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SPINAL FUSION AND INSTRUMENTATION IN CHILDREN WITH NEUROMUSCULAR SCOLIOSIS



Abstract

Introduction: Surgery in patients with neuromuscular scoliosis is aimed at improving truncal balance, facilitating sitting, prevention of progression of the curve and preservation of respiratory function.

Patients and Methods: This was a retrospective study of surgical results in a group of 24 patients with minimum follow up of 2 years an average post-operative follow up of 5 years (2–9 years) with neuromuscular scoliosis due to varying aetiologies. The aetiologies included SMA (7), CP (6), Duchenne (5), Congenital Myopathies (3), Spina Bifida (2) and Paraspinal Neuroblastoma (1).

Results: The average age at surgery was 10.6 years, the average duration was 4hrs 25mins with an average blood loss pf 1.1 liters. An average ICU stay was 1–2 days and stay in hospital is 11 days. The curves ranged from 25–103° (average 75.6°) pre-operative and we were able to obtain a correction of 56%. In all but 2 of our patients we were successful in preventing deterioration of respiratory function and all our patients could at least sit without support post-operatively. Our complications included only one deep infection (necessitating implant removal), 1 rod breakage and 2 patients with UTI. There were no significant respiratory complications in post-operation.

Conclusion: Spinal surgery in patients with neuromuscular scoliosis is safe and prevents deterioration of respiratory and improve truncal balance and hence quality of life.

The abstracts were prepared by Professor Jegan Krishnan. Correspondence should be addressed to him at the Flinders Medical Centre, Bedford Park 5047, Australia.