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

Publication ,  Journal Article
Buell, TJ; Christiansen, PA; Nguyen, JH; Chen, C-J; Yen, C-P; Shaffrey, CI; Smith, JS
Published in: Oper Neurosurg (Hagerstown)
September 15, 2020

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.

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Published In

Oper Neurosurg (Hagerstown)

DOI

EISSN

2332-4260

Publication Date

September 15, 2020

Volume

19

Issue

4

Start / End Page

403 / 413

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Thoracic Vertebrae
  • Spinal Fusion
  • Scoliosis
  • Retrospective Studies
  • Male
  • Humans
  • Female
  • Aged
  • Adult
 

Citation

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ICMJE
MLA
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Buell, T. J., Christiansen, P. A., Nguyen, J. H., Chen, C.-J., Yen, C.-P., Shaffrey, C. I., & Smith, J. S. (2020). Coronal Correction Using Kickstand Rods for Adult Thoracolumbar/Lumbar Scoliosis: Case Series With Analysis of Early Outcomes and Complications. Oper Neurosurg (Hagerstown), 19(4), 403–413. https://doi.org/10.1093/ons/opaa073
Buell, Thomas J., Peter A. Christiansen, James H. Nguyen, Ching-Jen Chen, Chun-Po Yen, Christopher I. Shaffrey, and Justin S. Smith. “Coronal Correction Using Kickstand Rods for Adult Thoracolumbar/Lumbar Scoliosis: Case Series With Analysis of Early Outcomes and Complications.Oper Neurosurg (Hagerstown) 19, no. 4 (September 15, 2020): 403–13. https://doi.org/10.1093/ons/opaa073.
Buell TJ, Christiansen PA, Nguyen JH, Chen C-J, Yen C-P, Shaffrey CI, et al. Coronal Correction Using Kickstand Rods for Adult Thoracolumbar/Lumbar Scoliosis: Case Series With Analysis of Early Outcomes and Complications. Oper Neurosurg (Hagerstown). 2020 Sep 15;19(4):403–13.
Buell, Thomas J., et al. “Coronal Correction Using Kickstand Rods for Adult Thoracolumbar/Lumbar Scoliosis: Case Series With Analysis of Early Outcomes and Complications.Oper Neurosurg (Hagerstown), vol. 19, no. 4, Sept. 2020, pp. 403–13. Pubmed, doi:10.1093/ons/opaa073.
Buell TJ, Christiansen PA, Nguyen JH, Chen C-J, Yen C-P, Shaffrey CI, Smith JS. Coronal Correction Using Kickstand Rods for Adult Thoracolumbar/Lumbar Scoliosis: Case Series With Analysis of Early Outcomes and Complications. Oper Neurosurg (Hagerstown). 2020 Sep 15;19(4):403–413.

Published In

Oper Neurosurg (Hagerstown)

DOI

EISSN

2332-4260

Publication Date

September 15, 2020

Volume

19

Issue

4

Start / End Page

403 / 413

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Thoracic Vertebrae
  • Spinal Fusion
  • Scoliosis
  • Retrospective Studies
  • Male
  • Humans
  • Female
  • Aged
  • Adult