Zielke Instrumentation in the Treatment of Scoliosis

Suk, Se Il; Park, Yoon Soo; Lee, Jae Won

Abstract

Zielke introduced new anterior instrumentation by modifying Dwyer system and called it the ventral derotation spondylodesis(VDS) system in 1976. This system is a powerful device and when the excised disc spaces are compressed with it, stable fixation can be obtained. But proper patient selection, meticulous operative technique and good post-operative care are essential to minimize serious complications. No results of this technique had been published in English-language literature until Moe reported the results of 66 cases of Zielke instrumentation in 1983. Zielke instrumentation was carried out in 12 cases of scoliosis;8 in idiopathic scoliosis and 4 in congenital scoliosis, at the Department of Orthopedic Surgery, Seoul National University Hospital, for 16 months from November 1984 to March 1986. Seven cases had been followed for more then 9 months and'following results were obtained. 1. Numbers of vertebrae involved in major curve and numbers of fused vertebrae were 6·3 respectively. 2. Average preoperative curve was 72.7 degrees and immediate postoperative curve was 17.6 degrees with 75.8% correction. There was only 1.0 degree loss of correction with an average follow-up of 14 months (9-16 months). 3. Zielke instrumentation has the advantage of shorter fusion and better correction in thoracolumbar and lumbar scoliosis.