{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:32:11Z","timestamp":1786649531521,"version":"build-2736575974"},"reference-count":6,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Instability of the occipitocervical junction may compress neural elements, resulting in progressive disability. After the\n                    <jats:italic toggle=\"yes\">Kickstand Rod<\/jats:italic>\n                    technique was developed to correct for thoracolumbar scoliosis, the\n                    <jats:italic toggle=\"yes\">Candy Cane<\/jats:italic>\n                    construct was developed for chin-on-chest deformity at the cervicothoracic junction as a similar three-rod approach. Demonstrated is a four-rod iteration utilized to stabilize the occipitocervical junction and correct condylar instability, termed the\n                    <jats:italic toggle=\"yes\">Catcher\u2019s Mitt<\/jats:italic>\n                    technique. A 34-year-old woman with Goldenhar syndrome, hemihypertrophy, and a complex neurosurgical history including Chiari decompression, clival chordoma resection, and a previous cervical fusion presented with quadriparesis, dysphagia, and bilateral upper extremity paresthesias. She was found to have pontomedullary and craniocervical instability with occipital translation and subluxation of the atlantooccipital joint, contributing to her neurological decline. A single midline incision and periosteal dissection exposed her prior O to C6 instrumented fusion. Existing rods were replaced, and a third plate-rod was placed on the right from O to C6. On the left, a fourth plate rod was positioned from C1 to C6. Four top-loading connectors secured the accessory rods to the primary construct. After confirming a stable lordotic alignment, distraction across the accessory rods was used to assist with coronal correction. The\n                    <jats:italic toggle=\"yes\">Catcher\u2019s Mitt<\/jats:italic>\n                    construct improved this patient\u2019s sagittal and coronal plane deformity. Postoperatively, the cervical sagittal vertical axis improved by 25 mm and the chin-brow angle by 20 mm. Significant improvements in functional status were achieved at 2-year follow-up. A one-stage posterior approach with construct augmentation using third and fourth accessory rods can correct atlantooccipital subluxation following failed occipitocervical fusion.\n                  <\/jats:p>","DOI":"10.4103\/jcvjs.jcvjs_87_25","type":"journal-article","created":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T14:00:53Z","timestamp":1751551253000},"page":"254-256","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Occipitocervical surgery rescue: The \u201cCatcher\u2019s Mitt\u201d technique"],"prefix":"10.4103","volume":"16","author":[{"given":"Samuel","family":"Adida","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta K.","family":"Sefcik","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical University of South Carolina, Charleston, SC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo J. Fern\u00e1ndez","family":"de-Thomas","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ananya","family":"Sen","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward G.","family":"Andrews","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nitin","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul A.","family":"Gardner","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. Kojo","family":"Hamilton","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,7,3]]},"reference":[{"key":"R1-20250707","doi-asserted-by":"crossref","first-page":"896","DOI":"10.14245\/ns.2245048.524","article-title":"Evaluation of cervicomedullary compression around the craniovertebral junction:Commentary on \u201cmeasurement of deformity at the craniovertebral junction:Correlation of triangular area and myelopathy\u201d","volume":"19","author":"Hong","year":"2022","journal-title":"Neurospine"},{"key":"R2-20250707","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1093\/neuros\/nyx028","article-title":"The health impact of adult cervical deformity in patients presenting for surgical treatment:Comparison to United States population norms and chronic disease states based on the EuroQuol-5 dimensions questionnaire","volume":"80","author":"Smith","year":"2017","journal-title":"Neurosurgery"},{"key":"R3-20250707","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1097\/BSD.0000000000000743","article-title":"Cervical versus thoracolumbar spinal deformities:A comparison of baseline quality-of-life burden","volume":"31","author":"Passias","year":"2018","journal-title":"Clin Spine Surg"},{"key":"R4-20250707","doi-asserted-by":"crossref","first-page":"3511","DOI":"10.1007\/s00586-023-07795-1","article-title":"Surgical treatment of craniocervical instability:Comparison of two constructs regarding clinical and radiological outcomes of 100 patients","volume":"32","author":"Ismail","year":"2023","journal-title":"Eur Spine J"},{"key":"R5-20250707","doi-asserted-by":"crossref","first-page":"798","DOI":"10.21037\/jss.2018.11.04","article-title":"The \u201ckickstand rod\u201dtechnique 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"},{"key":"R6-20250707","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1007\/s43390-023-00676-z","article-title":"The 'candy cane'technique for construct augmentation and correction of severe angular chin-on-chest kyphoscoliosis","volume":"11","author":"Agarwal","year":"2023","journal-title":"Spine Deform"}],"container-title":["Journal of Craniovertebral Junction and Spine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jcvjs.jcvjs_87_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T18:55:05Z","timestamp":1786647305000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jcvjs.jcvjs_87_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":6,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/jcvjs.jcvjs_87_25","relation":{},"ISSN":["0974-8237","0976-9285"],"issn-type":[{"value":"0974-8237","type":"print"},{"value":"0976-9285","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4]]},"assertion":[{"value":"2025-04-24","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-15","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}