Segmental Vertebral Body Derotation with the
EXPEDIUM VERSE System
Segmental Vertebral Body Derotation can be done as the sole
derotation maneuver or in addition to the en bloc maneuver
described previously. There are several methods which can be
employed to achieve the desired derotation.
Single Rod Derotation - Temporary Locking of the
Convex Screws
Implant the sagittally contoured concave rod and capture it
with Correction Keys or Unitized Set Screws.Only the
Correction Keys or Unitized Set Screws in the distal and
proximal neutral vertebra must be tightened.
Overcontouring of the concave rod can be used to facilitate
derotation of the spine.
Once the concave rod is captured (not reduced), lock the
distal neutral level EXPEDIUM VERSE Screws. Next,
temporarily lock the polyaxial head of the convex screws of
the levels requiring derotation. This can be achieved with a
short temporary rod segment and a counter torque handle
connected to a facilitator or quick stick tube while using the
Torque Limiting Handle with the Key Inserter/Tightener to
apply final tightening torque to the Poly Lock at these levels.
(FIGURE 51)
Apply facilitators to the distal anchors of the neutral
segment. Place another two facilitators on the next proximal
level. A Quick Stick must be attached to the concave screw
as application of a pull force is required.
Derotate the proximal vertebra to a neutral position and
tighten the concave Correction Key/Unitized Set Screw to
retain the derotation. The Facilitator/Quick Stick on the
neutral level must be used to apply a counter force as the
rotated segment is corrected to a neutral position. Repeat the
previous steps, moving proximally toward the apex.
Once all levels have been derotated and the concave rod is
fully reduced, the Correction Key on the convex screws can
be removed to allow placement of the convex rod. If
additional derotation is desired, the convex rod can be under
contoured. Once both rods are captured, all Correction Key
Poly Locks must be final tightened.
Compression or distraction can be performed segmentally at
this point if needed, as the EXPEDIUM VERSE Screws allow
for parallel compression/distraction on the rod when the
Correction Key Poly Lock is final tightened and the Rod Lock
is loose. Instruction is provided in the Compression and
Distraction Section.
FIGURE 51
FIGURE 52
27
DePuy Synthes Companies
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EXPEDIUM VERSE System
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System Guide
Summary of Contents for EXPEDIUM VERSE
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