Figure 9
Serial rod reduction to the apex of lordosis. This diagram demonstrates equal force distribution across multiple screw reduction towers. The goal is for reduction to the apex of lordosis first. With an initial display of 8 mm at the apex of lordosis, adjacent towers will likely read slightly higher in an appropriately overcontoured rod. By reducing the adjacent screw towers, this will lessen the forces on the rod at the apex of lordosis. Once the adjacent screw towers are reduced to 8 mm, the surgeon can reduce the apex to 4 mm. Switching back to the adjacent towers, the surgeon reduces L3 and L5 down to 4 mm. The apex should now easily reduce (RD). Once the apex of lordosis is reduced, the adjacent towers can be reduced as well. Reduction of the adjacent levels after the apex will hopefully impart a force onto the spine and create lordosis.
