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Lynn Shapiro, Writer | October 15, 2008

The second step was needed only for patients whose scoliosis affected the area between the lower end of the lumbar spine and the top of the sacral spine (the lumbar 5 and sacral 1 vertebrae), which cannot be accessed from the side because of the location of the pelvic bone. In these cases, the area was accessed from below, using the AxiaLIF® procedure, which allows the L5-S1 disc to be secured with a solid, sturdy screw.

The final stage, performed two or three days after the first, was the placement of rods on either side of the spine. This was accomplished with the use of the CD Horizon Longitude system and special high-tech screws.

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"The third technology making this correction possible for these patients is the percutaneous screw that can be placed through small nicks in the skin. Using fluoroscopic guidance, we're able to place the screws into the vertebral bodies and pass the rods through the skin into position. We then connect the rods to the screws and get further correction of the curve," Anand said.

Anand, first author of the journal article, is a paid consultant with the three companies that market the instrumentation and techniques. Because he was involved in the development of the percutaneous screws, he receives royalties from the manufacturer when the devices are used elsewhere, but he receives no royalties on any cases performed at Cedars-Sinai.

"With traditional surgical procedures and large incisions, patients would have to spend time after surgery in the intensive care unit for monitoring and blood transfusions, and there would be months of recuperation," said Anand. "With the new technologies and minimally invasive techniques, we lose very little blood and patients are back on a regular surgical nursing unit in about an hour. And instead of going through six months or more of painful, restricted recuperation, recovery time is much shorter and more comfortable. We're achieving the same correction but through different, smaller, safer portals of entry."

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