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SINGLE ROD SEGMENTAL SPINAL INSTRUMENT A TION IN THE TREATMENT OF NEUROMUSCULAR SCOLIOSIS



Abstract

Background: To assess whether modern instrumentation systems are biomechanically strong enough to allow instrumented fusion to pelvis on the concavity of the major curve only and if this confers a significant advantage with respect to complications rates and disadvantages with respect to correction achieved and fusion rates.

Methods: A retrospective review from the notes and radiographs of blood loss, operation time, complication rates, degree of correction and fusion rates. Comparisons drawn with neuromuscular curves of similar aetiology treated by same surgeon using more traditional two rod fusion techniques. Subjects were high risk children with progressive neuromuscular scoliosis of varying aetiology requiring stabilisation. (7 cases to date) We compared operation times, blood loss, complication rates, degree of correction and fusion rates with standard segmental fusion techniques in a similar cohort of children. Basic statistical analysis only required to compare the two groups (Analysis of Variance (ANOV A) and Chi squared tests)

Results: Mean operation times, blood loss and complication rates of this small cohort were lower than the control group. No implant failure to date with longest follow-up now approaching two years.

Conclusion: We hope to open a debate as to whether there is a place for this more limited fusion technique in an effort to minimise the complication rates in these highly challenging children

The abstracts were prepared by Mr Colin E. Bruce. Correspondence should be addressed to Colin E. Bruce, Consultant Orthopaedic Surgeon, Alder Hey Children’s Hospital, Eaton Road, Liverpool, L12 2AP.

References:

1 Benson ER. Results and morbidity in a consecutive series of patients undergoing spinal fusion for neuromuscular scoliosis. Spine1998 Nov 1 ;23 (21):2308–17 Google Scholar

2 Boachie-Adjei 0, Lonstein JE, Winter RB. Management of neuromuscular spinal deformities with Luque segmental instrumentation. JBJS Am1989 Apr;71 (4):548–62 Google Scholar