Modified Kickstand Rod Technique for the Correction of Adult Idiopathic Scoliosis

Abstract

Adult idiopathic scoliosis (ADIS) is the delayed form of adolescent idiopathic scoliosis (AIS) which is defined as a three-dimensional deformity with a lateral curvature of more than 10°in adults with prior history of AIS.Surgery is necessary for patients with symptoms of chronic pain, neuromotor deficits and cardiopulmonary problems with a Cobb angle exceeding 45°. In untreated patients, AIS may lead to ADIS which can cause serious problems like osteoarthritis, progressive deformity and spinal stenosis. In recent years, the kickstand rod technique has been introduced in addition to posterior transpedicular stabilization.A kickstand rod is an additional rod which is placed on a supporting iliac screw which is placed on the superior lateral edge of the ilium on the concave side of the deformity (or in other words on the ipsilateral side of the trunk shift)and is connected with a domino connector to the thoracolumbar junction.The rod is then distracted with the screw nuts locked on the contralateral side to achieve coronal correction. The classic kickstand works as a an additional aid to keep the spine in place during maneuvering.We established a modified kickstand rod technique where we put the rod on the concave side and apply compressionbetween the rod on the screw heads and the kickstandto bring the concavity to the midline.The kickstand was used as a temporary tool like a lever to push the spine medially with compression. We believe that our technique can be a useful alternative for correction of coronal imbalance besides the classic one.