The use of three rods in correcting severe scoliosis.
Date
2021-07
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Abstract
Purpose
The three-rod technique, utilising a short apical concavity rod is an option to achieve controlled correction in severe scoliosis. We describe this technique, the complications encountered, and the long-term outcomes.Method
All paediatric patients who had at least 2 years follow-up after undergoing corrective surgery for scoliosis ≥ 100° using 3 parallel rods were included. Radiographs were assessed to evaluate the correction and clinical records examined for any loss of correction, complications, revision procedures or neuromonitoring events.Results
Twenty-five patients met the inclusion criteria. Four underwent prior anterior fusion to prevent crankshaft phenomenon. The mean angle of the deformity was 112.0° (range 100.3-137.1). Mean maximal kyphosis was 48.8° (range 11.4-78.8°) and mean curve flexibility 4.4% (range 0-37.0%). Intraoperative traction achieved an average of 70.4% (95% CI 56.6-84.1%). Nine patients (39%) showed a reduction in MEPs during definitive surgery. All returned to within 75% of baseline by the end of surgery. All patients had normal postoperative neurology. One patient underwent removal of hardware for late infection. The mean overall Cobb correction was 55.7° (95% CI 50.2-61.2°), equating to 50.2% (95% CI 44.9-55.4%) of the mean initial deformity. Thoracic kyphosis reduced by a mean of 18.2° (95% CI 12.8-23.6°).Conclusion
Our series suggests that three-rod constructs are able to safely and effectively achieve 50% correction of severe scoliosis.Type
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Rocos, Brett, Eliane Rioux-Trottier, Masayoshi Machida, Amit Sigal, Jim Kennedy, David E Lebel and Reinhard Zeller (2021). The use of three rods in correcting severe scoliosis. Spine deformity, 9(4). pp. 969–976. 10.1007/s43390-021-00300-y Retrieved from https://hdl.handle.net/10161/29696.
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