PMID- 35397069
OWN - NLM
STAT- MEDLINE
DCOM- 20220817
LR  - 20220831
IS  - 2212-1358 (Electronic)
IS  - 2212-134X (Linking)
VI  - 10
IP  - 5
DP  - 2022 Sep
TI  - RCC (reinforced criss-cross construct): an easy and effective multi-rod 
      thoraco-lumbar posterior reconstruction technique.
PG  - 1203-1208
LID - 10.1007/s43390-022-00504-w [doi]
AB  - STUDY DESIGN: Surgical technical note and literature review. OBJECTIVES: To 
      describe a technique that uses 4 rod constructs in cases of complex thoracolumbar 
      spinal deformity correction or revision surgeries based on the hybrid use of two 
      different types of purchase points by a staggered pedicle screw fixation. It 
      utilizes two rods on either side of the spine using a lateral and medial entry 
      point of pedicle screws in the vertebral body. METHODS: Pedicle screws using 
      extra-pedicular technique are more converging screws and are inserted alternately 
      in the vertebral body and connected by rods. The left-out alternate vertebral 
      bodies are fixed by a relatively straighter pedicle entry screw and connected to 
      each other by a separate rod. So, two trajectories are independently used for a 
      four-rod construct. This reconstruction has been named RCC (reinforced 
      criss-cross construct). The screws in the index case were placed by free hand 
      method, but we have increasingly utilized navigation guidance for placement of 
      screws in recent times. RESULTS: We present a surgical technical note in a 
      patient with human immunodeficiency virus infection and acquired immune 
      deficiency syndrome (HIV-AIDS). He was diagnosed to have multi-drug-resistant 
      (MDR) tuberculous spondylodiscitis, complicated with Immune reconstitution 
      inflammatory syndrome (IRIS) and implant failure resulting in kyphosis and 
      thoracic myelopathy. RCC with pharmacological management achieved healing and 
      union, which was maintained at 4 years follow-up. Our method of four-rod 
      construct provides a strong and lasting construct in the management of spinal 
      deformities and three-column osteotomies. It provides good structural support to 
      the spine till bony union is achieved. CONCLUSION: Hybrid multi-rod construct 
      like RCC provides a rigid mechanical support to the instrumentation and reduces 
      the chances of rod failure especially in complex thoraco-lumbar spinal deformity 
      correction surgeries.
CI  - (c) 2022. The Author(s), under exclusive licence to Scoliosis Research Society.
FAU - Krishnan, Ajay
AU  - Krishnan A
AUID- ORCID: 0000-0001-9808-2371
AD  - Stavya Spine Hospital and Research Institute Pvt. Ltd, Mithakhali, Ahmedabad, 
      Gujarat, India. drajaykrishnan@gmail.com.
FAU - Raj, Aditya
AU  - Raj A
AD  - Stavya Spine Hospital and Research Institute Pvt. Ltd, Mithakhali, Ahmedabad, 
      Gujarat, India.
FAU - Meena, Umesh
AU  - Meena U
AD  - Stavya Spine Hospital and Research Institute Pvt. Ltd, Mithakhali, Ahmedabad, 
      Gujarat, India.
FAU - Degulmadi, Devanand
AU  - Degulmadi D
AD  - Stavya Spine Hospital and Research Institute Pvt. Ltd, Mithakhali, Ahmedabad, 
      Gujarat, India.
FAU - Rai, Ravi Ranjan
AU  - Rai RR
AD  - Stavya Spine Hospital and Research Institute Pvt. Ltd, Mithakhali, Ahmedabad, 
      Gujarat, India.
FAU - Mayi, Shivanand
AU  - Mayi S
AD  - Stavya Spine Hospital and Research Institute Pvt. Ltd, Mithakhali, Ahmedabad, 
      Gujarat, India.
FAU - Dave, Mirant
AU  - Dave M
AD  - Stavya Spine Hospital and Research Institute Pvt. Ltd, Mithakhali, Ahmedabad, 
      Gujarat, India.
FAU - Dave, Bharat R
AU  - Dave BR
AD  - Stavya Spine Hospital and Research Institute Pvt. Ltd, Mithakhali, Ahmedabad, 
      Gujarat, India.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20220409
PL  - England
TA  - Spine Deform
JT  - Spine deformity
JID - 101603979
SB  - IM
MH  - *Carcinoma, Renal Cell
MH  - Humans
MH  - *Kidney Neoplasms
MH  - Lumbar Vertebrae/surgery
MH  - Male
MH  - *Pedicle Screws
MH  - Thoracic Vertebrae/surgery
OTO - NOTNLM
OT  - Complex deformity
OT  - Hybrid pedicle fixation
OT  - Multi-rod
OT  - Navigation
OT  - Spine
EDAT- 2022/04/10 06:00
MHDA- 2022/08/18 06:00
CRDT- 2022/04/09 12:03
PHST- 2021/09/10 00:00 [received]
PHST- 2022/03/20 00:00 [accepted]
PHST- 2022/04/10 06:00 [pubmed]
PHST- 2022/08/18 06:00 [medline]
PHST- 2022/04/09 12:03 [entrez]
AID - 10.1007/s43390-022-00504-w [pii]
AID - 10.1007/s43390-022-00504-w [doi]
PST - ppublish
SO  - Spine Deform. 2022 Sep;10(5):1203-1208. doi: 10.1007/s43390-022-00504-w. Epub 
      2022 Apr 9.