Sarmiento J Manuel, Rymond Christina C, Kozan Abdulbaki, Lenke Lawrence G
1Department of Pediatric Orthopedic Surgery, Morgan Stanley Children's Hospital of New York-Presbyterian/Columbia University Irving Medical Center, New York, New York; and.
2Department of Neurosurgery, Cleveland Clinic Florida, Weston, Florida.
J Neurosurg Case Lessons. 2024 Mar 11;7(11). doi: 10.3171/CASE2433.
Internal distraction rods have been described as an alternative to halo gravity traction for the treatment of severe scoliosis. Distraction rods can be challenging to use in patients with existing fusion masses. The authors report an internal distraction, construct-to-construct rod technique using multiple-hook fixation in a patient with a sharply angulated cervicothoracic scoliosis fusion mass.
A 12-year-old female with previously diagnosed congenital scoliosis who had undergone cervical fusion in situ at age 2 presented to the clinic with shortness of breath exacerbated by increased levels of activity. Standing anteroposterior and lateral scoliosis radiographs revealed a left >150° cervicothoracic curve, right 140° thoracolumbar curve, and left 28° lumbosacral fractional curve with pelvic obliquity. The authors indicated this patient for a 3-stage all-posterior approach for spinal fusion and deformity correction. In the final fusion surgery, the authors set up a construct-to-construct internal distraction configuration connecting the left hemipelvis to the cervicothoracic fusion mass to aid in deformity correction.
A construct-to-construct internal distraction rod technique connecting a fusion mass to the pelvis can assist with curve correction in severe scoliosis.
内撑开棒已被描述为治疗严重脊柱侧弯的一种替代头环重力牵引的方法。对于已有融合块的患者，使用撑开棒可能具有挑战性。作者报告了一种在一名患有急剧成角的颈胸段脊柱侧弯融合块的患者中使用多钩固定的内撑开、构建物到构建物的棒技术。
一名12岁女性，既往诊断为先天性脊柱侧弯，2岁时原位进行了颈椎融合，因活动量增加导致呼吸急促而就诊。站立位前后位和侧位脊柱侧弯X线片显示，左侧颈胸段弯曲>150°，右侧胸腰段弯曲140°，左侧腰骶部部分弯曲28°伴骨盆倾斜。作者为该患者制定了一种分3期的全后路脊柱融合及畸形矫正方法。在最后一次融合手术中，作者建立了一种构建物到构建物的内撑开构型，将左半骨盆与颈胸段融合块相连，以辅助畸形矫正。
将融合块与骨盆相连的构建物到构建物的内撑开棒技术可有助于严重脊柱侧弯的弯曲矫正。
