12:45

Navigated posterior scoliosis correction for adolescent idiopathic scoliosis using Medtronic Solera system surgical technique

Overview

Subscribe to get full access to this operation and the extensive Spine Surgery Atlas.

SUBSCRIBE


Learn the Navigated posterior scoliosis correction for adolescent idiopathic scoliosis using Medtronic Solera system surgical technique with step by step instructions on OrthOracle. Our e-learning platform contains high resolution images and a certified CME of the Navigated posterior scoliosis correction for adolescent idiopathic scoliosis using Medtronic Solera system surgical procedure.

Posterior scoliosis correction is the most common surgical procedure used for adolescent idiopathic scoliosis. It can be performed using hooks, sublaminar wires, and pedicle screw contracts. This feature demonstrates the use of a pedicle screw construct with screw insertion using 3D navigation and partial correction of a large deformity to improve standing alignment. I discuss the indications for surgical intervention in idiopathic scoliosis and a technique to allow posterior release and mobilisation of the spine to achieve  correction of severe deformity. I also discuss the peri-operative considerations and imaging required.

The magnitude of scoliosis can vary from minimal curves of 10 degrees to very large curves of over 100 degrees.  Curves of less than 40-50 degrees are often managed non-operatively since they are unlikely to cause functional problems as the patient becomes older.  However, larger curves may cause back pain, sagittal or coronal imbalance, shoulder imbalance, and cosmetic concern which may effect mental health.  Very large curves can also cause restrictive lung pathology (>90 degrees) and rarely cardiac problems (>110 degrees).  Some patients may be asymptomatic whilst others may have shortness of breath in addition to the above features.  Also, larger curves are more likely to progress over the course of many years.

Having trained with freehand insertion and fluoroscopic-guided pedicle screw insertion, I now utilise navigation guidance for pedicle screw insertion in complex spinal conditions.  There are a large number of implants available for spine deformity correction and the requirements and benefits of some are discussed.  In this feature, I use Medtronic Solera implants which can be navigated after obtaining 3D fluoroscopic images using Medtronic O-arm.   Solera allows the choice of multi-axial screws, fixed angle screws, sagittal alignment screws, and uniplanar screws.  It also has the choice of titanium, titanium alloy, or cobalt chrome rods with 5.5 or 6.0mm diameter.  It comes with reduction towers that provide a very powerful correction tool for scoliosis.  During navigated spine surgery, there is the risk of error in navigated imaging; this feature helps demonstrate techniques for reducing this error by limiting movement of the spine during pedicle drilling and screw insertion.

A technique for anterior release of  a scoliotic deformity via thoracotomy is  detailed on https://www.orthoracle.com/library/anterior-release-of-scoliosis-access-by-thoracotomy/ and correction of kyphoscoliosis at https://www.orthoracle.com/library/congenital-kyphoscoliosis-correction-hemivertebra-excision-deformity-correction-and-posterior-instrumented-fusion/

Author: Mr Stephen Morris FRCS(Tr & Orth)

Institution: The Avon Orthopaedic Centre, Southmead Hospital, Bristol, UK

Feedback

  • Each operation and the questions associated become a named course in the CPD section
  • The operative technique itself is read as a lesson as is any company implant information if this is being assessed.
  • You’ll need to tick the box to confirm this has been done and can do this immediately if you have already read the op tech.
  • The vast majority of operations have a 10-15 MCQ quiz covering all aspects of the decision making and the technique
  • There are four possible answers of which one is correct (or on occasion more correct) than the others.
  • There are additional quiz modules on the surgical steps, the implants and problem cases being added continually
  • The course is completed once all the lessons are read and quizzes submitted and passed.
  • On successful completion of each quiz you will receive validated CPD points that add to the certificate in your CPD folder.
  • Your dashboard also will contain a record of the time you have spent logged onto and using the site.
  • The timer suspends after 5 minutes though if there is no activity.
  • When you restart you will resume at the same point in the module.
  • Once you have completed each quiz you will need to feedback on the module first then click “submit” and your paper will be marked.
    The pass mark is 75%.
  • If you fall below this level you will be directed back to re-read the slides where you’ve tripped up.
  • Once these have been read you can re-do just the questions you failed on.
  • Once you have passed the quiz you can return at a future stage & resit .

CPD Points:

  • Operation Quiz – 1 CPD point
  • Surgical steps Quiz – 1/4 CPD point
  • Implants Quiz – 1/4 CPD point
  • Problem case Quiz – 1/2 CPD point

One CPD point equates to one hour of academic activity

COURSE

Welcome to the Professional Development question section. The objective of taking these tests is to demonstrate that you have understood all aspects of the assessment and management of patients requiring surgical intevention. On successful completion you will receive a certificate accredited by both the Royal College of Surgeons of both England and Edinburgh as well as the British Orthopaedic Association.

Our content is designed for both Surgeons in independent practice and Surgeons in training.

COURSE PROGRESS

Lessons Status

Accreditations

Logo Logo Logo Logo Logo

Associates & Partners

Logo Logo Logo Logo Logo