Joseph C. Risser Sr., 1892–1982

This biographical sketch of Joseph C. Risser Sr. corresponds to the historic text, The Classic: The Iliac Apophysis: An Invaluable Sign in the Management of Scoliosis, available at DOI 10.1007/s11999-009-1096-z. Joseph C. Risser was born August 6, 1892, in Des Moines, Iowa. He earned his medical degree from the University of Iowa in 1923 and served his residency at the New York Orthopedic Hospital [7]. During his residency, he became a protégé of Russell Hibbs, MD (1869–1932), who pioneered spinal fusion for scoliosis patients in the early 20th century [14]. As a resident, Risser began to develop his own innovations in scoliosis treatment, most notably a program for long-term followup of patients. This research effort informed many of his contributions to the treatment of spinal curvatures over more than half a century, almost all of it spent in his practice in Pasadena, California [14]. What became known as the Risser Sign was not the result of a flash of inspiration but rather born from years of hard work and collaboration. Before the 1930s, the relationship between vertebral growth and deformity was not understood. As Risser summarized it in 1966, ‘‘One school of thought, including laymen and some of the profession, was that the spinal deformity of scoliosis did not increase after vertebral growth was completed. However, another school of thought, consisting of the specialists, believed that as long as there was motion in the spine, the deformity would increase’’ [9]. Along with Albert B. Ferguson, MD, another Hibbs’ trainee, Risser helped develop radiographic methods still used to assess scoliosis today. According to Wenger [14], Ferguson developed an angular method for measuring x-rays that was invaluable to Risser’s observation of the iliac crest. In 1936, the duo described the progression of scoliosis in untreated patients and noted slow growth of the spine, with gradual increase in deformity between the ages of 5 years and 10 years, and accelerated growth and deformity between the ages of 10 years and 15 years [10]. In 1947, Risser first described his observations regarding the relationship between spinal development and the iliac apophysis at the annual meeting of the American Academy of Orthopaedic Surgeons [2]. By the time he formally published his findings, 11 years later, grading systems based on his observations were in use across the United States. In the article from 1958 that we reproduce here, Risser describes the well-known sign to assess the state of vertebral growth and predict whether scoliosis curves would progress in growing children. Growth plates in the spine, he noted, are not easily visible and thus could not be used to assess spinal growth with any reliability. However, he observed, the ossification of the iliac apophysis coincided with that of the vertebral plates, and therefore, ‘‘the attachment of the iliac apophysis has proved to be an M. M. Manring, J. Calhoun (&) Department of Orthopaedic Surgery, The Ohio State University, N1043 Doan Hall, 410 W 10th Ave, Columbus, OH 43210-1228, USA e-mail: [email protected] M. M. Manring e-mail: [email protected] 123 Clin Orthop Relat Res (2010) 468:643–645 DOI 10.1007/s11999-009-1095-0