Temporary Internal Distraction as an Aid to Correction of Severe Scoliosis

Paul D. Sponseller, MD

Halo traction is a well-recognized adjunct for correcting severe, complex, rigid scoliotic curves, but it is associated with complications and is contraindicated in the presence of fixed cervical instability, kyphosis, or stenosis. In addition, halo traction often requires prolonged hospital stays and is not welcomed by all families. These limitations led to consideration of temporary internal distraction as an alternative. With the use of temporary distraction rods, corrective moments may be applied more effectively to the deformed portion of the spine than is possible with halo traction, resulting in improved curve correction and restoration of sagittal and coronal contours. The key and essential part of temporary internal distraction is to apply multiple episodes of small amounts of distraction throughout the operation to take advantage of the viscoelastic properties of the spine and allow maximum correction of the deformity with minimal stress on the tissues and implants. The authors have learned that one important advantage of temporary internal distraction is that anterior releases are generally unnecessary and that sufficient correction can usually be obtained through posterior surgery alone, thus avoiding the patient morbidity that accompanies anterior thoracic, thoracoabdominal, or abdominal approaches. In this JBJS/VJO video supplement, Dr. Paul Sponseller of Baltimore demonstrates his surgical technique.

Specifications

• Total Run Time: 18:57 minutes
• Catalog Number: 8021
• VJO Publication Date: September, 2007