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A Novel Posterior Rod-Link-Reducer System Provides Safer, Easier, and Better Correction of Severe Scoliosis

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Abstract

Study Design

Retrospective review.

Objectives

To compare the Cobb >75° scoliosis correction obtained using a novel Rod-Link-Reducer (RLR) system versus traditional corrective techniques (TCT) in patients with severe adolescent idiopathic scoliosis (AIS).

Summary of Background Data

Current implant strategies provide for good correction, especially for moderate curves; however, severe scoliosis continues to be challenging to obtain correction in a safe and effective manner.

Methods

A novel correction device was developed so that two provisional rods are placed on the convex side of the scoliosis proximally and distally, which are then linked to an external reduction device termed the RLR. A retrospective analysis was performed to compare the RLR versus the TCT in patients with curve > 75° with the diagnosis of AIS with respect to the radiographic outcomes, operative time, intraoperative blood loss, complications, and SRS-30 scores of a minimum 2-year follow-up.

Results

A total of 36 patients were evaluated (RLR-18, TCT-18). The data sets were similar for age, gender, coronal Cobb, curve flexibility, and follow-up period. The mean preoperative Cobb for the RLR group was 91.7° (76°–113°) and 91.8° (78°–108°) for the TCT group. The mean coronal Cobb correction rate was significantly greater for the RLR group (73.1% vs. 56.6%, p < .0001). The mean operative time was 74.8 minutes shorter in the RLR group (316.6 minutes vs. 391.4 minutes, p = .03). There were 2 late-developing infections and 3 intraoperative neuro-monitoring changes during the correction maneuvers in the TCT group compared with none in the RLR group (p = .02).

Conclusion

In a matched cohort, the use of the RLR exhibited greater coronal Cobb correction, shorter operative time, and was less likely to have critical neuro-monitoring changes compared with the TCT group. The RLR provides safer and improved correction for severe curves without adding surgical risk.

Level of Evidence

Level III.

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Author information

Authors and Affiliations

  1. Texas Scottish Rite Hospital for Children, 2222 Welborn St, 75219, Dallas, TX, USA

    Hong Zhang MD & Daniel J. Sucato MD, MS

  2. Department of Orthopedic Surgery, University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Blvd., 75390, Dallas, TX, USA

    Hong Zhang MD & Daniel J. Sucato MD, MS

Authors
  1. Hong Zhang MD
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  2. Daniel J. Sucato MD, MS
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Corresponding author

Correspondence to Hong Zhang MD.

Additional information

Author disclosures: HZ (other from Globus, during the conduct of the study; in addition, HZ has a patent Spinal Rod Link Reducer with royalties paid) and DJS (other from Globus, during the conduct of the study; grants from the Pediatric Orthopedic Society of North America [POSNA], outside the submitted work; in addition, DJC has a patent “Rod Link Reducer” with royalties paid).

IRB statement: This study was reviewed and approved by the UT Southwestern Institutional Review Board (approval no. 022011-127) and the Texas Scottish Rite Hospital for Children Research Advisory Panel (approval no. 10-03-670).

Funding Sources: No funding received for this study.

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Zhang, H., Sucato, D.J. A Novel Posterior Rod-Link-Reducer System Provides Safer, Easier, and Better Correction of Severe Scoliosis. Spine Deform 7, 445–453 (2019). https://doi.org/10.1016/j.jspd.2018.09.001

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  • DOI: https://doi.org/10.1016/j.jspd.2018.09.001

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