Correction manoeuvres in the surgical treatment of spinal deformities

Abstract

Correction manoeuvres are as important as the other issues such as hardware selection, graft options, fusion and osteotomy techniques in the surgical treatment of spinal deformities.The property of materials demonstrating both viscous and elastic characteristics when undergoing deformation is called visco-elasticity. Purely elastic materials change in shape with a stress, and go back to their initial form when the stress is removed. However, visco-elastic materials, like the spine, may protect their new formation unless a back stress is applied. Time is a very important parameter during manoeuvre application to the spine because of its visco-elastic behavior.The most common correction manoeuvres that can be used for spinal deformities are rod de-rotation, distraction-compression, in situ rod bending, segmental de-rotation, en bloc de-rotation and cantilever.Spontaneous correction of a minor curve is possible after selective fusion of a major curve due to coupling phenomenon.Cite this article: EFORT Open Rev 2017;2. DOI: 10.1302/2058-5241.2.170002. Originally published online at www.efortopenreviews.org

Accuracy assessment of pedicle screw insertion with patient specific 3D‑printed guides through superimpose CT-analysis in thoracolumbar spinal deformity surgery

“…Most of the deviations were seen both at the insertion point and final positioning of the screw head and at the distal tip of the screw; not within the pedicle itself. The screw positions were possibly slightly altered during maneuvers associated with deformity correction [21]. Nevertheless, the absence of any pedicle wall violations or perforation of any vertebral body cortices, clearly demonstrates the high level of accuracy obtained while adopting this technique in our clinical practice.…”

The “Rail Technique” for Correction of Cervicothoracic Kyphosis: Case Report and Surgical Technique Description

“…Another complicating phenomenon of in situ bending is the "spring back" of the rod that can prevent preserving the acquired deformity correction after removal of the bending force. 10 Given each of these 3 technique's potential limitations, the "rail technique" is an ideal alternative, as it allows for powerful focal kyphosis correction while minimizing stress on the bone-screw interfaces.…”

“…In situ bending is a very common technique that is suited for fine-tuning maneuvers of deformity correction, as it can place considerable stress at the bone-implant interfaces. Another complicating phenomenon of in situ bending is the “spring back” of the rod that can prevent preserving the acquired deformity correction after removal of the bending force [ 10 ]. Given each of these 3 technique’s potential limitations, the “rail technique” is an ideal alternative, as it allows for powerful focal kyphosis correction while minimizing stress on the bone-screw interfaces.…”

Cantilever method for severe kyphotic deformity correction in spondylitis tuberculosis: A technical note and literature review

“…Kyphotic deformity which is basically a sagittal-plane deformity (rarely with rotational component) usually sufficient with the cantilever technique. [ 4 ].…”

“…Appropriate surgical approaches and techniques are issues to face in correcting deformity without adding any harmful damage to the patient. [ 4 ].…”