Published by:
Courtney Sheedy

One Patient At A Time

Do you ever find yourself looking back on your successes in reflection of what the catalyst was? I do. Often. Its clear for me that everything in my career points back to one thing. Many claim luck. Others preparation. And for most, it’s a combination of those. For me, everything tracks back to scoliosis. My own diagnosis at age 15 was the catalyst on which my passion for spine was built.

Over the past 17 years, professionally I’ve been fortunate to do a little bit of everything: sales, marketing, product development, commercialization, operations. I’ve worked for corporate giants and start up ventures and worn hundreds of hats along the way, all in pursuit of my passion for making a small contribution to a massive industry. The foundation of that contribution has been scoliosis from the start. It’s been my ‘special sauce’. Because of my own diagnosis and experience with scoliosis, I have a unique combination of understanding the condition from all perspectives, which breeds a very rare brand of empathy.

I often feel compelled to make moves in my career that have nothing to do with what makes professional sense, but to move boldly in the direction of things that move me. Helping patients with scoliosis has always been a passion. Over the course of my career thus far, I’ve launched transformative scoliosis fusion systems aligned with prestigious surgeon developers. I abandoned a position directing a marketing department to be come become a team of one, at a startup up company on a mission to change the scoliosis bracing experience for adolescent girls. Most recently, a long-time friend and industry colleague’s post about a non-profit organization with a mission to make a global impact for children with some of the most clinically complex scoliosis cases that exist in the world moved me. I felt beyond compelled to get involved. Maybe I could contribute to the cause in some way. Over the following weeks and months, I became inspired by the hearts and minds behind 33 Spine Align and FOCOS Hospital in Ghana.

It’s a common phenomenon in taking on a cause so grand to get paralyzed by the magnitude of the macro need – they say take things one day at a time. For this cause, it’s actually one patient at a time.

It’s an interesting time for our Spine industry at present. We’re witnessing a massive consolidation of players; the economies of scale seem to be winning. What used to be innovation purely for the sake of patient care, recently has evolved into acquisition after acquisition with the goal of competing for market share. This isn’t a unique position. Not for med device, and not for spine. It’s been happening for decades in specialties that reach far beyond orthopedics, let alone spine. But speaking to my core competency, we’ll stick with the Spine M&A timeline…Medtronic (formerly Medtronic Sofmor Danek), Depuy Synthes, ZimVie (formerly Zimmer/Biomet/LANX/LDR), Stryker acquired K2M and the latest to the M&A party, Orthofix/Seaspine, Globus/NuVasive and Surgalign/Xtant. Most industry vets understand what this means to the street and the external implications from a business standpoint. Few people understand what it means to the internal organizations. Or if they do, most are wary to talk about it. As an employee native to LANX many years ago and having ridden the acquisition title wave through all phases to become the eventual Zimmer Biomet, well actually what exists now as the ZimVie organization, I speak from firsthand experience. Internally, a merger is chaos. It’s trying to organize vastly different cultures and create a new brand of awesome. It’s exhausting and deeply hard work. It’s tiring for everyone within the company hierarchy, from senior leadership to hourly employees and the ‘integration’ work touches everyone. No single role or title is unscathed. 

But what exists within the inherently traumatic and massive merger environment is a grand opportunity to do GOOD. The opportunity I’m specifically calling out lies among what’s referred to during the organizational integration process as ‘product rationalization activities.’ These exist nested within the laundry list of M&A integration project tasks. The it’s a required procedure for every spine merger that ever closed. It’s the process of evaluating each of the company’s product portfolios and taking inventory of which products rank superior and where there is specific overlap. The overlap is the opportunity to do GOOD. When two merging companies have products that directly compete, one is selected to live out is true product lifecycle, and the other is tagged for ‘rationalization,’ which basically means that the product will be discontinued. Decisions for the duration of time a product remains commercially active and what to do with excess inventory, instrumentation, etc. can vary widely from company to company and scenario to scenario. Often, perfectly good implants need to be scraped and, in the process, millions of dollars in inventory are written off.  

Here's where I see the opportunity, specifically for Orthofix and Seaspine, Globus and NuVasive and Surgalign and Xtant (along with the inevitable others that follow). The call-to-action is simply to find a way donate these implants, instruments, equipment and supplies to global outreach organizations where these systems… that technology… those dollars can impact and dramatically improve the lives of wildly deserving patients that are so desperately in need of our help. Maybe it could be considered paying a toll for the pause in dedication to innovation efforts that each combined company will be forced to take in order to become a newly amazing, consolidated union. For the interested parties, you ask who are the worthy recipients? Stay with me. Keep reading to learn about two global non-profit organizations who are internationally responsible for making an impact on beyond worthy spine causes and how to seize the opportunity to do GOOD. Be a part of the of the GOOD movement.


33 Spine Align has been serving Ghanian children with rare spinal deformities since 2019 via a partnership with FOCOS Hospital. Providing surgeons and medical devices and supplies, 33 Spine has transformed the lives of dozens of children, who, prior to their sponsorship wouldn’t have had a chance at leading a normal life. Through the philanthropic power of dollars, training, education and healing, 33 Spine organizes, staffs and facilitates annual mission trips to FOCOS Hospital to provide these life-altering second chances for children with some of the most extreme cases of scoliosis in the world. Due to malnutrition, lack of preventative care, lack of access to education and healthcare, unfortunately these types of spinal deformities are commonplace in Africa.

33 Spine Align came to fruition when President and Co-Founder, Ryan Normandeau, was inspired to build an organization that focused on the treatment of pediatric treatment of spinal deformities in Africa. He envisioned a collaboration that would allow the organization to support critical spine care, specifically in West Africa. Having been a part of the Spinal Implant industry for many years prior, Ryan was keenly aware of the need for a host hospital infrastructure to bring this vison to life. Ryan began evangelizing about the mission-driven need and opportunity, while leveraging his network to cultivate a partnership with an existing hospital organization with kindred mission, FOCOS Hospital.  FOCOS had the infrastructure in place and standing list of complex and deserving patients - opening the door for 33 Spine Align to concentrate its fundraising efforts directly aimed at FOCOS patients in Accra, Ghana.  During the first mission trip in 2019, 33 Spine Align was able to successfully fundraise and support 8 patient surgeries. Despite global COVID-19 challenges, 33 Spine Align returned to Africa in 2022 and will continue to do so each year with the goal of increasing the cadence of two trips each year, and hopefully more frequently as volunteers, fundraising and donations continue to grow. Recently, with the organization's perseverance and continued fundraising efforts, 33 Spine presented FOCOS with a check for $100,000 to fund scoliosis patient care, which barely scratches the surface of the organization’s devoted clinicians and committed board have for the partnership with FOCOS and the community it serves.

FOCOS - The Foundation of Orthopedics and Complex Spine

The Foundation of Orthopedics and Complex Spine (FOCOS) is a non-profit organization, established in 1998 by the globally recognized peditatric spine surgeon, Dr. Oheneba Boachie-Adjei, who was Chief of the Scoliosis Service at the Hospital for Special Surgery, New York and Professor of Orthopaedic Surgery at Weill-Cornell Medical College for Cornell University.

The FOCOS mission is to provide comprehensive and affordable orthopedic care to those who would not otherwise have access to such treatment. Specifically, FOCOS is in constant pursuit to enhance access to expert surgical and non-surgical care for patients with debilitating musculoskeletal disorders, specifically complex spine deformities in underserved regions of Africa. Dr. Oheneba Boachie-Adjei utilized his expertise, training and experience to bring elite spine care to the underserved people in his native country, Ghana and extend that care to the entire sub-Saharan region. In bringing his passion and dreams to life, he was able to build a bridge from the US to Ghana and create a sustained legacy in FOCOS hospital.

FOCOS is maintained by donation and sponsorship in the USA and Ghana and has been able to raise roughly $20 Million dollars from over 11,000 donors since the inception of the cause. FOCOS has utilized these funds to treat patients and to invest in its capability to scale and treat more and more patients in the coming years by expanding its footprint and constructing the current FOCOS Orthopedic hospital in Accra, Ghana. The current facility maintains 70 beds and includes fully accredited inpatient and outpatient departments. The hospital campus offers state of the art Radiology, Laboratory and PT departments and includes an ER, Pharmacy, Cafeteria and Laundry services. The hospital is also in the process of becoming accredited by the Joint Commission International (JCI), the globally recognized body for the accreditation of hospitals, which is known worldwide to stand for superb quality of care. Since its establishment in 1998, FOCOS has seen over 55,000 patients and conducted nearly 3,000 complex spine, joint replacement and other complex musculoskeletal surgeries on patients in need. FOCOS has hosted over 500 global volunteers including surgeons, nurses, physical therapists and many others.

Personalized patient care is what sets FOCOS Hospital apart. When a patient visits FOCOS Orthopedic Hospital, they truly receive world class care. All patients are greeted with an unmatched level of empathy, respect and capability, as expert physician specialists and caring clinical staff provide an exceptional patient experience.

The FOCOS staff treats some of the most severe cases in the world, many that no other team of surgeons would challenge themselves with taking on. With the support of a highly dedicated and skilled staff, ample volunteers, generous donors and connected partners, FOCOS is highly capable of transforming the lives of patients throughout Africa and the world.


In talking with those who have made it their life’s mission to be committed to this work, the needs are grand. The waiting list of children with spinal deformities is far too long. No donation is too small. Everything from osteotomes, to cell-savers, from PPE to imaging, from sutures to surgical implants are welcomed and needed. Aside from material needs, in order to scale the project beyond the 1-2 trips per year, people are needed too. We need to be more globally minded. Surgeon, nurse, rep, tech and patient experience volunteers are needed to enact more trips. The patients FOCOS treats are the most clinically complex orthopedic conditions in the world. Wouldn’t this be the greatest opportunity for pediatric scoliosis fellows and residents interested in becoming the spine innovators of the future to learn? And meanwhile gaining valuable perspective on how blessed we are in the western world to have ready access to all of modern medicine’s surgical advancements.

I’m committed. I’ll be taking it one editorial at a time. One post at a time. One call at a time. One presentation at a time. All for the opportunity to do better for scoliosis patients on a global level, while being focused on doing GOOD one patient at a time.


The Dedicated Forces of Nature Behind 33 Spine Align & FOCOS 

Irene Wulff, MD, Medical Director of FOCOS

The formidable leader who graciously fills the shoes of FOCOS founder Dr. Boachie (known locally and to friends as ‘Prof’).  Native to Africa, she’s on a passionate mission to improve the quality of healthcare in her country. The only thing that exceeds her levels of kindness and generosity are her capabilities as a physician. She became involved with FOCOS as a Jr. Resident and has been involved ever since, as her responsibilities and impact on the surgical program have grown immensely. She began working fulltime for FOCOS Hospital as Chief of Anesthesia in 2014 and took on the role of Medical Director incrementally, as Dr. Boachie gradually retired from the position. When questioned about growing challenges since his departure, Dr. Wulff suggested that exposure to the US Spine industry and connections with organizations like SRS have been slightly diminished, since many of the faculty members had direct relationships with Dr. Boachie and that open line of communication has lessened.

She indicated that there are more than 4000 children on FOCOS’ list who need help and cannot afford to pay. Some wait for close to five years and die waiting to be treated. The list, as she described it, is inexhaustible. When organizations like 33 Spine Align get involved and raise funding for 10 kids at a time, it’s a huge deal – an incredible gift of life to children who sometimes are deteriorating very quickly. These donations are not only gifting the children with healthcare, these surgeries also save them from a life of being socially stigmatized, shunned and bullied. She talked about Jonah who came in for surgery only able to mobilize on all-fours, having multiple severe spinal and limb deformities. After surgery and recovery, Jonah was able to walk for the first time in his life. As he departed FOCOS to return home, he was gifted with his first pair of shoes to begin the next phase of his life’s journey. Miraculous is what many would classify the work that the FOCOS personnel are doing.

Dr. Wulff mentioned a strong desire for more volunteers but noted the importance of recruiting the right volunteers – those that have a passion for improving global healthcare and have a strong sense of perseverance and tireless work ethic. She described the mission trips as rewarding, but more so as very hard work, with little sleep afforded to be able to help as many children as possible with the resources granted. It requires a special kind of person who can connect with the children, the ability to treat them with dignity and respect, to communicate to their parents through a sometimes-thick language barrier. Dr. Wulff concluded our conversation with a reminder that where there is passion to solve a problem, solutions come. And that one patient at a time is how big strides are made, rather than being discouraged by the magnitude of how many children need help.

Dr. Kushagra Verma

Dr. Kush Verma (known to friends and colleagues as ‘Kush”) became exposed to FOCOS as a med student in New York whilst attending an IMAST meeting. Dr. Boachie was presenting on some of the complex work he had done at FOCOS in Ghana on a mission trip. From there, Dr. Verma went on his first mission trip to FOCOS and has returned every few years since then to volunteer. He’s been constantly amazed by the complexity of the conditions treated and the sheer resilience of the children. Dr. Verma’s demeanor is deeply passionate about telling the stories of the kids 33 Spine Align has helped. He reiterated the power of the impressive work they have facilitated with the organization in such a short amount of time. He too mentioned that the influx of funding Dr. Boachie’s reputation brought to FOCOS and matched Dr. Wulff’s sentiments regarding the existing funding and exposure challenges FOCOS has faced since Dr. Boachie’s departure. Dr. Verma credit’s Dr. Boachie’s mentorship and the FOCOS mission program’s ministry to his success as a deformity-specialized spine surgeon in the US. The ministry program was a major catalyst that steered Dr. Verma’s interest and eventual passion in pediatric deformity surgery. Dr. Verma initially thought he might be overwhelmed seeing such need, thinking the trip may be a sad one. His mind was quickly changed. “It charges you up as a surgeon. You engage with such talent working alongside the experienced and talented attendings and are surrounded by the happy and hopeful attitudes of the patients. It ties everyone together in a very positive way. It’s the number one thing that keeps me going as a doctor today – knowing that I can still do really GOOD work once or twice a year…the work that’s consistently done at FOCOS day after day. I’m a more compassionate doctor for sure. What you do there results in you bringing home more heart. I’m a more confident, more experienced, and just plain better person and doctor because of this work.” The exposure to the FOCOS outreach, the surgeon volunteers and research work cemented Dr. Verma’s interest in pediatrics and scoliosis, having complete bought into the outstanding work being done by the surgeons at DuPont Hospital. Sharing the FOCOS mission experience with kindred emerging pediatric scoliosis specialists was a formative experience. At present day, Dr. Verma drives home the importance of identifying the right surgeons to volunteer, those that are dedicated to a life-long commitment to not only patient safety and complex surgical excellence, but those that have a deep desire to participate in global outreach. He describes the circular benefit of becoming involved with outreach like the work FOCOS and 33 Spine Align are doing, by circular he means that involvement includes giving and receiving. Volunteering early in one’s career and having access to expert mentorship in the early stages of becoming a surgeon can become a powerful display of what medicine is all about. Exposure to a global stage where the most complex spine surgery is being done can and should be a breeding ground for better surgeons, better humanitarians and a better career. Dr. Verma recently spoke to the surgical program at Vanderbilt University, building awareness for global outreach and mission-driven work. He continues to preach the benefits of outreach and mentorship within the spine community and beyond to any and all audiences.

Ryan Normandeau, 
President & Co-Founder of 

Ryan co-founded 33 Spine Align in 2018 as an effort to collaborate with other organizations on a mission to raise funding for spinal deformity care in Africa. Ryan is also the owner and founder of Empire Medical, LLC, a primarily Stryker distributorship located in Albany, New York. Ryan has a passion for helping others and has been vastly inspired and forever changed by the culture of Africa. Since inception, Ryan and the 33 Spine Align team have raised funds to facilitate 31 corrective scoliosis surgeries at FOCOS Hospital. Ryan and the team traveled to Ghana on the first mission trip with 33 Spine Align in 2019. Along with donated equipment and dollars, in December 2022 Ryan led a life-changing trip where the lives of 9 sponsored children’s lives were eternally transformed. While there, 33 Spine Align donated a $100,000 check to FOCOS in addition to the volunteer team they traveled with. In 2023, 33 Spine Align has its sights set on two trips to FOCOS in Ghana with the goal of doubling their fund raising efforts to multiply the organization’s ability to make a sustaining global impact on pediatric scoliosis.