Abstract
Correction of spinal deformities such as those seen in idiopathic scoliosis, are one of the challenging aspects of the spine surgeon’s routine. A significant progress has been made in sense of the surgical approaches, implants design and methods of correction during the last two decades. Since the pioneer conception of Paul Harrington that a scoliotic curve can be corrected by distraction, other methods such as derotation and translation came out as an alternative ways to get a straight and balanced spine. Recently, a new concept of correction for spinal deformities named in-situ contouring, has brought to our attention. This method is based on a 6mm Titanium rod (SCS Eurosurgical Inc.) connected to the spine with a multiple hooks and screws system. The rod is bend according to the curve in the coronal plane and loosely secure with setscrews. Following primary application of the rod, the surgeon begins to bend it manually in situ, in a contrary direction to the curve’s shape. By applying a combination of a sagittal and coronal plane forces, the surgeon is able to achieve a final result of a straight and nicely balanced spine.
Methods: The medical records of patients with idiopathic scoliosis, who had surgery during the last three years, were reviewed. Patients, whose operation evolves using of the SCS system, enrolled into the study group. Clinical as well as radiographical data were retrieved from the hospital charts. Curves were classified according to King et al., measurements were taken using the Cobb’s method.
Results: There were 10 patients in the study group (7 females, 3 males, mean age: 16.6 years). All curves were primary thoracic from which 9 were type II and only one was type III. Mean pre-operative angle of the primary curve was 56°, mean post-operative angle was 22° with a 61% correction rate. Patients were followed for an average period of 12 months. No complications related to surgery, correction techniques, or neurological status was noted.
Conclusions: The in-situ contouring system has no drawbacks compare to other known methods. Our feeling is that this new technique gives the surgeon an ability to achieve the final position of the corrected spine, by a slow and gradual manipulation. This is taking a crucial advantage of the elastic property of the spine in order to get good correction and to avoid neurological complications or hooks pull out.
The abstracts were prepared by Orah Naor. Correspondence should be addressed to him at the Israel Orthopaedic Association, PO Box 7845, Haifa 31074, Israel.
