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. 2020 Sep-Oct;11(5):848-852.
doi: 10.1016/j.jcot.2020.07.013. Epub 2020 Jul 23.

Active Apex Correction: An overview of the modified SHILLA technique and its clinical efficacy

Alaaeldin Azmi Ahmad  1   2 , Akash Agarwal  2
Affiliations

Active Apex Correction: An overview of the modified SHILLA technique and its clinical efficacy

Alaaeldin Azmi Ahmad et al. J Clin Orthop Trauma. 2020 Sep-Oct.

Erratum in

Abstract

Objective: Provide current overview of Active Apex correction as a new technique for surgical management for Early Onset Scoliosis by dynamically remodulating the apex of the deformity and mitigate loss of correction and presents a comparative correction data against the long-established systems.

Method: Summary of the surgical technique and review of the existing retrospective data on APC surgical technique and its comparison against other existing techniques.

Results: Retrospective clinical results showed the efficiency of the APC technique in active remodulation of the apex of the curve with lower incidence of implant related complications in comparison to SHILLA and Magnetically Controlled Growing Rods (MCGR). APC also showed similar results with traditional growing rods without the need for repeated distraction surgeries for 4 years.

Conclusion: Active Apex Control is safe and viable option in surgical management for Early Onset Scoliosis patients even in areas with limited resources.

Keywords: Active apex correction; Adding-on; Crankshafting; Growth guidance; Growth rod; Modified SHILLA technique.

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Figures

Fig. 1
Fig. 1
Pedicle screws on the convex side of the apex above and below the most wedged vertebrae.
Fig. 2
Fig. 2
With dominos connecting the proximal and distal rods with the tethering rod on the convex side and domino connecting the proximal and distal rod on the concave side with at least 4 cm sliding rod length.
Fig. 3
Fig. 3
Schematic showing key differences in established SHILLA procedure and the modified SHILLA approach used in this study. (Used with Permission).
Figs. 4
Figs. 4
5 years old female with progressive EOS despite brace treatment.
Fig. 5
Fig. 5
Same patient with correction of the deformity with APC technique the tethering screws site with 5.5 rod in the Apex.
See this image and copyright information in PMC

References

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