# Construct-to-Construct Internal Distraction and Compression Technique for Scoliosis Correction

## TL;DR

A new surgical technique using internal distraction and compression is described to correct severe scoliosis more effectively.

## Contribution

The novel construct-to-construct technique uses lateral domino connectors to apply distraction or compression forces during scoliosis surgery.

## Key findings

- Internal distraction using the construct-to-construct method improves correction of severe scoliosis.
- The technique utilizes viscoelastic properties of the spine for gradual correction.
- The method can also be used to close three-column osteotomies and manage growing rod constructs.

## Abstract

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.