Document Detail


Intra-Operative Skull - Femoral (Skeletal) Traction in Surgical Correction of Severe Scoliosis (>80 degrees) in adult neglected scoliosis.
MedLine Citation:
PMID:  23060059     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Study design: Retrospective reviewObjective: The purpose of this study is to evaluate the effectiveness, safety and reliability of intra-operative skeletal traction in the surgical correction of severe adult neglected scoliosis.Summary: Literature shows curves >80 that do not reduce to 50-55 on bending radiographs require an anterior release. A combined anterior and posterior approach is often used for treating severe rigid scoliosis. However anterior approach has its own complications in the form of increased morbidity, increased blood loss, operative time and pulmonary complications. Corrective surgery gets even more challenging if the patients are adults.Material & Methods: Ten patients with severe scoliosis(>80) and low flexibility index(<0.5) treated with intra-operative skeletal traction were a part of this study. The patients were operated between April-2008 and May-2010. Eight patients with neglected Adolescent Idiopathic Scoliosis(AIS) and 2 with Neuromuscular Scoliosis (NMS) were included. The mean age was 27.4 years(19-36). Corrective surgery and fusion was performed using intra-operative skeletal traction.Results: Cobb-angle improved from a mean of 89.35 pre-operatively to 40.25 post - operatively giving a mean correction of 55.29%. Apical vertebral rotation (Nash & Moe) improved from a mean of grade-3(2-4) to a mean of grade-2(1-3). Apical vertebral translation improved from a mean of 2.19 cm pre-op to 0.98 cm post-op (55.41% correction). There were no intra-operative adverse events or post-operative complications. All patients had good shoulder balance and were satisfied with the correction achieved.Conclusion: Intra-operative skull - femoral traction can be a safe and effective method to assist correction of severe and rigid scoliosis. It facilitates surgical exposure and pedicle screw insertion. It obviates the need of an anterior release surgery and associated morbidity thus reducing the hospital stay and costs. It provides a much simpler way to correct the sagittal and coronal imbalance, as well as the pelvic obliquity.
Authors:
Arvind G Kulkarni; Sambhav P Shah
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-10
Journal Detail:
Title:  Spine     Volume:  -     ISSN:  1528-1159     ISO Abbreviation:  Spine     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1( Corresponding author), Consultant Spine Surgeon, Mumbai Spine Scoliosis & Disc Replacement Centre, Bombay Hospital and Medical Research Centre, Room Nos. 206, 12, New Marine Lines, 2nd Floor, Mumbai-400020, Mobile:919892875490, e-mail:drarvindspines@gmail.com, website: http://www.indiaspinesurgery.com 2Clinical Fellow, Department of Orthopaedics, Bombay Hospital & Medical Research Centre, Mumbai-400020, Mobile: 919833165660, Email: docsambhav@gmail.com.
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