Abstract:
STUDY DESIGN:Retrospective analysis. OBJECTIVE:To determine, in pediatric patients with neuromuscular deformity undergoing vertebral column resection (VCR), the (1) characteristics of the surgery performed; (2) amount of pelvic obliquity restoration, and coronal and sagittal correction achieved; (3) associated blood loss and complications; and (4) extent to which curve type and VCR approach influenced correction, blood loss, and complications. SUMMARY OF BACKGROUND DATA:VCR allows for correction of severe, rigid spinal deformity. This technique has not been previously reported in children with neuromuscular disorders. METHODS:We retrospectively reviewed the records of 23 children with neuromuscular disorders (mean age, 15 years) and spinal deformities (severe scoliosis, 9; global kyphosis or angular kyphosis, 4; kyphoscoliosis, 10) who underwent VCR. The Student t test was used to compare correction differences (statistical significance, P < 0.05). RESULTS:A mean 1.5 vertebrae (27 thoracic and 6 lumbar) were resected per patient. Significant corrections were achieved in pelvic obliquity (11°, from 19° ± 13° to 8° ± 7°), in major coronal curve (56°, from 94° ± 36° to 38° ± 20°), and in major sagittal curve (46°, from 86° ± 37° to 40° ± 19°). There was no difference in correction between various curve types. VCR was associated with substantial blood loss (mean, 76% [estimated blood loss per total blood volume]), which correlated with patient weight and operating time. Overall, 6 patients experienced major complications: spinal cord injury, pleural effusion requiring chest tube insertion, pneumonia, pancreatitis, deep wound infection, and prominent implant requiring revision surgery. There were no deaths or permanent neurological injuries. CONCLUSION:VCR achieved significant pelvic obliquity restoration and coronal and sagittal correction in children with neuromuscular disorders and severe, rigid spinal deformity. However, this challenging procedure involves the potential for major complications.
journal_name
Spine (Phila Pa 1976)journal_title
Spineauthors
Sponseller PD,Jain A,Lenke LG,Shah SA,Sucato DJ,Emans JB,Newton POdoi
10.1097/BRS.0b013e318244460dsubject
Has Abstractpub_date
2012-05-15 00:00:00pages
E655-61issue
11eissn
0362-2436issn
1528-1159journal_volume
37pub_type
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