Use of an articulating hinge to facilitate cervicothoracic deformity correction during vertebral column resection

Rajiv R. Iyer, Benjamin D. Elder, Tomas Garzon-Muvdi, Justin Michael Sacks, Ian Suk, Jean Paul Wolinsky

Research output: Contribution to journalArticle

Abstract

Background: Surgical treatment of severe cervicothoracic kyphotic deformity may require the use of 3-column osteotomies such as the pedicle subtraction osteotomy and vertebral column resection (VCR), or VCR with anterior longitudinal ligament resection. Such procedures are extensive and are associated with high intra- and perioperative morbidity, in part, due to the need for risky reduction maneuvers. Objective: To describe a novel technique utilizing a laterally placed articulating hinge to facilitate kyphotic deformity correction of the cervicothoracic spine. Methods: A patient with severe chin-on-chest deformity of the cervicothoracic spine presented for evaluation and a 2-stage VCR with anterior longitudinal ligament resection was planned. To reduce the risk of intraoperative neurological injury and for increased control during reduction maneuvers, lateral instrumentationwas placed through the chest wall resection above and below the level of VCR, which was adjoined with an articulating hinge rod apparatus. Results: Satisfactory reduction of the kyphosis was achieved utilizing the hinge rod apparatus for controlled deformity correction. The patient remained neurologically intact following this procedure with improvement in their spinal alignment. Conclusion: We present a novel technique utilizing a lateral hinge rod apparatus for efficient, controlled correction of severe kyphotic deformity.

Original languageEnglish (US)
Pages (from-to)278-284
Number of pages7
JournalOperative Neurosurgery
Volume15
Issue number3
DOIs
StatePublished - Jan 1 2018

Fingerprint

Spine
Longitudinal Ligaments
Osteotomy
Chin
Kyphosis
Thoracic Wall
Thorax
Morbidity
Wounds and Injuries
Therapeutics

Keywords

  • Articulating hinge
  • Cervicothoracic deformity
  • Kyphosis
  • Reduction
  • Spondylectomy
  • Threecolumn osteotomy
  • Vertebral column resection

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Use of an articulating hinge to facilitate cervicothoracic deformity correction during vertebral column resection. / Iyer, Rajiv R.; Elder, Benjamin D.; Garzon-Muvdi, Tomas; Sacks, Justin Michael; Suk, Ian; Wolinsky, Jean Paul.

In: Operative Neurosurgery, Vol. 15, No. 3, 01.01.2018, p. 278-284.

Research output: Contribution to journalArticle

Iyer, Rajiv R. ; Elder, Benjamin D. ; Garzon-Muvdi, Tomas ; Sacks, Justin Michael ; Suk, Ian ; Wolinsky, Jean Paul. / Use of an articulating hinge to facilitate cervicothoracic deformity correction during vertebral column resection. In: Operative Neurosurgery. 2018 ; Vol. 15, No. 3. pp. 278-284.
@article{b4df4e43f56a4df79438c17b2da9b635,
title = "Use of an articulating hinge to facilitate cervicothoracic deformity correction during vertebral column resection",
abstract = "Background: Surgical treatment of severe cervicothoracic kyphotic deformity may require the use of 3-column osteotomies such as the pedicle subtraction osteotomy and vertebral column resection (VCR), or VCR with anterior longitudinal ligament resection. Such procedures are extensive and are associated with high intra- and perioperative morbidity, in part, due to the need for risky reduction maneuvers. Objective: To describe a novel technique utilizing a laterally placed articulating hinge to facilitate kyphotic deformity correction of the cervicothoracic spine. Methods: A patient with severe chin-on-chest deformity of the cervicothoracic spine presented for evaluation and a 2-stage VCR with anterior longitudinal ligament resection was planned. To reduce the risk of intraoperative neurological injury and for increased control during reduction maneuvers, lateral instrumentationwas placed through the chest wall resection above and below the level of VCR, which was adjoined with an articulating hinge rod apparatus. Results: Satisfactory reduction of the kyphosis was achieved utilizing the hinge rod apparatus for controlled deformity correction. The patient remained neurologically intact following this procedure with improvement in their spinal alignment. Conclusion: We present a novel technique utilizing a lateral hinge rod apparatus for efficient, controlled correction of severe kyphotic deformity.",
keywords = "Articulating hinge, Cervicothoracic deformity, Kyphosis, Reduction, Spondylectomy, Threecolumn osteotomy, Vertebral column resection",
author = "Iyer, {Rajiv R.} and Elder, {Benjamin D.} and Tomas Garzon-Muvdi and Sacks, {Justin Michael} and Ian Suk and Wolinsky, {Jean Paul}",
year = "2018",
month = "1",
day = "1",
doi = "10.1093/ons/opx221",
language = "English (US)",
volume = "15",
pages = "278--284",
journal = "Operative Neurosurgery",
issn = "2332-4252",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Use of an articulating hinge to facilitate cervicothoracic deformity correction during vertebral column resection

AU - Iyer, Rajiv R.

AU - Elder, Benjamin D.

AU - Garzon-Muvdi, Tomas

AU - Sacks, Justin Michael

AU - Suk, Ian

AU - Wolinsky, Jean Paul

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: Surgical treatment of severe cervicothoracic kyphotic deformity may require the use of 3-column osteotomies such as the pedicle subtraction osteotomy and vertebral column resection (VCR), or VCR with anterior longitudinal ligament resection. Such procedures are extensive and are associated with high intra- and perioperative morbidity, in part, due to the need for risky reduction maneuvers. Objective: To describe a novel technique utilizing a laterally placed articulating hinge to facilitate kyphotic deformity correction of the cervicothoracic spine. Methods: A patient with severe chin-on-chest deformity of the cervicothoracic spine presented for evaluation and a 2-stage VCR with anterior longitudinal ligament resection was planned. To reduce the risk of intraoperative neurological injury and for increased control during reduction maneuvers, lateral instrumentationwas placed through the chest wall resection above and below the level of VCR, which was adjoined with an articulating hinge rod apparatus. Results: Satisfactory reduction of the kyphosis was achieved utilizing the hinge rod apparatus for controlled deformity correction. The patient remained neurologically intact following this procedure with improvement in their spinal alignment. Conclusion: We present a novel technique utilizing a lateral hinge rod apparatus for efficient, controlled correction of severe kyphotic deformity.

AB - Background: Surgical treatment of severe cervicothoracic kyphotic deformity may require the use of 3-column osteotomies such as the pedicle subtraction osteotomy and vertebral column resection (VCR), or VCR with anterior longitudinal ligament resection. Such procedures are extensive and are associated with high intra- and perioperative morbidity, in part, due to the need for risky reduction maneuvers. Objective: To describe a novel technique utilizing a laterally placed articulating hinge to facilitate kyphotic deformity correction of the cervicothoracic spine. Methods: A patient with severe chin-on-chest deformity of the cervicothoracic spine presented for evaluation and a 2-stage VCR with anterior longitudinal ligament resection was planned. To reduce the risk of intraoperative neurological injury and for increased control during reduction maneuvers, lateral instrumentationwas placed through the chest wall resection above and below the level of VCR, which was adjoined with an articulating hinge rod apparatus. Results: Satisfactory reduction of the kyphosis was achieved utilizing the hinge rod apparatus for controlled deformity correction. The patient remained neurologically intact following this procedure with improvement in their spinal alignment. Conclusion: We present a novel technique utilizing a lateral hinge rod apparatus for efficient, controlled correction of severe kyphotic deformity.

KW - Articulating hinge

KW - Cervicothoracic deformity

KW - Kyphosis

KW - Reduction

KW - Spondylectomy

KW - Threecolumn osteotomy

KW - Vertebral column resection

UR - http://www.scopus.com/inward/record.url?scp=85055203461&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85055203461&partnerID=8YFLogxK

U2 - 10.1093/ons/opx221

DO - 10.1093/ons/opx221

M3 - Article

C2 - 29165712

AN - SCOPUS:85055203461

VL - 15

SP - 278

EP - 284

JO - Operative Neurosurgery

JF - Operative Neurosurgery

SN - 2332-4252

IS - 3

ER -