[Augmentation of VDS (ventral derotation spondylodesis) using double rod instrumentation: surgical method and early results]. 1994

H Halm
Klinik und Poliklinik für Allgemeine Orthopädie, Westfälische Wilhelms-Universität Münster.

OBJECTIVE The advantages of the VDS according to Zielke with excellent three dimensional correction and shorter fusion levels in comparison to posterior instrumentation techniques are well known. A disadvantage is the postoperatively necessary long immobilisation in a body cast due to lack of primary stability. Aim of the presented double-rod-VDS is to optimize the system by augmentation and allow a postoperative plaster cast- and brace-free treatment. METHODS Following thoracolumbar phrenotomy and ligation of the segmental vessels Kaneda-clamps are inserted. First VDS-screws are implanted into the posterior holes of these clamps. Using a M-4 compression rod, correction is obtained by centripetal compressive forces to the nuts. Next VDS-screws for the M-5 treated rod are inserted into the anterior holes of the Kaneda clamps. The rod is implanted in a slightly compressive manner and augments the system. Within a prospective study 12 patients with idiopathic and neuromuscular scoliosis underwent this surgical procedure. Three patients with thoracolumbar scoliosis have been followed for 12 months postoperatively and are presented as case reports. All patients were treated brace-free postoperatively, only using a semi-elastic vest for 4 months. RESULTS Remarkable intra- and postoperative complications have not been noted. Curve correction ranged from 75 to 86%. Implant related complications and loss of correction have not been noted so far. The sagittal plane was within physiological limits postoperatively. Scanning stereography demonstrated excellent three dimensional correction. CONCLUSIONS The results of the Double-rod-VDS allow the statement, that the advantages of the VDS according to Zielke are optimized by augmentation of the system with the possibility of plaster cast and brace-free postoperative treatment. Larger operation numbers and a longer follow-up period are needed for further assessment.

UI MeSH Term Description Entries
D008297 Male Males
D010780 Photogrammetry Making measurements by the use of stereoscopic photographs. Stereophotogrammetry,Photogrammetries,Stereophotogrammetries
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D011859 Radiography Examination of any part of the body for diagnostic purposes by means of X-RAYS or GAMMA RAYS, recording the image on a sensitized surface (such as photographic film). Radiology, Diagnostic X-Ray,Roentgenography,X-Ray, Diagnostic,Diagnostic X-Ray,Diagnostic X-Ray Radiology,X-Ray Radiology, Diagnostic,Diagnostic X Ray,Diagnostic X Ray Radiology,Diagnostic X-Rays,Radiology, Diagnostic X Ray,X Ray Radiology, Diagnostic,X Ray, Diagnostic,X-Rays, Diagnostic
D005260 Female Females
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D012600 Scoliosis An appreciable lateral deviation in the normally straight vertical line of the spine. (Dorland, 27th ed) Scolioses

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