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T10 to L3 Scoliotic Spinal Fusion

This selection of surgical illustrations is taken from an instructional sequence visualizing the latter half of a scoliotic spinal fusion. The primary goal was to clearly depict this specific surgery as it was performed by the observed surgeon, Dr. Stephen Lewis of Toronto Western Hospital. Emphasis was put on effective storytelling as well as anatomical and procedural accuracy. Input from the surgeon was also considered, including the request to focus on the unique procedural aspects of his surgical workflow and to illustrate from a surgeon’s viewpoint. See below for further details and work in progress.


Surgical students


Prof. Michael Corrin

Dr. Stephen Lewis


Print (textbook)

11" x 17"


June 2018

Tools Used


Adobe Photoshop

Adobe Illustrator

Other Inked Illustrations

Surgical Sequence, Pencil Sketches

Due to the length and complexity of the surgery, I worked together with my classmate and partner Nitai Steinberg to illustrate the final sequence of pencil sketches. In the accompanying figures, I was responsible for Figures 1-5 as well as 9-11. The sketches for Figures 6-10 shown here (lightened) are my rough drafts from earlier in the revision process.

Progress Work


Nitai and I used 3D models in Cinema 4D to aid us in accurately illustrating our subjects. We obtained a pre-made model of a spine and manipulated it to match our patient's scoliotic X-rays. We also created simple models of surgical tools (including screws, extenders, and rods) and placed them correctly relative to our spine model.


In the OR during surgical observation, I recorded, wrote notes, and drew rough sketches of the surgical procedure. From there, I worked out which steps of the procedure to focus on and how to illustrate them. Through several rounds of review with Professor Corrin, Professor-emerita Margot Mackay, and Dr. Lewis, I improved the accuracy and storytelling clarity of each draft.

References: DeWald, R.L., V. Arlet, A.L. Carl, and M.F. O’Brien. 2003 Spinal Deformities: The Comprehensive Text: Thieme. Haher, T.R., and A.A. Merola. 2003. Surgical Techniques for the Spine: Thieme. Moe, J.H., R.B. Winter, D.S. Bradford, and J.E. Lonstein. 1978 Scoliosis and other spinal deformities: W.B. Saunders Company. Vaccaro, A.R., and T.J. Albert. 2003. Spine Surgery Tricks of the Trade: Thieme. BodyParts3D, © The Database Center for Life Science licensed under CC Attribution-Share Alike 2.1 Japan CD HORIZON® SOLERA™ Spinal System booklet (Medtronics). CD HORIZON® LONGITUDE™ Multi-level Percutaneous Fixation System animated video (Medtronics) Slides from Dr. Stephen Lewis (the surgeon)


AMY CAO 2019