Abstract：
BACKGROUND:Kyphosis in myelomeningocele is a rare and difficult problem. Many strategies have been used with no single procedure universally agreed on. Techniques involving anterior and posterior fixation may provide better fusion. QUESTIONS/PURPOSES:We describe a novel procedure for anteroposterior kyphectomy in patients with myelomeningocele. Apical posterior kyphectomy is followed by the insertion of two rods distally into the vertebral bodies and sacrum. Sublaminar wires are placed superiorly and the kyphosis is reduced by sequential tightening. We determined kyphosis correction and intraoperative blood loss for this new procedure. METHODS:We retrospectively reviewed 22 patients (average age, 7.6 years [range, 2-17 years]) who underwent apical kyphectomy from 1982 to 2008. Charts were examined and radiographs measured preoperatively, immediately postoperatively, and at final followup. Followup averaged 6.4 years (range, 0-14 years) with 19 patients having at least 2 years of followup. RESULTS:Kyphosis decreased from a mean of 123° (range, 79°-163°) preoperatively to 40° (range, 13°-92°) immediately postoperatively and was a mean of 60° (range, 14°-126°) at final followup. Operating time was 248 minutes (range, 180-345 minutes), estimated blood loss was 765 mL (range, 140-2100 mL), and length of stay was 14 days (range, 1-57 days). Ten of the 22 patients had complications with eight requiring reoperation. CONCLUSIONS:This anteroposterior kyphectomy provided a high level of kyphosis correction, which was largely maintained over the study period. Blood loss, surgical time, and complication rates were acceptable as compared with other techniques reported in the literature.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Comstock SA,Cook PC,Leahey JL,El-Hawary R,Hyndman JCdoi
10.1007/s11999-010-1611-2subject
Has Abstractpub_date
2011-05-01 00:00:00pages
1265-71issue
5eissn
0009-921Xissn
1528-1132journal_volume
469pub_type
杂志文章abstract：:Low-intensity pulsed ultrasound has been shown to accelerate fracture healing. This experiment investigated its possible role in distraction. Thirty-four New Zealand White rabbits had distraction osteogenesis, followed by low-intensity pulsed ultrasound therapy. Seventeen animals had the ultrasound transducer switched...
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journal_title：Clinical orthopaedics and related research
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journal_title：Clinical orthopaedics and related research
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journal_title：Clinical orthopaedics and related research
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journal_title：Clinical orthopaedics and related research
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journal_title：Clinical orthopaedics and related research
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