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The Journal of Spinal Surgery


Introduction: There are numerous biomechanical studies, but no clinical study to support or refute the use of transverse connectors (TCs) in scoliosis constructs. The aim of the study is to critically assess the role of TCs in scoliosis constructs.

Material and methods: All patients of scoliosis that underwent pedicle screw constructs without the use of TCs between July 2007 and July 2011 were evaluated. The immediate postoperative erect radiographs were compared with the erect radiographs at the last follow-up (at least 12 months) by two independent observers (spine fellows). The radiographs were assessed critically for any rotation at the apical vertebra using the Nash-Moe technique. The intraobserver and interobserver reliability were analyzed. The radiographs were additionally evaluated for any loss of correction and implant failure.

Results: There were 28 cases in the study. The total number of levels fused was 277. The average follow-up was 33 months. The average preoperative Cobb angle of the major curve was 72.5° (40-110°) and postoperative angle was 24.75° (5-50°). The mean percentage correction in the preoperative and postoperative Cobb angle of the major curve was 68.88% (46.80-92.3%). The intraobserver reliability was 100%; there was no change in the rotation of the levels evaluated by either observer. The interobserver reliability was 100%. There were no cases of implant failure. There were two cases of distal junctional kyphosis requiring extension of construct distally, not attributable to implant characteristics.

Conclusion: The TCs are not essential to maintain derotation and do not add to stability of long scoliosis constructs. The authors make a strong statement that TCs may not be necessary to maintain derotation in scoliosis constructs.

Clinical significance: The additional complications of implant prominence, metal corrosion, skin breakdown, pseudoarthrosis, and costs can be prevented by excluding TCs from the scoliosis constructs.

Keywords: Derotation, Scoliosis, Transverse connectors.

How to cite this article: Kulkarni AG, Kantharajanna SB, Dhruv A, Bassi A. Do we need Transverse Connectors to maintain Derotation in Scoliosis Constructs? J Spinal Surg 2017;4(1):4-8.

Source of support: Nil

Conflict of interest: None

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