Method for improved spinal correction surgery implementing non-fusion anterior scoliosis correction techniques
Spinal correction surgical techniques and methodologies for correction of scoliosis using non fusion anterior scoliosis correction, including soft tissue releases, unique correction techniques such as de-rotation, and unique single and dual anchor screw/cord applications.
1. An improved method of performing spinal correction surgery on a patient in which a plurality of vertebrae are adjusted with respect to each other using a double screw/double cord methodology, wherein a plurality of anchor screws are inserted into corresponding vertebrae to enable the spinal correction, wherein each of the anchor screws comprises a channel suitable for accepting a tensioning cord;
the vertebrae forming a double scoliosis curve comprising
an upper curve defined by an upper set of vertebrae disposed substantially in a first direction,
a lower curve defined by a lower set of vertebrae disposed substantially in a second direction substantially opposite to the first direction, and
a neutral vertebra located between the upper set of vertebrae and the lower set of vertebrae;
the method comprising the steps of:
creating a vertical mini-opening in a side of the patient to enable a surgeon to access directly the plurality of the vertebrae;
for the upper set of vertebrae:
inserting a pair of anchor screws into each vertebra in the upper set of vertebrae and the neutral vertebra along the convexity of the upper curve, such that a substantially aligned upper posterior row of upper posterior anchor screws are formed along the upper vertebrae and the neutral vertebra next to a substantially aligned upper anterior row of upper anterior anchor screws formed along the upper vertebrae and the neutral vertebra;
for the lower set of vertebrae:
inserting a pair of anchor screws into each vertebra in the lower set of vertebrae and the neutral vertebra along the convexity of the lower curve which is substantially opposite the convexity of the upper curve, such that a substantially aligned lower posterior row of lower posterior anchor screws are formed along the lower vertebrae and the neutral vertebra next to a substantially aligned lower anterior row of lower anterior anchor screws formed along the lower vertebrae and the neutral vertebra;
disposing an upper posterior tensioning cord within the channels of the upper posterior row of upper posterior anchor screws to enable an upper posterior adjustment procedure on the upper set of vertebrae and the neutral vertebra;
performing an upper posterior vertebrae adjustment procedure in which each of the set of upper vertebrae and the neutral vertebra is adjusted with respect to at least one other upper vertebra and the upper posterior tensioning cord is secured within the channels of the upper posterior anchor screws in order to maintain the upper posterior adjustment of the vertebrae;
disposing an upper anterior tensioning cord within the channels of the upper anterior row of upper anterior anchor screws to enable an upper anterior adjustment procedure on the upper set of vertebrae and the neutral vertebra;
performing an upper anterior vertebrae adjustment procedure in which each of the set of upper vertebrae and the neutral vertebra is adjusted with respect to at least one other upper vertebra and the upper anterior tensioning cord is secured within the channels of the upper anterior anchor screws in order to maintain the upper anterior adjustment of the vertebrae;
disposing a lower posterior tensioning cord within the channels of the lower posterior row of lower posterior anchor screws to enable a lower posterior adjustment procedure on the lower set of vertebrae and the neutral vertebra;
performing a lower posterior vertebrae adjustment procedure in which each of the set of lower vertebrae and the neutral vertebra is adjusted with respect to at least one other lower vertebra and the lower posterior tensioning cord is secured within the channels of the lower posterior anchor screws in order to maintain the lower posterior adjustment of the vertebrae;
disposing a lower anterior tensioning cord within the channels of the lower anterior row of lower anterior anchor screws to enable a lower anterior adjustment procedure on the lower set of vertebrae and the neutral vertebra; and
performing a lower anterior vertebrae adjustment procedure in which each of the set of lower vertebrae and the neutral vertebra is adjusted with respect to at least one other lower vertebra and the lower anterior tensioning cord is secured within the channels of the lower anterior anchor screws in order to maintain the lower anterior adjustment of the vertebrae.
2. The method of claim 1 wherein the upper posterior vertebrae adjustment procedure is a de-rotation procedure comprising the steps of
locating a stationary tower on a first upper posterior anchor screw of a first upper vertebra,
locating a de-rotation tower on a second upper posterior anchor screw of a second upper vertebra,
performing a de-rotation maneuver by
applying a downwards translational force vector to the de-rotation tower,
applying a lateral force vector to the de-rotation tower, and
simultaneously applying a lateral counterforce vector to the stationary tower in opposition to the lateral force vector being applied to the de-rotation tower,
tensioning the upper posterior tensioning cord in the channel of the second upper posterior anchor screw,
securing the upper posterior tensioning cord in the channel of the second upper posterior anchor screw in order to maintain the de-rotation of the upper vertebrae,
re-locating the de-rotation tower to the upper posterior anchor screw of a subsequent upper vertebra, and
repeating the de-rotation maneuver until all of the upper vertebrae and the neutral vertebra have been de-rotated as desired.
3. The method of claim 1 wherein the upper anterior vertebrae adjustment procedure is a de-rotation procedure comprising the steps of
locating a stationary tower on a first upper anterior anchor screw of a first upper vertebra,
locating a de-rotation tower on a second upper anterior anchor screw of a second upper vertebra,
performing a de-rotation maneuver by
applying a downwards translational force vector to the de-rotation tower,
applying a lateral force vector to the de-rotation tower, and
simultaneously applying a lateral counterforce vector to the stationary tower in opposition to the lateral force vector being applied to the de-rotation tower,
tensioning the upper anterior tensioning cord in channel of the second upper anterior anchor screw,
securing the upper anterior tensioning cord in the channel of the second upper anterior anchor screw in order to maintain the de-rotation of the upper vertebrae,
re-locating the de-rotation tower to the upper anterior anchor screw of a subsequent upper vertebra, and
repeating the de-rotation maneuver until all of the upper vertebrae and the neutral vertebra have been de-rotated as desired.
4. The method of claim 1 wherein the lower posterior vertebrae adjustment procedure is a de-rotation procedure comprising the steps of
locating a stationary tower on a first lower posterior anchor screw of a first lower vertebra,
locating a de-rotation tower on a second lower posterior anchor screw of a second lower vertebra,
performing a de-rotation maneuver by
applying a downwards translational force vector to the de-rotation tower,
applying a lateral force vector to the de-rotation tower, and
simultaneously applying a lateral counterforce vector to the stationary tower in opposition to the lateral force vector being applied to the de-rotation tower,
tensioning the lower posterior tensioning cord in channel of the second lower posterior anchor screw,
securing the lower posterior tensioning cord in the channel of the second lower posterior anchor screw in order to maintain the de-rotation of the lower vertebrae,
re-locating the de-rotation tower to the lower posterior anchor screw of a subsequent lower vertebra, and
repeating the de-rotation maneuver until all of the lower vertebrae and the neutral vertebra have been de-rotated as desired.
5. The method of claim 1 wherein the lower anterior vertebrae adjustment procedure is a de-rotation procedure comprising the steps of
locating a stationary tower on a first lower anterior anchor screw of a first lower vertebra,
locating a de-rotation tower on a second lower anterior anchor screw of a second lower vertebra,
performing a de-rotation maneuver by
applying a downwards translational force vector to the de-rotation tower,
applying a lateral force vector to the de-rotation tower, and
simultaneously applying a lateral counterforce vector to the stationary tower in opposition to the lateral force vector being applied to the de-rotation tower,
tensioning the lower anterior tensioning cord in channel of the second lower anterior anchor screw,
securing the lower anterior tensioning cord in the channel of the second lower anterior anchor screw in order to maintain the de-rotation of the lower vertebrae,
re-locating the de-rotation tower to the lower anterior anchor screw of a subsequent lower vertebra, and
repeating the de-rotation maneuver until all of the lower vertebrae and the neutral vertebra have been de-rotated as desired.
6. An improved method of performing spinal correction surgery on a patient in which a plurality of vertebrae are adjusted with respect to each other using a double screw/double cord methodology, wherein a plurality of anchor screws are inserted into corresponding vertebrae to enable the spinal correction, wherein each of the anchor screws comprises a channel suitable for accepting a tensioning cord;
the vertebrae forming a double scoliosis curve comprising
an upper curve defined by an upper set of vertebrae disposed substantially in a first direction,
a lower curve defined by a lower set of vertebrae disposed substantially in a second direction substantially opposite to the first direction, and
a neutral vertebra located between the upper set of vertebrae and the lower set of vertebrae;
the method comprising the steps of:
creating a vertical mini-opening in a side of the patient to enable a surgeon to access directly the plurality of the vertebrae;
for the upper set of vertebrae:
inserting a pair of anchor screws into each vertebra in the upper set of vertebrae along the convexity of the upper curve, such that a substantially aligned upper posterior row of upper posterior anchor screws are formed along the upper vertebrae next to a substantially aligned upper anterior row of upper anterior anchor screws formed along the upper vertebrae;
for the lower set of vertebrae:
inserting a pair of anchor screws into each vertebra in the lower set of vertebrae along the convexity of the lower curve which is substantially opposite the convexity of the upper curve, such that a substantially aligned lower posterior row of lower posterior anchor screws are formed along the lower vertebrae next to a substantially aligned lower anterior row of lower anterior anchor screws formed along the lower vertebrae; and
for the neutral vertebra:
inserting an upper neutral posterior anchor screw and an upper neutral anterior anchor screw into the neutral vertebra on the same side as the convexity of the upper curve, and
inserting a lower neutral posterior anchor screw and a lower neutral anterior anchor screw into the neutral vertebra on the same side as the convexity of the lower curve;
disposing an upper posterior tensioning cord within the channels of the upper posterior row of upper posterior anchor screws and the upper neutral posterior anchor screw, and an upper bridge posterior tensioning cord within the channels of the upper neutral posterior anchor screw and the upper posterior anchor screw adjacent the upper neutral posterior anchor screw to enable an upper posterior adjustment procedure on the upper set of vertebrae;
performing an upper posterior vertebrae adjustment procedure in which each of the set of upper vertebrae is adjusted with respect to at least one other upper vertebra and the upper posterior tensioning cord and upper bridge posterior tensioning cord are each secured within the channels of the upper posterior anchor screws in order to maintain the upper posterior adjustment of the vertebrae;
disposing an upper anterior tensioning cord within the channels of the upper anterior row of upper anterior anchor screws and the upper neutral anterior anchor screw, and an upper bridge anterior tensioning cord within the channels of the upper neutral anterior anchor screw and the upper anterior anchor screw adjacent the upper neutral anterior anchor screw to enable an upper anterior adjustment procedure on the upper set of vertebrae;
performing an upper anterior vertebrae adjustment procedure in which each of the set of upper vertebrae is adjusted with respect to at least one other upper vertebra and the upper anterior tensioning cord and upper bridge anterior tensioning cord are each secured within the channels of the upper anterior anchor screws in order to maintain the upper anterior adjustment of the vertebrae;
disposing a lower posterior tensioning cord within the channels of the lower posterior row of lower posterior anchor screws and the lower neutral posterior anchor screw, and a lower bridge posterior tensioning cord within the channels of the lower neutral posterior anchor screw and the lower posterior anchor screw adjacent the lower neutral posterior anchor screw, to enable a lower posterior adjustment procedure on the lower set of vertebrae;
performing a lower posterior vertebrae adjustment procedure in which each of the set of lower vertebrae is adjusted with respect to at least one other lower vertebra and the lower posterior tensioning cord and lower bridge posterior tensioning cord are each secured within the channels of the lower posterior anchor screws in order to maintain the lower posterior adjustment of the vertebrae;
disposing a lower anterior tensioning cord within the channels of the lower anterior row of lower anterior anchor screws and the lower neutral anterior anchor screw, and a lower bridge anterior tensioning cord within the channels of the lower neutral anterior anchor screw and the lower anterior anchor screw adjacent the lower neutral anterior anchor screw to enable a lower anterior adjustment procedure on the lower set of vertebrae; and
performing a lower anterior vertebrae adjustment procedure in which each of the set of lower vertebrae is adjusted with respect to at least one other lower vertebra and the lower anterior tensioning cord and lower bridge anterior tensioning cord are each secured within the channels of the lower anterior anchor screws in order to maintain the lower anterior adjustment of the vertebrae.