Posterior Double Vertebral Column Resections Combined with Satellite Rod Technique to Correct Severe Congenital Angular Kyphosis

Abstract

This paper presents a highly challenging technique involving posterior double vertebral column resections (VCRs) and satellite rods placement. This was a young adult case with severe angular thoracolumbar kyphosis of 101 degrees, secondary to anterior segmentation failure from T11 to L1 . There were hemivertebrae at T11 and T12 , and a wedged vertebra at L1 . He received double VCRs at T12 and T11 and instrumented fusion from T6 to L4 via a posterior only approach. Autologous grafts and a cage were placed between the bony surfaces of the osteotomy gap. Once closure of osteotomy was achieved, bilateral permanent CoCr rods were placed with addition of satellite rods. Postoperative X-ray demonstrated marked correction of kyphosis. On the 10(th) days after surgery, the patient was able to walk without assistance. In conclusion, double VCRs are effective to correct severe angular kyphosis, and addition of satellite rods may be imperative to enhance instrumentation strength and thus prevent correction loss.

Total En Bloc Spondylectomy Combined with the Satellite Rod Technique for Spinal Tumors

“…The satellite rod technique, a multirod construct, has been proven to have the potential to reduce pseudarthrosis and fatigue fracture at the 3-column osteotomy site by enhancing the stability and stiffness of the construct for adult spinal deformity correction [10]. Some surgeons have attempted to connect additional rods to the broken rods in a reoperation [26]. This practice can serve as a reminder to add satellite rods during primary TES, and in this study, we routinely used satellite rods across the osteotomy area in patients with spinal tumors undergoing TES.…”

Total en bloc spondylectomy combined with the satellite rod technique for spinal tumors

“…Shen et al [30] reviewed "dual construct" for 36 complex spinal reconstructions and found that the dual construct is a safe alternative to traditional 2-rod, which could avoid revision surgery after rod breakage. Some surgeons also attempted to connect additional rods to the broken rods in a reoperation for spinal tumors [14]. This practice can serve as a reminder to add satellite rods during primary TES, and in this study, we routinely used satellite rods across the osteotomy area in patients with spinal tumors undergoing TES.…”

“…In recent years, the satellite rod technique, a complex of bilateral satellite rods in addition to the 2-rod construct around three-column osteotomy sites, has been widely performed for treating severe spinal deformities [10][11][12]. Compared with a standard 2-rod construct, the novel 4-rod technique has been con rmed to be a safe, simple, and effective method to provide increased stability and signi cantly prevent IF and symptomatic pseudarthrosis with the following advantages [13] : (1) the multi-rod construct shares the stress at the osteotomy site [10]; (2) control the closing of the osteotomy to reduce the risk of vertebral body translation [14]; (3) help to better maintain balance in the coronal and sagittal planes [14]; (4) convenient and simple to add satellite rods through a double U head connector [14].…”

Scoliosis in China

“…In the recent years, many domestic centers adopted vertebral column resection for the treatment of severe rigid scoliosis. [ 10 ] Vertebral resection, decompression, and 360° fusion can be completed at one stage, which reduces the number of operations and avoids the spinal cord injury caused by dislodgement of anterior bone graft in the second-stage posterior surgery. However, it has more intraoperative blood loss, longer operation time, and more complications.…”