Back to Search
Start Over
Spine deformity correction in Marfan syndrome.
- Source :
-
Spine [Spine (Phila Pa 1976)] 2002 Sep 15; Vol. 27 (18), pp. 2003-12. - Publication Year :
- 2002
-
Abstract
- Study Design: Retrospective review of records and radiographs with postoperative questionnaire of patients with Marfan syndrome receiving surgical correction for spinal deformity.<br />Objective: To characterize and analyze the challenges of surgical correction for spinal deformity in Marfan syndrome and to present recommendations that may reduce morbidity and increase success for these procedures.<br />Summary of Background Data: Spinal deformities are common in Marfan syndrome and usually refractory to conservative management. The few, smaller studies of surgical intervention reported on earlier surgical techniques but suggested increased complication rates.<br />Methods: Records and radiographs of 39 patients with confirmed Marfan syndrome who underwent surgical management at either of two institutions for primary scoliosis (n = 26), kyphosis (n = 7), or deformity secondary to previous surgery elsewhere (n = 6) were reviewed. Presentation features, complications, and therapeutic results were analyzed. Low back outcome scores were generated from a questionnaire given to patients after surgery.<br />Results: Increased blood loss and rates of infection (10%), dural tear (8%), instrumentation fixation failure (21%), pseudarthrosis (10%), and coronal (8%) and sagittal (21%) curve decompensation were noted. Infection was often associated with dural tear and decompensation with extreme correction. One patient died of valvular insufficiency 11 weeks after surgery.<br />Conclusion: The cardiopulmonary condition of patients with Marfan syndrome should be evaluated and planned for before surgery. Preoperative computed tomograph to assess bony adequacy for fixation and magnetic resonance imaging to evaluate dural ectasia are indicated. Attention paid to the sagittal profile, extension of fusion to vertebrae neutral and stable in both planes, minimization of soft tissue dissection, and avoidance of extreme correction may prevent curve decompensation.
- Subjects :
- Adolescent
Adult
Blood Loss, Surgical statistics & numerical data
Child
Female
Humans
Intraoperative Complications
Kyphosis diagnostic imaging
Lordosis complications
Lordosis surgery
Magnetic Resonance Imaging
Male
Postoperative Complications
Reoperation statistics & numerical data
Retrospective Studies
Scoliosis diagnostic imaging
Spinal Fusion adverse effects
Spine diagnostic imaging
Spine surgery
Surgical Wound Infection etiology
Tomography, X-Ray Computed
Treatment Outcome
Kyphosis complications
Kyphosis surgery
Marfan Syndrome complications
Scoliosis complications
Scoliosis surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1528-1159
- Volume :
- 27
- Issue :
- 18
- Database :
- MEDLINE
- Journal :
- Spine
- Publication Type :
- Academic Journal
- Accession number :
- 12634560
- Full Text :
- https://doi.org/10.1097/00007632-200209150-00008