A novel Hinge-Link correction system for vertebral column resection: a pilot study in a porcine model.

Abstract

To introduce a novel Hinge-Link (HL) correction system for vertebral column resection (VCR) in the most severe scoliosis and surgically assess the device in a porcine scoliosis model. The HL was introduced and described how it works on a reproduced three-dimensional spine model of severe scoliosis. A right thoracic scoliosis was surgically created in five 4-month-old pigs. Two weeks later, the VCR was performed to correct the deformity using the HL to test its feasibility and neurological safety in the pig scoliosis model. The surgically created right thoracic scoliosis averaged 32° ± 9.3 prior to the VCR. All animals tolerated the VCR procedure awakening neurologically intact and ambulated for 24h. The HL takes advantage of the ability to provide three-dimensional correction of the deformity and excellent control of the spine segments to prevent damage to the spinal cord in the VCR procedure. The mean correction of the scoliosis was 94% correcting to 1.8° ± 0.8. At sacrifice, the pathological anatomy of the neural axis demonstrated no vertebral subluxation and no dural impingement in any animal. The HL was feasible and neurologically safe for the VCR procedure in the pig scoliosis model. It can provide significant correction of the spinal deformity with appropriate mild shortening at the resected levels and overall lengthening without neurologic deficits. The rigid control of the spine segments provided by this device should allow for improved correction with decreased neurologic deficits and potentially shorter surgical time.