Nanjing Drum Tower Hospital Orthopedics Creates World's First Dual-Headed Screw for Complex Spinal Deformity

Background

Spinal deformity is a condition that seriously affects patients' quality of life. Reports from January 2026 state that there are more than 5 million patients with spinal deformity in China, with a relatively high proportion of moderate to severe cases. Traditional spinal correction surgery uses pedicle screws that were invented in the 1950s. Although improved over decades, these screws face challenges in complex spinal deformities, including difficult rod installation and risks such as rod breakage due to insufficient fixation strength.

Since 2011, Professor Zhu Zezhang's team in the orthopedics department at Nanjing Drum Tower Hospital has focused on these clinical problems, conducting more than a decade of research to develop innovations in both instrumentation and surgical technique.

What was achieved

The team developed the world's first dual-headed screw, a novel spinal correction internal fixation instrument. This design allows one pedicle screw to connect two rods simultaneously. Combined with the 'sequential correction' technique system they pioneered, it forms a standardized approach described as a 'Chinese solution' for the precise treatment of complex spinal deformities. The project won first prize in the life sciences innovation group at the 10th 'KeChuang Jiangsu' Innovation and Entrepreneurship Competition, with finals held in Nanjing and results reported on January 8, 2026. A separate project on a generative AI-driven intelligent screening system for pediatric scoliosis won third prize in the same competition.

The technology has been industrialized through cooperation with enterprises. It has been applied in nearly 1,000 cases of complex spinal surgery, including spinal deformities, tumors and severe fractures, at more than 20 tertiary hospitals in China. It has also been promoted to more than 10 countries, including in Europe, Africa and the Americas. European physicians have visited the hospital to learn the approach and arranged to import the screws locally.

How it works

In standard spinal correction surgery, pedicle screws are placed into the vertebrae and connected with rods on one or both sides. Surgeons then use maneuvers such as rod rotation and translation to correct the spinal curvature. In severe or complex deformities this process can be technically demanding. Concentrated mechanical stress at certain points increases the risk of rod fracture, screw pull-out or loss of correction after surgery.

The dual-headed screw modifies the traditional single-slot pedicle screw by incorporating two connection heads or slots on one implant. This permits a single screw to secure both a primary rod and an auxiliary satellite rod, enabling four-rod constructs without increasing the number of screws and thereby doubling fixation strength. The associated sequential correction technique divides the correction process into staged steps targeting the rigid apical region of the deformity separately from the more flexible ends. This staged, multi-planar method allows controlled incremental correction while maintaining stability, reported to simplify installation, reduce operative time and blood loss, lower the risk of neurological complications, and improve overall safety and controllability.

What it means for international patients

Nanjing Drum Tower Hospital maintains extensive international academic exchanges, including annual international vision weeks that bring together experts from multiple countries for collaboration on clinical practice, research and education. The hospital group includes affiliated facilities with international medical departments that have provided services to patients from over 60 countries and offer multilingual support along with dedicated coordination.

International patients interested in evaluation or treatment for complex spinal deformity using this instrument or technique should contact the hospital directly to confirm eligibility, current availability and all details of care. Specific arrangements, including suitability for individual cases, must be verified with the hospital.

About the hospital

Nanjing Drum Tower Hospital is a tertiary Grade A comprehensive hospital located in Nanjing, Jiangsu Province. Founded in 1892 as one of China's earliest Western medicine hospitals, it is affiliated with the Medical School of Nanjing University and integrates medical treatment, teaching and scientific research.

Its orthopedics department, which includes the spine surgery division established in 2001, is recognized as a national key clinical specialty. The spine team, led by professors including Zhu Zezhang and with earlier contributions from Yong Qiu, specializes in the treatment of various spinal deformities such as scoliosis. It has accumulated a large clinical database, performs a high volume of complex corrective procedures annually and has received multiple national and provincial science awards.