Temporary Flexible Rods for Correction of Severe Pediatric Spinal Deformity

Area of Science:

• Orthopedics
• Pediatric Spine Surgery
• Spinal Deformity Correction

Background:

• Surgical correction of severe pediatric spinal deformities (scoliosis, kyphosis) presents significant risks.
• Traditional methods may involve higher rates of perioperative complications, including neurological injury and blood loss.

Purpose of the Study:

• To evaluate the efficacy and safety of using titanium temporary flexible rods (TFRs) as an adjunct technique.
• To assess TFRs in achieving gradual, stepwise intraoperative correction for severe pediatric spinal deformities.

Main Methods:

• Retrospective review of 34 pediatric patients undergoing spinal fusion (2007-2019) with TFRs.
• Posterior spinal fusion with pedicle screw instrumentation and temporary placement of TFRs for stepwise correction.
• All patients underwent Ponte osteotomies.

Main Results:

• Significant correction achieved: mean Cobb angle reduced from 89.3° to 40.2° in scoliosis (53.6% correction).
• Kyphosis correction: mean T5-T12 angle reduced from 73.8° to 43.3° (30.4% correction).
• 11.8% of patients experienced reversible neuromonitoring alerts, with one related to TFR insertion.

Conclusions:

• Titanium temporary flexible rods (TFRs) are effective adjuncts for correcting severe pediatric spinal deformities.
• TFRs facilitate gradual intraoperative correction in a single-stage procedure, enhancing surgical management.
• While neuromonitoring alerts can occur, they are typically reversible, supporting the safety profile of TFRs.