Surgical and Clinical Results of Scoliosis Surgery Using Zielke Instrumentation

Moskowitz, Alan; Trommanhauser, Scott

doi:10.1097/00007632-199312000-00013

Cited by 38 publications

(22 citation statements)

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“…Since introduction of the VDS-Zielke instrumentation [44], this procedure has become an accepted technique for correction of thoracolumbar and lumbar curves [11,12,20,28,29,[31][32][33]. In comparison to CDI, VDS-Zielke is reported to provide a better frontal plane correction with a shorter fusion length [12,29,38].…”

Section: H Halm T Niemeyer T Link U Liljenqvistmentioning

confidence: 99%

Segmental pedicle screw instrumentation in idiopathic thoracolumbar and lumbar scoliosis

Halm¹,

Niemeyer²,

Link

et al. 2000

European Spine Journal

166

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Section: H Halm T Niemeyer T Link U Liljenqvistmentioning

confidence: 99%

Segmental pedicle screw instrumentation in idiopathic thoracolumbar and lumbar scoliosis

Halm¹,

Niemeyer²,

Link

et al. 2000

European Spine Journal

166

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“…With this correction, the tilt angle of the lowest intrumented vertebra was well corrected. Correction of the major curve led to spontanous correction of the upper compensatory curve, which also occurs after VDS [3,4,14,17,21].…”

Section: Discussionmentioning

confidence: 99%

“…A major shortcoming of VDS is a kyphogenic effect within the instrumented levels [8,[13][14][15][16][17][18]. With development of our system we aimed at preserving the established and proved correcting principles of VDS.…”

Section: Discussionmentioning

confidence: 99%

“…This is a wellknown complication related to the anterior exposure of the lumbar spine, and occurs in up to 30% of cases [17]. It is related to the mobilization and retraction of the psoas muscle and irritation of the underlying nerve root.…”

Section: Discussionmentioning

confidence: 99%

“…A few authors pointed out that the sagittal plane can be positively influenced with VDS [3,4,21]. However, others have reported a kyphogenic effect [1,11,[13][14][15][16][17][18]20]. Another major disadvantage of VDS is lack of stability, which makes longterm brace or even cast treatment necessary.…”

mentioning

confidence: 99%

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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

Halm

Liljenqvist

Niemeyer

et al. 1998

European Spine Journal

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IntroductionFirst published in 1969, Dwyer instrumentation was the first anterior system for correction of scoliotic deformities of the spine [2]. Major disadvantages of this system were a marked kyphogenic effect, ineffectiveness of derotation, frequent cable fractures with pseudarthrosis and screw pullouts. Ventral Derotation Spondylodesis (VDS), also known as Zielke instrumentation, was developed to preserve the advantages and to eliminate the disadvantages of Dwyer's technique [21]. VDS is the gold standard of scoliosis surgery from the anterior approach [7]. Whereas frontal plane correction and derotation have been reported to be superior to posterior instrumentation techniques, the influence of VDS on the sagittal plane has been a subject of debate during the last two decades. A few authors pointed out that the sagittal plane can be positively influenced with VDS [3,4,21]. However, others have reported a kyphogenic effect [1,11,[13][14][15][16][17][18]20]. Another major disadvantage of VDS is lack of stability, which makes longterm brace or even cast treatment necessary. Screw pullouts, especially at the most superiorly instrumented level and fractures of the threaded rod were reported by several authors [8,13,16,19]. These were associated with painful pseudarthrosis and loss of correction in quite a number of patients. Halm-Zielke instrumentation (HZI) was developed to eliminate the disadvantages of Zielke VDS.Abstract Halm-Zielke instrumentation (HZI) was developed to eliminate the disadvantages of Zielke instrumentation (VDS) in terms of lack of primary stability and a kyphogenic effect. HZI is an anterior double-rod system. The system is composed of a lid-plate, which is fixed at the lateral aspect of the vertebral body with two screws, a sunk screw anteriorly and a VDS screw posteriorly. The lid-plate design provides the lowest possible implant profile. The longitudinal components consist of a threaded VDS rod and a solid, fluted rod. Correction is performed with the threaded rod and the solid rod. The solid rod allows internal derotation and relordosation, eliminates the Zielke three-point lever system and augments the system. The fluted design of the rod provides rotatory stability. This is a report of the first ten consecutive adolescent idiopathic scoliosis patients in a prospective clinical trial using HZI with a minimum follow-up of 2 years. Curves ranged from 36°to 77°. Correction of the frontal plane averaged 77.5% and 72.2% postoperatively and at follow-up, respectively. Thoracolumbar kyphosis was present in three patients and corrected in all from an average of + 18°to +1.7°at follow-up. Implant-related complications were not observed. All patients were treated without any additional external immobilization. In our opinion, HZI is a major improvement on the original Zielke VDS. It eliminates the kyphogenic effect and provides primary stability.

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Blood Loss in pediatric spine surgery

Shapiro

Sethna

Haemostasis in Spine Surgery

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Surgical and Clinical Results of Scoliosis Surgery Using Zielke Instrumentation

Cited by 38 publications

References 0 publications

Segmental pedicle screw instrumentation in idiopathic thoracolumbar and lumbar scoliosis

Segmental pedicle screw instrumentation in idiopathic thoracolumbar and lumbar scoliosis

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

Blood Loss in pediatric spine surgery

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