Fig. 13.1
Rod passage with rotation of the rod along its long axis to drive the rod laterally or medially to engage all the screw heads in a deformed spine. This requires a bend at the leading portion of the rod
From the center to periphery, the extenders are then reduced in a stepwise fashion with the aid of the reduction nuts, which are facilitated by the markers visible on the extender ends. Usually three rounds are needed until complete reduction to allow successive correction to avoid screw pullout.
The contralateral rod is inserted after the necessary pre-contouring. The inserter is detached after all set screws are tight and final imaging control, has been performed.
References
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Ringel F, Stoffel M, Stüer C, Meyer B. Percutaneous transmuscular pedicle screw fixation of the thoracic and lumbar spine. Neurosurgery. 2006;59(ONS Suppl 4):361–7.
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Foley KT, Gupta SK. Percutaneous pedicle screw fixation of the lumbar spine: preliminary clinical results. J Neurosurg. 2002;97 Suppl 1:7–12.PubMed
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Anand N, Baron EM, Thaiyananthan G, Khalsa K, Goldstein TB. Minimally invasive multilevel percutaneous correction and fusion for adult lumbar degenerative scoliosis: a technique and feasibility study. J Spinal Disord Tech. 2008;21(7): 459–67.PubMedCrossRef
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