The “kickstand rod” technique for correction of coronal malalignment: two-year clinical and radiographic outcomes

Puvanesarajah, Varun; Raad, Micheal; Hassan, Fthimnir M.; Lombardi, Joseph M.; Sardar, Zeeshan M.; Lehman, Ronald A.; Lenke, Lawrence G.

doi:10.1007/s43390-022-00564-y

Cited by 4 publications

(13 citation statements)

References 19 publications

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“…The full texts of these 10 articles were then read to assess for eligibility. Of these, six studies were included in the review, and data were extracted for pooled analysis [18][19][20][21][22][23] (Fig. 1).…”

Section: Search and Screening Resultsmentioning

confidence: 99%

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The kickstand rod technique for correction of coronal malalignment in patients with adult spinal deformity: a systematic review and pooled analysis of 97 cases

Kumar,

Dhatt,

Bansal

et al. 2024

Asian Spine J

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Coronal malalignment (CM) has recently gained focus as a key predictor of functional outcomes in patients with adult spinal deformity (ASD). The kickstand rod technique has been described as a novel technique for CM correction using an accessory rod on the convex side of the deformity. This review aimed to evaluate the surgical technique and outcomes of corrective surgery using this technique. The literature search was conducted on three databases (PubMed, EMBASE, and Scopus). After reviewing the search results, six studies were shortlisted for data extraction and pooled analysis. Weighted means for surgical duration, length of stay, amount of coronal correction, and sagittal parameters were calculated. The studies included in the review were published between 2018 and 2023, with a total sample size of 97 patients. The mean age of the study cohort was 61.1 years, with female preponderance. The mean operative time was 333.6 minutes. The mean correction of CM was 5.1 cm (95% confidence interval [CI], 3.6–6.6), the mean sagittal correction was 5.6 cm (95% CI, 4.1–7.1), and the mean change in lumbar lordosis was 17° (95% CI, 10.4–24.1). Preoperative coronal imbalance and mean correction achieved postoperatively were directly related with age. The reoperation rate was 13.2%. The kickstand rod technique compares favorably with conventional techniques such as asymmetric osteotomies in CM management. This technique provides an additional accessory rod that helps increase construct stiffness. Because of limited data, definitive conclusions cannot be drawn from this review; however, this technique is a valuable tool for a surgeon dealing with ASD.

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Section: Search and Screening Resultsmentioning

confidence: 99%

“…2), which ranged from a mean age of 54 years (range, 20-73 years) [23] to 72.2±1.9 years [20]. Five studies reported sex distribution in the study cohort; of these, 18 of the 76 individuals (23.7%) were male [18][19][20]22,23].…”

Section: Patient Characteristicsmentioning

confidence: 99%

The kickstand rod technique for correction of coronal malalignment in patients with adult spinal deformity: a systematic review and pooled analysis of 97 cases

Kumar,

Dhatt,

Bansal

et al. 2024

Asian Spine J

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“…12 Other case series have shown similar findings. 15,16,19 In addition, in a comparative study of 21 patients undergoing ASD surgery with KSR matched to 36 controls, those undergoing a KSR had a significantly higher coronal malalignment correction, with no increase in mechanical complications. Although these previous studies have proven its efficacy, we aim to provide a simple 8-step process to perform the KSR technique, with easy-to-follow images and video.…”

Section: Discussionmentioning

confidence: 99%

“…Vector forces are then applied to the opposite side of the coronal deviation, which depresses the ipsilateral pelvis and improves coronal correction. 12,13 Although multiple studies have demonstrated the efficacy of the KSR technique in restoring coronal alignment, 3,4,[14][15][16][17] an in-depth, step-by-step description of how to implement the technique is lacking. In addition, reports with intraoperative images and videos are sparse.…”

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confidence: 99%

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Placement of a Kickstand Rod in Adult Spinal Deformity Surgery: A Simple 8-Step Process With Intraoperative Images and Video

Younus,

Chanbour,

Ali

et al. 2023

Operative Neurosurgery

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BACKGROUND AND OBJECTIVES: In adult spinal deformity (ASD) surgery, operative correction of coronal malalignment remains a challenging surgical task. Given the proven effectiveness and longevity of the kickstand rod (KSR) technique and its powerful ability to correct coronal malalignment, this technique is an important tool to have available. Therefore, we sought to provide a simple 8-step description of the KSR technique using intraoperative images and video in a patient undergoing combined sagittal and coronal malalignment correction. METHODS: A 68-year-old female with a previous history of T11-S1 posterior spinal fusion presented with mid thoracic back pain, leg paresthesias, and a right-leaning posture. The patient underwent a T4-pelvis extension of fusion, T8-11 posterior column osteotomies, and placement of a right-sided KSR to address her coronal malalignment. RESULTS: The KSR technique is summarized in the following steps: (1) place kickstand screw, (2) place contralateral main rod and tighten all set plugs, (3) place ipsilateral main rod and keep rod long distally, (4) place a domino in the lower/mid thoracic area, (5) place the KSR and leave the rod long proximally, (6) tighten the ipsilateral main rod above the domino, (7) loosen the ipsilateral main rod below the domino, and (8) place a rod gripper below the domino and distract. Postoperatively, the coronal vertical axis improved from 4.8 to 0.6 cm, and the sagittal vertical axis improved from 9.5 to 3.9 cm. CONCLUSION: The current case report provides a simple 8-step description of the KSR technique to improve coronal malalignment accompanied by intraoperative images and video.

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Use of the kickstand rod improves coronal alignment and maintains correction compared to control at 2 year follow-up

Hassan,

Bautista,

Reyes

et al. 2024

Spine Deform

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The “kickstand rod” technique for correction of coronal malalignment: two-year clinical and radiographic outcomes

Cited by 4 publications

References 19 publications

The kickstand rod technique for correction of coronal malalignment in patients with adult spinal deformity: a systematic review and pooled analysis of 97 cases

The kickstand rod technique for correction of coronal malalignment in patients with adult spinal deformity: a systematic review and pooled analysis of 97 cases

Placement of a Kickstand Rod in Adult Spinal Deformity Surgery: A Simple 8-Step Process With Intraoperative Images and Video

Use of the kickstand rod improves coronal alignment and maintains correction compared to control at 2 year follow-up

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