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Minimally Invasive Surgery for Neuromuscular Scoliosis: Results and Complications at a Minimal Follow-up of 5 Years
- Publication Year :
- 2021
- Publisher :
- Lippincott Williams & Wilkins, 2021.
-
Abstract
- STUDY DESIGN A prospective study. OBJECTIVE The aim of this study was to report the results of an alternative technique to growing rods (GR) for neuromuscular scoliosis using a minimally invasive fusionless surgery with a minimum of 5 years' follow-up. SUMMARY OF BACKGROUND DATA Conservative treatment is not effective in progressive neuromuscular scoliosis. Early surgery using GR is increasingly advocated to control the deformity while preserving spinal and thoracic growth before arthrodesis. These techniques still provide a high rate of complications. METHODS The technique relies on a bilateral double rod sliding instrumentation anchored proximally by four hooks claws and distally to the pelvis by iliosacral screws through a minimally invasive approach. The clinical and radiological outcomes of 100 consecutive patients with neuromuscular scoliosis who underwent this fusionless surgery with a minimum follow-up of 5 years were reviewed. RESULTS 6.5 ± 0.7 years after initial surgery, six patients were lost of follow-up and 11 died of unrelated raison. Of the 83 remaining patients at latest follow-up, mean Cobb angle was stable to 35.0° which correspond to 61% correction of the initial deformation. Mean pelvic obliquity was 29.6° (0.3°-80.0°) preoperatively and 7.2 (0.2°-23.5°) at latest follow-up. Correction of the hyper kyphosis remained stable. Skeletal maturitywas reached in 42 of 83 patients (50.6%). None of these patients has required spinal fusion. The global complication rate was 31.3%. CONCLUSION The outcomes of this minimally invasive fusionless technique at 5 years follow-up showed a stable correction of spinal deformities and pelvic obliquity over time, with a reduced rate of complication. The arthrodesis was not required for all patients at skeletal maturity. This technique could be a good alternative to arthrodesis for neuromuscular scoliosis.Level of Evidence: 3.
- Subjects :
- medicine.medical_specialty
medicine.medical_treatment
Arthrodesis
Kyphosis
Clinical Neurology
Fusionless surgery
Bipolar technique
medicine
Deformity
Humans
Minimally Invasive Surgical Procedures
Growth guided surgical technique
Orthopedics and Sports Medicine
Minimally invasive fusionless surgery
Prospective Studies
Prospective cohort study
Pelvis
Retrospective Studies
Cobb angle
business.industry
medicine.disease
Surgery
medicine.anatomical_structure
Spinal Fusion
Treatment Outcome
Scoliosis
Spinal fusion
Sciences du vivant
Neuromuscular scoliosis
Neurology (clinical)
medicine.symptom
Complication
business
Follow-Up Studies
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....9032c06e561da534b1c45a06593a8d1c