ROD DEROTATION TECHNIQUES FOR THORACOLUMBAR SPINAL DEFORMITY

OBJECTIVEThe operative correction of scoliosis requires multiple intraoperative techniques and tools to achieve an adequate result. Frequently, multiple methods are used to accomplish this, such as rod cantilever techniques, in situ bending, Smith-Petersen and pedicle subtraction osteotomies, closed reduction methods, and rod derotation techniques. Rod derotation techniques will be reviewed and discussed in this article. METHODSA review of the available literature on anterior and posterior rod derotation is performed with a case example of the authors' experience utilizing this technique. RESULTSRod derotation is one technique that can transform a pathological scoliotic curve to normal physiological kyphosis or lordosis by simply rotating a rod intraoperatively. CONCLUSIONIn this article, the authors present rod derotation as a valuable technique in the surgical arsenal for the treatment of scoliosis, including a discussion of the technique and its limitations.

[1]  K. Zielke Ventrale Derotationsspondylodese. Behandlungsergebnisse bei Idiopathischen Lumbalskoliosen , 1982 .

[2]  K. Cho,et al.  Is anterior release necessary in severe scoliosis treated by posterior segmental pedicle screw fixation? , 2007, European Spine Journal.

[3]  B. Lonner,et al.  Thoracoscopic spinal fusion compared with posterior spinal fusion for the treatment of thoracic adolescent idiopathic scoliosis. Surgical technique. , 2007, The Journal of bone and joint surgery. American volume.

[4]  B. Lonner,et al.  Thoracoscopic spinal fusion compared with posterior spinal fusion for the treatment of thoracic adolescent idiopathic scoliosis. , 2006, The Journal of bone and joint surgery. American volume.

[5]  M. Muschik,et al.  Comparison of anterior and posterior double-rod instrumentation for thoracic idiopathic scoliosis: results of 141 patients , 2006, European Spine Journal.

[6]  L. Lenke,et al.  Monaxial Versus Multiaxial Thoracic Pedicle Screws in the Correction of Adolescent Idiopathic Scoliosis , 2005, Spine.

[7]  Meic H. Schmidt,et al.  Surgical technique and results of endoscopic anterior spinal canal decompression. , 2005, Journal of neurosurgery. Spine.

[8]  G. Picetti,et al.  Thoracoscopic techniques for the treatment of scoliosis , 2004, Child's Nervous System.

[9]  Sang Min Lee,et al.  Direct Vertebral Rotation: A New Technique of Three-Dimensional Deformity Correction With Segmental Pedicle Screw Fixation in Adolescent Idiopathic Scoliosis , 2004, Spine.

[10]  U. Liljenqvist,et al.  Selektive ventrale Derotationsspondylodese bei idiopathischen Thorakalskoliosen: eine prospektive Studie , 2003 .

[11]  H. Halm,et al.  [Selective ventral derotation spondylodesis in idiopathic thoracic scoliosis: a prospective study]. , 2003, Zeitschrift fur Orthopadie und ihre Grenzgebiete.

[12]  K. Bridwell,et al.  Surgical treatment of idiopathic adolescent scoliosis. , 1999, Spine.

[13]  S. Tredwell,et al.  Rotations of a helix as a model for correction of the scoliotic spine. , 1999, Spine.

[14]  R. Betz,et al.  Comparison of anterior and posterior instrumentation for correction of adolescent thoracic idiopathic scoliosis. , 1999, Spine.

[15]  H. Halm,et al.  [Augmentation of VDS(ventral derotation spondylodesis) by double rod instrumentation. A critical analysis of 2-to-4-year outcomes]. , 2008, Zeitschrift fur Orthopadie und ihre Grenzgebiete.

[16]  C. Dickman,et al.  Thoracoscopic microsurgical excision of herniated thoracic discs. , 1998, Journal of neurosurgery.

[17]  V. Bühren,et al.  [Endoscopically controlled division of the diaphragm. A minimally invasive approach to ventral management of thoracolumbar fractures of the spine]. , 1998, Der Unfallchirurg.

[18]  U. Liljenqvist,et al.  Halm-Zielke instrumentation for primary stable anterior scoliosis surgery: operative technique and 2-year results in ten consecutive adolescent idiopathic scoliosis patients within a prospective clinical trial , 1998, European Spine Journal.

[19]  V. Bühren,et al.  Minimal-invasive ventrale Spondylodesen bei Verletzungen der Brust- und Lendenwirbelsäule , 1997, Der Chirurg.

[20]  K Kaneda,et al.  Anterior Correction of Thoracic Scoliosis With Kaneda Anterior Spinal System: A Preliminary Report , 1997, Spine.

[21]  V. Bühren,et al.  [Minimally invasive ventral spondylodesis in injuries to the thoracic and lumbar spine]. , 1997, Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen.

[22]  G. Picetti,et al.  Results of Video-Assisted Exposure of the Anterior Thoracic Spine in Idiopathic Scoliosis , 1996 .

[23]  G. Marquardt,et al.  Anterior decompression and stabilization using a microsurgical endoscopic technique for metastatic tumors of the thoracic spine. , 1996, Journal of neurosurgery.

[24]  C. Dickman,et al.  Thoracic vertebrectomy and reconstruction using a microsurgical thoracoscopic approach. , 1996, Neurosurgery.

[25]  P. Eysel,et al.  [CDH--preliminary report on a primary stable ventral lumbar spine instrumentation]. , 2008, Zeitschrift fur Orthopadie und ihre Grenzgebiete.

[26]  H. Halm [Augmentation of VDS (ventral derotation spondylodesis) using double rod instrumentation: surgical method and early results]. , 2008, Zeitschrift fur Orthopadie und ihre Grenzgebiete.

[27]  J. Regan A comparison of video-assisted thoracoscopic surgery (VATS) with open thoracotomy in thoracic spinal surgery , 1994 .

[28]  J Dubousset,et al.  NEW UNIVERSAL INSTRUMENTATION IN SPINAL SURGERY , 1988, Clinical orthopaedics and related research.

[29]  K. Zielke [Ventral derotation spondylodesis. Results of treatment of cases of idiopathic lumbar scoliosis (author's (author's transl)]. , 1982, Zeitschrift fur Orthopadie und ihre Grenzgebiete.

[30]  A. Sherwood,et al.  26 An Anterior Approach to Scoliosis: A Preliminary Report , 1969, Clinical orthopaedics and related research.

[31]  E. Hipp [Treatment of scoliosis]. , 1967, Therapie der Gegenwart.

[32]  P. R. Harrington,et al.  Treatment of scoliosis. Correction and internal fixation by spine instrumentation. , 1962, The Journal of bone and joint surgery. American volume.