{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:51:47Z","timestamp":1786125107537,"version":"build-2736575974"},"reference-count":5,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2019,10,4]],"date-time":"2019-10-04T00:00:00Z","timestamp":1570147200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Operative Surg.","ONSURG"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Restoration of spinal alignment and balance is a major goal of adult scoliosis surgery. In the past, sagittal alignment has been emphasized and was shown to have the greatest impact on functional outcomes. However, recent evidence suggests the impact of coronal imbalance on pain and functional outcomes has likely been underestimated.\n                    <jats:sup>1,2<\/jats:sup>\n                    In addition, iatrogenic coronal imbalance may be common and frequently results from inadequate correction of the lumbosacral fractional curve.\n                    <jats:sup>2,3<\/jats:sup>\n                    The \u201ckickstand rod\u201d is a recently described technique to achieve and maintain significant coronal-plane correction.\n                    <jats:sup>4<\/jats:sup>\n                    Also, of secondary benefit, the kickstand rod may function as an accessory supplemental rod to offload stress and bolster primary instrumentation. This may reduce occurrence of rod fracture (RF) or pseudarthrosis (PA).\n                    <jats:sup>5<\/jats:sup>\n                  <\/jats:p>\n                  <jats:p>\u2003Briefly, this technique involves positioning the kickstand rod on the side of coronal imbalance (along the major curve concavity or fractional curve convexity in our video demonstration). The kickstand rod spans the thoracolumbar junction proximally to the pelvis distally and is secured with an additional iliac screw placed just superior to the primary iliac screw. By using the iliac wing as a base, powerful distraction forces can reduce the major curve to achieve more normal coronal balance. This operative video illustrates the technical nuances of utilizing the kickstand rod technique for correction of severe lumbar scoliosis and coronal malalignment in a 60-yr-old male patient. Alignment correction was achieved and maintained without evidence of RF\/PA after nearly 6 mo postoperatively. The patient gave informed consent for surgery and to use imaging for medical publication.<\/jats:p>","DOI":"10.1093\/ons\/opz306","type":"journal-article","created":{"date-parts":[[2019,10,4]],"date-time":"2019-10-04T04:57:00Z","timestamp":1570165020000},"page":"E163-E164","source":"Crossref","is-referenced-by-count":19,"title":["Kickstand Rod Technique for Correcting Coronal Imbalance in Adult Scoliosis: 2-Dimensional Operative Video"],"prefix":"10.1227","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8137-524X","authenticated-orcid":false,"given":"Thomas J","family":"Buell","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of Virginia Health System, Charlottesville, Virginia"},{"name":"Department of Neurosurgery, Auckland City Hospital, Auckland, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avery L","family":"Buchholz","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Virginia Health System, Charlottesville, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus D","family":"Mazur","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Utah, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey P","family":"Mullin","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University at Buffalo, Buffalo, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ching-Jen","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Virginia Health System, Charlottesville, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer D","family":"Sokolowski","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Virginia Health System, Charlottesville, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun-Po","family":"Yen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Virginia Health System, Charlottesville, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark E","family":"Shaffrey","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Virginia Health System, Charlottesville, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher I","family":"Shaffrey","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin S","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Virginia Health System, Charlottesville, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,8]]},"reference":[{"issue":"2","key":"bib1-20231031","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1007\/s00586-015-3898-x","article-title":"Factors influencing radiographic and clinical outcomes in adult scoliosis surgery: a study of 448 European patients","volume":"25","author":"Koller","year":"2016","journal-title":"Eur Spine J"},{"issue":"9","key":"bib2-20231031","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1097\/BSD.0b013e3182aab2ff","article-title":"Coronal spinal balance in adult spine deformity patients with long spinal fusions: a minimum 2- to 5-year follow-up study","volume":"28","author":"Ploumis","year":"2015","journal-title":"J Spinal Disord Tech"},{"issue":"7","key":"bib3-20231031","doi-asserted-by":"crossref","first-page":"690","DOI":"10.1177\/2192568218764904","article-title":"Risk factors for postoperative coronal balance in adult spinal deformity surgery","volume":"8","author":"Lewis","year":"2018","journal-title":"Global Spine J"},{"issue":"4","key":"bib4-20231031","doi-asserted-by":"crossref","first-page":"798","DOI":"10.21037\/jss.2018.11.04","article-title":"The \u201ckickstand rod\u201d technique for correction of coronal imbalance in patients with adult spinal deformity: theory and technical considerations","volume":"4","author":"Makhni","year":"2018","journal-title":"J Spine Surg"},{"issue":"7","key":"bib5-20231031","doi-asserted-by":"crossref","first-page":"E388","DOI":"10.1097\/BRS.0000000000001282","article-title":"Use of supplemental short pre-contoured accessory rods and cobalt chrome alloy posterior rods reduces primary rod strain and range of motion across the pedicle subtraction osteotomy level: an in vitro biomechanical study","volume":"41","author":"Hallager","year":"2016","journal-title":"Spine (Phila Pa 1976)"}],"container-title":["Operative Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ons\/article-pdf\/19\/2\/E163\/33491373\/opz306.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ovid.com\/10.1093\/ons\/opz306","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:50:22Z","timestamp":1786121422000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1093\/ons\/opz306"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,4]]},"references-count":5,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.1093\/ons\/opz306","relation":{},"ISSN":["2332-4252","2332-4260"],"issn-type":[{"value":"2332-4252","type":"print"},{"value":"2332-4260","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10,4]]}}}