Document Detail

Unit rod segmental spinal instrumentation in the management of patients with progressive neuromuscular spinal deformity.
MedLine Citation:
PMID:  2617359     Owner:  NLM     Status:  MEDLINE    
Thirty-four nonambulatory patients with progressive neuromuscular spinal deformity were surgically managed using a 1/4" U-shaped double rod construct with segmental instrumentation from T2 to the pelvis accompanied by posterior spinal fusion. Diagnoses included 17 patients with cerebral palsy, six with spinal bifida, and 11 with other diseases (spinal muscular atrophy, Friedreich's ataxia, polyneuropathy, nemaline myopathy, and polio). Twenty-three patients had single uncompensated thoracolumbar curves, and 11 had a double curve pattern. The mean preoperative major curve was 66 degrees (range, 22-132 degrees), the secondary curve 58 degrees (range, 23-84 degrees). No postoperative spinal support was used. Mean curve correction was 36 degrees or 54.6%. There were four major complications, including two implant failures requiring revision and two patients sustaining excessive intraoperative blood loss necessitating completion of the procedure in a second stage. There were two neurologic complications including one case of postoperative seizures and an L4 monoradicular neuropathy in a spina bifida patient. Four patients had temporary postoperative ileus, one gastroesophageal reflex, and four had urinary tract infections. There were no significant postoperative pulmonary complications. Excluding the patients with rod failure, mean loss of correction at mean follow-up of 21.3 months was 6.5%. The stability and curve correction obtained using this system supports its continued use in patients with progressive neuromuscular scoliosis.
D F Bell; C F Moseley; J Koreska
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Spine     Volume:  14     ISSN:  0362-2436     ISO Abbreviation:  Spine     Publication Date:  1989 Dec 
Date Detail:
Created Date:  1990-03-06     Completed Date:  1990-03-06     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:  1301-7     Citation Subset:  IM    
Division of Orthopaedic Surgery, Hospital for Sick Children, Toronto, Ontario, Canada.
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MeSH Terms
Equipment Failure
Intraoperative Complications
Kyphosis / therapy
Lordosis / therapy
Neuromuscular Diseases / complications*
Orthopedic Fixation Devices* / adverse effects
Postoperative Complications
Scoliosis / therapy
Spinal Diseases / etiology,  radiography,  therapy*

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

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