Minimally Invasive Surgical procedure for Neuromuscular Scoliosis: Outcomes and Issues in a Collection of 100 Sufferers.
Backbone (Phila Pa 1976). 2018 Feb 06;:
Authors: Miladi L, Gaume M, Khouri N, Johnson M, Topouchian V, Glorion C
STUDY DESIGN: A retrospective evaluate.
OBJECTIVES: To report the outcomes of an alternate method utilizing a minimally invasive fusionless surgical procedure. The originality relies on the progressive correction of the deformities with proximal and distal fixation and on the reliability of the pelvic fixation utilizing ilio-sacral screws on osteoporotic bones.
SUMMARY OF BACKGROUND DATA: Spinal deformities are widespread in neuromuscular illnesses. Typical remedy entails bracing, adopted by spinal instrumented fusion. Rising rod methods are more and more advocated however have a excessive price of issues.
METHODS: The method depends on a bilateral double rod sliding assemble anchored proximally by four hooks claws and distally to the pelvis by ilio-sacral screws via a minimally invasive strategy.100 sufferers with neuromuscular scoliosis underwent the identical fusionless surgical procedure prolonged from T1 to the pelvis. The common age at preliminary surgical procedure was 11+6y. Diagnoses included cerebral palsy (61), spinal muscular atrophy (22), muscular dystrophy (10), and different neurological etiologies (7).Cobb angle and pelvic obliquity had been measured earlier than and after preliminary surgical procedure, and at closing follow-up. Issues had been reviewed.
RESULTS: At newest follow-up three+9 y (vary 2y – 6+3y), the imply Cobb angle improved from 89° to 35° which corresponds to 61% correction. Imply pelvic obliquity improved from 29° to five° which corresponds to 83% correction. Imply T1-S1 size elevated from 30.02?cm to 37.28?cm. Imply preoperative hyper kyphosis was diminished from 68.44° to 33.29°. Issues occurred in 22 sufferers together with mechanical issues (12) and wound infections (16). No arthrodesis was required finally follow-up.
CONCLUSION: This unique fusionless method is secure and efficient, preserving spinal and thoracic progress. It gives a big correction of spinal deformities and pelvic obliquity with a diminished issues price. The power and stability of this modular assemble over time enable the avoidance of ultimate arthrodesis.
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PMID: 29419720 [PubMed – as supplied by publisher]