In situ contouring

Last revised by Henry Knipe on 11 Aug 2021

Citation, DOI, disclosures and article data

Citation:

Knipe H, In situ contouring. Reference article, Radiopaedia.org (Accessed on 24 Apr 2024) https://doi.org/10.53347/rID-92104

DOI:

https://doi.org/10.53347/rID-92104

Permalink:

https://radiopaedia.org/articles/92104

rID:

92104

Article created:

11 Aug 2021, Henry Knipe ◉ ◈

Disclosures:

At the time the article was created Henry Knipe had no recorded disclosures.

View Henry Knipe's current disclosures

Last revised:

11 Aug 2021, Henry Knipe ◉ ◈

Disclosures:

At the time the article was last revised Henry Knipe had no recorded disclosures.

View Henry Knipe's current disclosures

Revisions:

1 time, by 1 contributor - see full revision history and disclosures

Systems:

Musculoskeletal, Spine

Tags:

cases

Synonyms:

In situ contouring (ISC)

In situ contouring is a surgical technique used in thoracolumbar scoliosis surgery and thoracolumbar fracture reduction and fixation.

Procedure

Thoracolumbar scoliosis surgery

The key of this technique is to " make the rod take the shape of the spine and then to make the spine take the shape of the rod" ¹. Cranial to T10 pedicle hooks are used, and distal to T10 pedicle screws are used with every second level instrumented. A working rod is placed (thoracic concave, lumbar convex) and both frontal and sagittal contouring manoeuvers are performed by iron benders with the aim to move the thoracic apex backwards (sagittal manoeuver) and medially (frontal manoeuver). This technique aims for derotation, reduction of scoliosis and improved kyphosis ^1,2.

Thoracolumbar fracture reduction and fixation

Typically performed via a posterior approach, two rods are countered and fixated across the kyphotic deformity (two screws above and below the fracture level +/- hooks) and contouring maneuvers are performed simultaneously to reduce the kyphotic deformity 3.