Multi-rod fixation in spinal neuroarthropathy: a novel surgical technique

Journal of Spine Surgery, 2023 · DOI: 10.21037/jss-22-103 · Published: March 24, 2023

Simple Explanation

Spinal neuroarthropathy (SNA) is a severe degenerative disease that destroys vertebral joints, leading to spinal deformity and pain, especially in spinal cord injury (SCI) patients. Surgical treatment for SNA is challenging due to high shear forces and reduced bone density, often resulting in construct failure and multiple revision surgeries. This paper introduces a novel surgical technique using triple rod stabilization and tricortical laminovertebral (TLV) screws to improve construct stability and reduce revision rates in SNA patients.

Study Duration

9 months

Participants

Three patients with complete SCI of the thoracic spinal cord

Evidence Level

Technical report / Case series

Key Findings

1
Triple rod stabilization with TLV screws improved construct stability in three SCI patients with SNA.
2
Patients reported improved Spinal Cord Independence Measure III (SCIM III) scores after surgery.
3
None of the patients experienced construct failure during at least 9 months of follow-up.

Research Summary

This technical note introduces a novel surgical technique for treating spinal neuroarthropathy (SNA) using triple rod fixation and tricortical laminovertebral (TLV) screws. The technique was applied to three patients with complete spinal cord injury (SCI), and results showed improved construct stability and Spinal Cord Independence Measure III (SCIM III) scores with no construct failures within a 9-month follow-up period. The authors suggest that this technique could reduce revision rates and improve patient outcomes in SNA, although further prospective trials are needed to validate these findings.

Practical Implications

Improved Construct Stability

The triple rod and TLV screw technique provides enhanced stability, potentially reducing construct failure rates.

Reduced Revision Surgeries

The novel surgical technique may decrease the need for multiple revision surgeries in SNA patients.

Enhanced Patient Outcomes

Improved construct stability and reduced revision rates may lead to better overall patient outcomes and quality of life.

Study Limitations

1
Descriptive study without statistical analysis.
2
Potential risks associated with TLV screw placement, such as CSF fistulas or arachnopathies.
3
Lack of visual confirmation for successful bony fusion.

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