Use of sub-transverse process polyester bands in pediatric spine surgery: A case series of 4 patients with a minimum of 12 months' follow-up

Objective In a previous study, the authors reported on their experience with the use of sublaminar polyester bands as part of segmental spinal constructs. However, the risk of neurological complications with sublaminar passage of instrumentation, such as spinal cord injury, limits the use of this technique. The present study reports the novel use of sub-transverse process polyester bands in posterior instrumented spinal fusions of the thoracic and lumbar spines and sacrum or ilium in 4 patients. Methods The authors retrospectively reviewed the demographic and procedural data of patients who had undergone posterior instrumented fusion using sub-transverse process polyester bands. Results Four patients, ranging in age from 11 to 22 years, underwent posterior instrumented fusion for neuromuscular scoliosis (3 patients) and thoracic hyperkyphosis (1 patient). There were 3 instances of transverse process fracture, with application and tensioning of the polyester band in 1 patient. Importantly, there was no instance of spinal cord injury with sub-transverse process passage of the polyester band. The lessons learned from this technique are discussed. Conclusions This study has shown the "Eleghia" technique of passing sub-transverse process bands to be a technically straightforward and neurologically safe method of spinal fixation. Pedicle screws, laminar/pedicle/transverse process hooks, and sublaminar metal wires/bands have been incorporated into posterior spinal constructs; they have been widely reported and used in the thoracic and lumbar spines and sacrum or ilium with varying success. This report demonstrates the promising results of hybrid posterior spinal constructs that include the Eleghia technique of passing sub-transverse process polyester bands. This technique incorporates technical ease with minimal risk of neurological injury and biomechanical stability.