Document Detail


Submuscular Isola rod with or without limited apical fusion in the management of severe spinal deformities in young children: preliminary report.
MedLine Citation:
PMID:  11547206     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY DESIGN: Retrospective review of the results of submuscular rod placement with and without limited apical fusion for the treatment of severe spinal deformities in young children. OBJECTIVES: To determine the success of this method for controlling severe deformities while allowing for spinal growth and to compare this method with previously reported results. SUMMARY OF BACKGROUND DATA: A variety of methods for controlling scoliosis in young children have been reported, but complications including spontaneous fusion, loss of correction, instrumentation failure, and limited spinal growth are common. METHODS: The cases of 29 young children with progressive scoliosis or kyphoscoliosis as a result of a variety of diagnoses treated with a submuscular Isola rod and a postoperative orthosis were retrospectively reviewed. Eleven patients also had a short anterior and posterior apical fusion or convex hemiepiphysiodesis to aid in correction and stabilization of their deformity. The remaining 18 patients had a submuscular rod only. RESULTS: The mean age at surgery was 6.7 years (range, 1-11 years). The initial preoperative mean magnitude of the major curve was 66 degrees (range, 42-112 degrees ). After surgery this decreased to a mean of 38 degrees (range, 16-70 degrees ). The most recent radiographs demonstrated a mean 47 degrees curve (range, 28-79 degrees ). The mean number of lengthenings per patient has been two (range, 0-5). Nine patients have reached a suitable age and have been converted to a posterior spinal fusion and segmental spinal instrumentation. Nine complications have occurred in seven patients (24%). These included five hook displacements and three rod breakages. These were treated by hook reinsertion and rod exchange or sleeve and a repeat lengthening. There was one superficial infection treated medically. CONCLUSION: This technique is useful in the management of severe spinal deformities in young children who have either failed, or have a contraindication to, orthotic management. Complications are relatively frequent but well tolerated.
Authors:
L C Blakemore; P V Scoles; C Poe-Kochert; G H Thompson
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Spine     Volume:  26     ISSN:  0362-2436     ISO Abbreviation:  Spine     Publication Date:  2001 Sep 
Date Detail:
Created Date:  2001-09-07     Completed Date:  2001-10-25     Revised Date:  2009-07-09    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2044-8     Citation Subset:  IM    
Affiliation:
Department of Orthopaedic Surgery, University of Michigan Medical Center, Ann Arbor, Michigan, USA.
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MeSH Terms
Descriptor/Qualifier:
Bone Nails*
Child
Child, Preschool
Equipment Failure
Female
Humans
Infant
Internal Fixators
Kyphosis / physiopathology,  radiography
Lordosis / physiopathology,  radiography
Lumbar Vertebrae / physiopathology,  radiography,  surgery
Male
Postoperative Complications
Retrospective Studies
Scoliosis / physiopathology,  radiography,  surgery*
Spinal Fusion / adverse effects,  instrumentation*,  methods
Thoracic Vertebrae / physiopathology,  radiography,  surgery
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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