Coronal Correction Using Kickstand Rods for Adult Thoracolumbar/Lumbar Scoliosis: Case Series With Analysis of Early Outcomes and Complications.

Published

Journal Article

BACKGROUND: The "kickstand rod technique" has been recently described for achieving and maintaining coronal correction in adult spinal deformity (ASD). Kickstand rods span scoliotic lumbar spine from the thoracolumbar junction proximally to a "kickstand iliac screw" distally. Using the iliac wing as a base, kickstand distraction produces powerful corrective forces. Limited literature exists for this technique, and its associated outcomes and complications are unknown. OBJECTIVE: To assess alignment changes, early outcomes, and complications associated with kickstand rod distraction for ASD. METHODS: Consecutive ASD patients treated with kickstand distraction at our institution were retrospectively analyzed. RESULTS: The cohort comprised 19 patients (mean age: 67 yr; 79% women; 63% prior fusion) with mean follow-up 21 wk (range: 2-72 wk). All patients had posterior-only approach surgery with tri-iliac fixation (third iliac screw for the kickstand) for mean fusion length 12 levels. Three-column osteotomy and lumbar transforaminal lumbar interbody fusion were performed in 5 (26%) and 15 (79%) patients, respectively. Postoperative alignment improved significantly (coronal balance: 8 to 1 cm [P < .001]; major curve: 37° to 12° [P < .001]; fractional curve: 20° to 10° [P < .001]; sagittal balance: 11 to 4 cm [P < .001]; pelvic incidence to lumbar lordosis mismatch: 38° to 9° [P < .001]). Pain Numerical Rating Scale scores improved significantly (back: 7.2 to 4.2 [P = .001]; leg: 5.9 to 1.7 [P = .001]). No instrumentation complications occurred. Motor weakness persisted in 1 patient. There were 3 reoperations (1-PJK, 1-wound dehiscence, and 1-overcorrection). CONCLUSION: Among 19 ASD patients treated with kickstand rod distraction, alignment, and back/leg pain improved significantly following surgery. Complication rates were reasonable.

Full Text

Duke Authors

Cited Authors

  • Buell, TJ; Christiansen, PA; Nguyen, JH; Chen, C-J; Yen, C-P; Shaffrey, CI; Smith, JS

Published Date

  • September 15, 2020

Published In

Volume / Issue

  • 19 / 4

Start / End Page

  • 403 - 413

PubMed ID

  • 32357222

Pubmed Central ID

  • 32357222

Electronic International Standard Serial Number (EISSN)

  • 2332-4260

Digital Object Identifier (DOI)

  • 10.1093/ons/opaa073

Language

  • eng

Conference Location

  • United States