Reduction of X-ray exposure in scoliosis surgery

Reduction of X-ray exposure in scoliosis surgery for the patient and OR staff by use of infralaminar hooks (LSZ) from SIGNUS Medizintechnik

Posterior systems with transpedicular screws as basic element for stabilizing the spinal column have become the gold standard in surgical treatment of spinal deformities and are used in the majority of cases where correction of scoliosis or segmental fixation is required.

What is to be done though in cases of severe kyphotic or scoliotic spinal deformities, particularly in connection with developmental anomalies such as hyperplasia or aplasia of the pedicles, which render it more difficult to introduce a screw? Not only does this often lead to an increase in the total time required for surgery, but the X-ray exposure time is also often increased considerably, resulting in unnecessary additional exposure of the patient and OR staff. The question arises whether other fixation methods can be resorted to.

Infralaminar hooks (LSZ) from SIGNUS Medizintechnik provide a useful alternative to pedicle screws in specific sections of the spinal column. Their stability is comparable to that of pedicle screws, as has been proven by a recent biomechanical in-vitro study [1]. The interaction between the infralaminar hooks and the pedicle screws is optimized in the DIPLOMAT®Deformity system from SIGNUS Medizintechnik. Enhanced anchorage in cases of hypoplastic pedicles on the concave side, force transmission in translation too, extension of the posterior column and decreased implant density are achieved as a result of the hybrid technique.

You can view the biomechanical study directly on: Springer online

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Further information on the hybrid technique with the DIPLOMAT® Deformity System

1Wilke HJ, Kaiser D, Volkheimer D, Hackenbroch C, Püschel K, Rauschmann M. A pedicle screw system and a lamina hook system provide similar primary and long-term stability: a biomechanical in vitro study with quasi-static and dynamic loading conditions. EurSpine J, 2016 Jul 12. DOI 10.1007/s00586-016-4679-x.