Thoracic Pedicle Screws

Dr. Lenke has been a key leader in developing, teaching and safely using thoracic pedicle screws, special implants that can correct spinal deformities.

What are they?
When a disorder like scoliosis or kyphosis is severe and progressive, spine surgery is sometimes needed to correct the deformity and stabilize the spinal column. This type of spine surgery requires the use of special instruments and implants to permanently fix the affected part of the spinal column into a more normal position. In the past, the primary method for correcting this type of deformity involved inserting a system of hooks with rods attached to straighten the spine. The hook and rod system was not ideal, however; there were limits to the amount of curve correction that could be achieved, and sometimes the systems did not hold up to patient activity and wear and tear over time. Dr. Lenke has been influential in adopting and teaching a new and better method of instrumentation involving thoracic pedicle screws.

How do they work?
Thoracic pedicle screws are used in both pediatric and adult patients with spinal deformities. These screws are implanted into the spine’s pedicles, which are dense stem-like bony structures that project from the rear, on the left and right sides of each vertebra. The screws then secure strong but malleable rods to the spinal column.

Why are they better?
Thoracic pedicle screws allow instrumentation to be attached to all three columns of the vertabrae: front, middle, and rear. They give the surgeon better control in correcting a patient’s curve through applying greater force and remaining tightly fixed to the spine without slipping. In addition, the screws are more stable than hooks and are better for maintaining the correction of the spine after surgery. They also in most cases diminish the need for anterior surgery (from the front of the body), thus simplifying the surgical approach and lowering the risk of surgical complications.

Dr. Lenke was one of the first surgeons in the U.S. to begin using thoracic pedicle screws instead of hooks in the treatment of spinal deformities in the mid to late 1990s. He has pioneered many new ways of using thoracic pedicle screws to treat complex and severe spinal deformities, and these practices are now widely accepted. Dr. Lenke routinely teaches other surgeons how to use thoracic pedicle screws at national and international meetings, and he continues to research ways to improve and enhance their use in correcting spinal deformity.