Universal Spine System

The USS was designed so that the cranial and caudal ends of the construct are rigidly fixed to two rods to create a frame. The screws are placed in the most caudal and cranial segments of the deformity, and a rod is placed between them to create a frame. Instrumentation is then placed in each intervening vertebral segment, and the Vertebral Bodies are rotated and/or translated into the frame. Recently, thoracic pedicle screws have been used as an alternative to hooks. They provide better anchor points, and the authors of clinical studies have shown that more effective curve correction can be achieved using these devices than with hooks.

The Texas Scottish Rite Hospital instrumentation system involves principles of correction similar to those of the USS but also has side-loading connectors that make revision surgery easier. The latest generation of pedicle screws have polyaxial heads that facilitate rod placement in cases in which the pedicles are not well aligned.

In the 1990s further developments in the fields of surgical endoscopy led to the application of thoracoscopy to spinal surgery.5 Video-assisted thoracoscopy has been used to perform anterior release as well as anterior fusion and stabilization in cases of spinal deformity. Morbidity seems to be reduced with this approach. Further studies are necessary to validate the effectiveness of this newer technology.