{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T12:29:31Z","timestamp":1781612971018,"version":"3.54.5"},"reference-count":16,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T00:00:00Z","timestamp":1759190400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.mdpi.com"],"crossmark-restriction":true},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Temporary internal distraction is a safe surgical technique that has been shown to improve correction of severe scoliosis. The traditional surgical adjunct for scoliosis treatment in the perioperative period is halo gravity traction, but there are several known disadvantages of this technique. We describe the technical nuances of temporary internal distraction using the construct-to-construct technique, a surgical adjunct that utilizes two rods joined by lateral domino connectors to enact powerful internal distraction or compression forces on the spine for achieving spinal deformity correction. Methods: This study was designed as a retrospective review and illustrative surgical technique report. The primary aim was to describe the construct-to-construct internal distraction and compression technique for scoliosis correction, with illustrative models and representative clinical cases. Results: Internal distraction using the construct-to-construct configuration is performed early in the surgery to take advantage of the viscoelastic properties of the spine as gradually increasing distraction forces are applied. The surgical technique for applying internal distraction and compression using the construct-to-construct configuration is discussed in detail. Conclusions: Construct-to-construct internal distraction and compression techniques are powerful methods to correct severe scoliosis curves, serially distract traditional growing rod constructs, and close three-column osteotomies.<\/jats:p>","DOI":"10.3390\/jcm14196939","type":"journal-article","created":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T14:16:29Z","timestamp":1759241789000},"page":"6939","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Construct-to-Construct Internal Distraction and Compression Technique for Scoliosis Correction"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1887-9354","authenticated-orcid":false,"given":"J. Manuel","family":"Sarmiento","sequence":"first","affiliation":[{"name":"Pauline Braathen Neurological Center, Department of Neurosurgery, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL 33331, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodrigo","family":"Navarro-Ramirez","sequence":"additional","affiliation":[{"name":"Pauline Braathen Neurological Center, Department of Neurosurgery, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL 33331, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hoon","family":"Choi","sequence":"additional","affiliation":[{"name":"Pauline Braathen Neurological Center, Department of Neurosurgery, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL 33331, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony S.","family":"Rinella","sequence":"additional","affiliation":[{"name":"Duly Health and Care, 120 Spalding Drive, Suite 400, Naperville, IL 60540, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7482-6994","authenticated-orcid":false,"given":"Han Jo","family":"Kim","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery, Spine and Scoliosis Service, 535 East 70th Street, New York, NY 10021, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence G.","family":"Lenke","sequence":"additional","affiliation":[{"name":"Department of Pediatric Orthopaedics, New York-Presbyterian Morgan Stanley Children\u2019s Hospital, 3959 Broadway-8 North, New York, NY 10032, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael G.","family":"Vitale","sequence":"additional","affiliation":[{"name":"Department of Pediatric Orthopaedics, New York-Presbyterian Morgan Stanley Children\u2019s Hospital, 3959 Broadway-8 North, New York, NY 10032, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1097\/00007632-199603010-00024","article-title":"Spinal deformity and axial traction","volume":"21","author":"Kumar","year":"1996","journal-title":"Spine"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1097\/01.brs.0000153707.80497.a2","article-title":"Perioperative halo-gravity traction in the treatment of severe scoliosis and kyphosis","volume":"30","author":"Rinella","year":"2005","journal-title":"Spine"},{"key":"ref_3","first-page":"2035","article-title":"Temporary internal distraction as an aid to correction of severe scoliosis","volume":"88","author":"Buchowski","year":"2006","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_4","first-page":"297","article-title":"Temporary internal distraction as an aid to correction of severe scoliosis. Surgical technique","volume":"89","author":"Buchowski","year":"2007","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1007\/s43390-020-00239-6","article-title":"Interobserver and intraobserver reliability of determining the deformity angular ratio in severe pediatric deformity curves","volume":"9","author":"Zuckerman","year":"2021","journal-title":"Spine Deform."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1447","DOI":"10.1097\/BRS.0000000000001547","article-title":"Deformity Angular Ratio Describes the Severity of Spinal Deformity and Predicts the Risk of Neurologic Deficit in Posterior Vertebral Column Resection Surgery","volume":"41","author":"Wang","year":"2016","journal-title":"Spine"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1227\/NEU.0000000000000182o","article-title":"The comprehensive anatomical spinal osteotomy classification","volume":"74","author":"Schwab","year":"2014","journal-title":"Neurosurgery"},{"key":"ref_8","first-page":"100516","article-title":"Lumbar pedicle subtraction osteotomy: Techniques and outcomes","volume":"19","author":"Bourghli","year":"2024","journal-title":"N. Am. Spine Soc. J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1007\/s11999-009-1037-x","article-title":"Vertebral column resection for the treatment of severe spinal deformity","volume":"468","author":"Lenke","year":"2010","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1007\/s43390-022-00602-9","article-title":"Temporary internal distraction for severe scoliosis: Two-year minimum follow-up","volume":"11","author":"Badin","year":"2023","journal-title":"Spine Deform."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e464","DOI":"10.1016\/j.wneu.2020.07.183","article-title":"Clinical and Radiological Outcomes of Less Invasive Temporary Internal Distraction Followed by Staged Pedicle Screw Instrumentation in Adolescents with Severe Idiopathic Scoliosis at 2-Year Minimum Follow-Up","volume":"143","author":"Grabala","year":"2020","journal-title":"World Neurosurg."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Grabala, P., Galgano, M.A., Grabala, M., and Buchowski, J.M. (2024). Radiological and Pulmonary Results of Surgical Treatment of Severe Idiopathic Scoliosis Using Preoperative Halo Gravity Traction Compared with Less Invasive Temporary Internal Distraction in Staged Surgery in Adolescents. J. Clin. Med., 13.","DOI":"10.3390\/jcm13102875"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1038\/sc.2009.19","article-title":"Paralysis as a result of traction for the treatment of scoliosis: A forgotten lesson from history","volume":"47","author":"Weiner","year":"2009","journal-title":"Spinal Cord"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"247","DOI":"10.3171\/2013.12.PEDS13188","article-title":"Neuromonitoring changes in pediatric spinal deformity surgery: A single-institution experience","volume":"13","author":"Ferguson","year":"2014","journal-title":"J. Neurosurg. Pediatr."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"15S","DOI":"10.1177\/2192568219836993","article-title":"Responding to Intraoperative Neuromonitoring Changes During Pediatric Coronal Spinal Deformity Surgery","volume":"9","author":"Lewis","year":"2019","journal-title":"Glob. Spine J."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.jspd.2013.09.009","article-title":"Neuromonitoring Changes Are Common and Reversible With Temporary Internal Distraction for Severe Scoliosis","volume":"2","author":"Skaggs","year":"2014","journal-title":"Spine Deform."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/19\/6939\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T14:36:02Z","timestamp":1759242962000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/19\/6939"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,30]]},"references-count":16,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2025,10]]}},"alternative-id":["jcm14196939"],"URL":"https:\/\/doi.org\/10.3390\/jcm14196939","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,30]]}}}