Institute of France is the result and the continuity of a personal long story. It has the role of gathering and of helping all those which will be able to answer it. It remains always much of grounds to explore in the field of the diseases of the vertebral column.

 

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