Clinical and radiological results of kyphectomy and sliding growing rod surgery technique performed in children with myelomeningocele

Abstract

Background The aim of this study was to present clinical and radiological results of myelomeningocele (MMC) patients treated with the sliding growing rod (SGR) technique after kyphectomy. Methods Between 2016 and 2019, 30 patients (21 males and nine females) who underwent the SGR technique with kyphectomy and posterior instrumentation due to MMC were retrospectively reviewed. Patients’ pre- and postoperative kyphosis, scoliosis, correction rates, bleeding during surgery, blood supply during and after surgery, operation time, instrumentation levels, number of vertebrae removed, MMC onset levels, hospital stay, annual lengthening amounts, and complications were evaluated. Results The mean patient age was 6.9 (4–10) years. Mean preoperative kyphosis was 115° (87–166°), mean early postoperative kyphosis was 3.9° (20–10°), and final follow-up postoperative kyphosis was 5.1° (22–8°). In nine patients presenting with scoliosis, scoliosis was evaluated as 60.2° (115–35°) preoperative, as 12.9° (32–0°) early postoperative, and 15.7° (34–0°) in the final measurement. The kyphotic deformity correction rate was 96.5%, and the scoliotic deformity correction rate was 74.9%. A statistically significant difference was seen between pre- and early postoperative values in kyphosis and scoliosis measurements (p < 0.05). The annual prolongation of the patients was calculated as averages of 0.72 and 0.77 cm/year between T1–T12 and T1–S1, respectively. Conclusion Kyphectomy performed during the early MMC period patients appears to be an excellent method for facilitating rehabilitation and daily care of these patients. It appears that the SGR technique, which provides lung volume protection and lengthening with kyphectomy, is a safe and reliable method in patients. Level of evidence Level 4

Posterior vertebral column resection: Exploring practical uses in clinical settings

“…[ 9 ] Twenty-one patients with myelomeningocele operated by Özcan et al ., the kyphotic angle has been reduced from 115° to 3.9° postoperatively. [ 10 ] We also found similar correction rates reported in the literature. Preoperative kyphosis angle decreased from 67.65° to 7.42° in patients operated for severe and rigid angulation.…”

Comparison of Culture-Negative Adult Knee Septic Arthritis Patients with Culture-Positive Patients

“…In another study reporting the results of CN pediatric septic arthritis, [7] although the results were not bad, the need for different diagnostic tests for etiological research was emphasized. In another similar study, [8] they stated that failure to identify the causative agent in pediatric septic arthritis cannot exclude the diagnosis of septic arthritis, and therefore broad-spectrum antibiotics should be used. While the sequelae caused by septic arthritis in adult patients mostly concern the relevant joint, in pediatric patients it is more important as it paves the way for different complications such as growth defects, deformity, septicemia and contracture.…”