Abstract:
STUDY DESIGN:Risks and benefits of using a tibial graft for posterior spinal fusion in neuromuscular scoliosis were evaluated in a long-term follow-up study. A consecutive series of 72 patients underwent posterior spinal fusion for neuromuscular scoliosis. OBJECTIVES:Radiologic outcome was assessed to evaluate the quality of the spinal fusion. Patients were followed serially to detect donor site complications. Mean follow-up was 17 years and 8 months (minimum: 6 years, 6 months). SUMMARY OF BACKGROUND DATA:Mean age of the patients at the time of surgery was 15 years. Progression of the curvature was minimal at last follow-up (mean progression at last follow-up: lumbar curve, 4.5 degrees; thoracic curve, 5.3 degrees). Concerning donor site complications, four patients had a leg length discrepancy of less than 2 cm at last follow-up. This complication was related to tibial overgrowth at the donor site. METHODS:Solid fusion was defined in this long-term study as the absence of modification of the radiologic aspect at last follow-up in addition to the presence of a massive contagious trabecular fusion mass. RESULTS:The fusion appeared to be solid in all patients. No obvious pseudarthrosis could be documented. The constant successful outcome differs significantly from spinal fusion that uses bank bone. The absence of stress fracture was correlated to the low level of constraint in this essentially nonambulatory population. CONCLUSION:This experience indicates that the tibial graft deserves consideration in posterior spinal fusion for neuromuscular scoliosis.
journal_name
Spine (Phila Pa 1976)journal_title
Spineauthors
Zeller RD,Ghanem I,Miladi L,Dubousset Jdoi
10.1097/00007632-199407001-00012subject
Has Abstractpub_date
1994-07-15 00:00:00pages
1628-31issue
14eissn
0362-2436issn
1528-1159journal_volume
19pub_type
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