Use of the Universal Clamp for deformity correction and as an adjunct to fusion: Preliminary results in scoliosis

Jean-Luc Jouve,Jérôme Sales De Gauzy,Benjamin Blondel,Franck Accadbled,Gérard Bollini,Franck Launay

doi:10.1007/s11832-009-0221-6

Jean-Luc Jouve, Jérôme Sales De Gauzy + Show 4 more

Open Access

https://doi.org/10.1007/s11832-009-0221-6

Copy DOI

Abstract

Evaluation of a novel instrumentation device for adolescent idiopathic scoliosis. A new osteosynthesis implant (Universal Clamp) primarily consisting of a sublaminar band and titanium clamp was prospectively studied in 32 patients (average age, 15years) with a major thoracic curve. The Universal Clamp was used without anterior release to reduce and maintain correction of the thoracic curve, which improved from 55.1° preoperatively to 14.5° at 3months without neurological complication or loss of kyphosis. This implant distributes stress over a larger area of the laminar cortex than sublaminar wires, patently reducing the risk of laminar fracture for equivalent reduction forces, and permits progressive reduction at several apical levels simultaneously.

Highlights

There is currently a lack of consensus regarding the ideal surgical technique for treating scoliosis [1,2,3,4]
The Universal Clamp was used without anterior release to reduce and maintain correction of the thoracic curve, which improved from 55.1° preoperatively to 14.5° at 3 months without neurological complication or loss of kyphosis
While many surgeons agree that, among posterior techniques, pedicle screw-based deformity reduction and fixation is the method of choice for lumbar scoliosis [5], the use of pedicle screws in the thoracic spine is less widespread despite reports of excellent deformity correction in the coronal plane [6,7,8]

Summary

Introduction

There is currently a lack of consensus regarding the ideal surgical technique for treating scoliosis [1,2,3,4]. Various soft sublaminar bands have been proposed as thoracic anchors They obviate the neurovascular risks associated with screws or wires, provide immediate stability that is lacking with hooks, are anchored around the strongest portion of the neural arch, and apply less stress at any given point on the bony surface than wires, reducing the risk of cutout fractures during deformity reduction [25,26,27,28,29]. Once these bands are tightened, fixation to the fusion rod depends on rudimentary knots, which do not prevent movement up or down the rod

Methods

Results

Discussion

Conclusion