The complicated curvature of a scoliotic spine has long fascinated Associate Professor Paige Little.
As a mechanical engineer, she has dedicated the past 18 years of her career to spinal research, particularly focused on spinal deformities, such as the incurable, though treatable, scoliosis in children.
Working in the QUT School of Mechanical, Medical and Process Engineering, Professor Little is involved in designing bespoke 3D-printed braces for children with the condition, as well as custom mattresses for use during surgery.
The results, she says, are “phenomenally rewarding’’ – a toddler sitting up just that little bit straighter; a surgeon delivering better patient care; a parent delighted their child is willingly wearing a well-fitting and comfortable brace. Sometimes, it is heartfelt words of thanks, or, simply, a smile from a child.
Professor Little, the research director of QUT’s Biomechanics and Spine Research Group (BSRG) – bringing together the university’s medical engineering researchers and spinal orthopaedic surgeons at Queensland Children's Hospital - also works to improve the understanding of what makes scoliosis develop.
The condition – a sideways curve of the spine along with a rotation along its axis - most commonly develops during the growth spurt before puberty and is more common in girls than boys.
Scoliosis in younger children is less common, but treatment is still needed to try to prevent the deformity from worsening. For some children, who are too young for corrective surgery, a bespoke brace to support their spine is the best option.
“A spine really is a central part of the body, providing vital support to the trunk and head, and when the spine isn’t developing typically, it really has a big impact,’’ Professor Little said.
“But for a very young child - maybe they are only two or three years old – there’s more happening at that age than just their spine and skeletal development. They need to be developing fine and gross motor skills, cognitive skills, social skills.
“So, it's really wonderful to hear a parent say a brace fits well, that a child is wearing it, sitting up straighter, able to do things better.
“Just getting one amazing outcome that improves a surgeon's ability to deliver care, as well as that child's outcome, is phenomenally rewarding for a researcher.
“It's a joyous feeling. It's what every researcher hopes that they might be able to achieve.’’
Dr Little studies MRI images from patients to better understand the “biomechanical process’’ of bone growth and mechanical loading on the bones.
“I am of the opinion that scoliosis development is related to spinal bone development, particularly an irregularity in the bone growth,’’ she said.
“And by understanding the mechanical impetus for this atypical growth, we can better understand the underlying causes for scoliosis in otherwise healthy young children.”
An engineer in the making
Growing up in Toowoomba as one of four siblings to parents, Grahame, an irrigation consultant, and Jan, the primary carer of the kids at home, Professor Little was considering studying medicine after graduating from high school at Fairholme College.
“I don’t think I’m necessarily cut out to do surgery, but radiology is a really interesting discipline. I think I would have loved to have done radiology, to be honest,’’ she said.
However, after receiving an annual scholarship to study an undergraduate degree at the University of Southern Queensland, she pivoted to engineering, taking on board advice from her mum and following her love of physics and maths. She also had several engineers in the family - a brother, two uncles, and several cousins.
Professor Little had an eureka moment during her Bachelor of Engineering, majoring in Mechanical Engineering, when she was studying the mechanics of teeth fractures and realised she could apply her engineering skills in a medical setting.
“Suddenly, the concept of using my mechanical knowledge to understand something about a human body was just ‘wow’, it was a perfect match,’’ she said.
“I knew I wanted to use my mechanics knowledge in a human body because the human body is essentially just a big machine.’’
With this newfound direction, and because she “couldn’t bear the thought of not learning anymore’’, she embarked on a PhD at QUT in medical engineering with Emeritus Professor Mark Pearcy (the foundational chair of biomedical engineering at the university) who was an expert in spine biomechanics.
In 2004, Professor Little moved to England, working as a research engineer at University of Oxford, where she turned her attention to hips, working in a hospital setting and liaising with clinical staff for her studies into hip replacement surgery.
She returned to Australia in 2006 with her husband, criminologist Dr Simon Little (because “it was his turn to develop his research career”, which had been on hold while she worked in Oxford) and took up an opportunity to work in spines again with the Paediatric Spine Research Group. This was a former collaboration between QUT, the Mater Public Children’s Hospital and the Queensland Orthopaedic Research Trust focusing on spine deformity (now BSRG).
This cemented her love of translational research – converting research into tangible patient benefits.
Professor Little also works to create new design criteria for commercial mattresses in a partnership with Sealy Australia at QUT’s Centre for Biomechanics and Sleep Research; and investigates new remote health technology and improved treatment for kids with scoliosis who don’t live in Brisbane.
“I love translational research. Seeing application of my research is really exciting,’’ Professor Little said.
“All our projects have a clear impact because they are driven by clinical need, or by an industry need, which I love. There’s so much to learn and I still learn every day.’’
You can't be what you can't see
Working closely with children in a hospital setting and watching her own daughters grow up healthy and strong, Professor Little knew her girls were fortunate. They had good health but they were also blessed with opportunity, and a loving, secure home and family.
Not all children are so blessed.
Aware of the vast disparity in prospects for some children from socio-economic disadvantage, Professor Little, as a female mechanical engineer working in STEM, was also conscious of the gender and social inequality in her chosen industry.
And so, it was time that a chance conversation, on the sideline of her daughter’s touch football game several years earlier, came into play.
The conversation, with the then-principal of Mabel Park State High, in Logan, south of Brisbane, touched on the school’s many innovative programs to help its disadvantaged students, such as an on-site school psychologist and GP, flexible schooling, supplied breakfast, and help with uniforms.
In 2021, with support from the QUT School of Mechanical, Medical and Process Engineering, Professor Little began a STEM immersion program for Mabel Park State High students, focusing on girls from socio-economic disadvantage as well as First Nations backgrounds.
Beginning with a cohort of eight girls, the program has grown every year, is now expanded across the whole Faculty of Engineering and includes boys.
“I wanted to encourage these kids to develop confidence in their STEM abilities, and to see themselves achieving amazing things and learning new skills in a university space – for them to feel a sense of belonging at uni,’’ Professor Little said.
“You can’t be what you can’t see. You need a role model, otherwise you don’t realise that’s the thing you could be.’’
June is Scoliosis Awareness Month.
Aligned with the United Nations Sustainable Development Goals
In 2015, UN member states agreed to 17 global Sustainable Development Goals (SDGs) to end poverty, protect the planet and ensure prosperity for all.
