Clinical Efficacy of the Vertebral Wedge Osteotomy for the Fusionless Treatment of Paralytic Scoliosis

Mccarthy, Kevin P.; Chafetz, Ross S.; Mulcahey, M. J.; Frisch, Richard; D’Andrea, Linda; Betz, Randal R.

doi:10.1097/brs.0b013e3181c3e89a

Cited by 7 publications

(8 citation statements)

References 30 publications

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“…A temporary rod was left in place for 12 weeks and was then removed. The reported result 42,43 of this was that a 50% correction was maintained in 11 of the 14 patients (Fig. 27.7).…”

Section: ■ Correction Of Existing Deformity After Growth Is Completedmentioning

confidence: 85%

27 Correction Without Fusion

Newton¹,

O’Brien²,

Shufflebarger³

et al. 2011

Idiopathic Scoliosis

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“…A temporary rod was left in place for 12 weeks and was then removed. The reported result 42,43 of this was that a 50% correction was maintained in 11 of the 14 patients (Fig. 27.7).…”

Section: ■ Correction Of Existing Deformity After Growth Is Completedmentioning

confidence: 85%

27 Correction Without Fusion

Newton¹,

O’Brien²,

Shufflebarger³

et al. 2011

Idiopathic Scoliosis

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“…4 Other alternatives to definitive instrumentation include fusionless wedge osteotomies with a temporary rod, but outcomes have not been directly compared with those for standard instrumented fusions. 12,20 Fusion outcomes in the literature are sparse and limited to older instrumentation types (wiring, Luque rods) and mixed neuromuscular pathological entities. Spinal cord injury-related scoliosis tends to appear in a small fraction of these series, with most patients having other types of neuromuscular scoliosis such as myelomeningoceles.…”

Section: Discussionmentioning

confidence: 99%

“…Overall, 54% (20) of patients experienced a perioperative complication (41 complications total; Table 4). The intraoperative complication rate was 11% (4 complications in 4 patients), which included a dural tear in 2 patients (5%), an optic nerve injury (3%), and an instance of electrocardiography (EKG) changes that caused early cessation of the surgical procedure.…”

Section: Intraoperative Perioperative and Postoperative Parameters mentioning

confidence: 99%

Management of spinal cord injury–related scoliosis using pedicle screw–only constructs

Hwang

Safain

King

et al. 2015

SPI

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OBJECT Almost all pediatric patients who incur a spinal cord injury (SCI) will develop scoliosis, and younger patients are at highest risk for curve progression requiring surgical intervention. Although the use of pedicle screws is increasing in popularity, their impact on SCI-related scoliosis has not been described. The authors retrospectively reviewed the radiographic outcomes of pedicle screw–only constructs in all patients who had undergone SCI-related scoliosis correction at a single institution. Methods Medical records and radiographs from Shriner's Hospital for Children–Philadelphia for the period between November 2004 and February 2011 were retrospectively reviewed. Results Thirty-seven patients, whose mean age at the index surgery was 14.91 ± 3.29 years, were identified. The cohort had a mean follow-up of 33.2 ± 22.8 months. The mean preoperative coronal Cobb angle was 65.5° ± 25.7°, which corrected to 20.3° ± 14.4°, translating into a 69% correction (p < 0.05). The preoperative coronal balance was 24.4 ± 22.6 mm, with a postoperative measurement of 21.6 ± 20.7 mm (p = 1.00). Preoperative pelvic obliquity was 12.7° ± 8.7°, which corrected to 4.1° ± 3.8°, translating into a 68% correction (p < 0.05). Preoperative shoulder balance, as measured by the clavicle angle, was 8.2° ± 8.4°, which corrected to 2.7° ± 3.1° (67% correction, p < 0.05). Preoperatively, thoracic kyphosis measured 44.2° ± 23.7° and was 33.8° ± 11.5° postoperatively. Thoracolumbar kyphosis was 18.7° ± 12.1° preoperatively, reduced to 8.1° ± 7.7° postoperatively, and measured 26.8° ± 20.2° at the last follow-up (p < 0.05). Preoperatively, lumbar lordosis was 35.3° ± 22.0°, which remained stable at 35.6° ± 15.0° postoperatively. Conclusions Pedicle screw constructs appear to provide better correction of coronal parameters than historically reported and provide significant improvement of sagittal kyphosis as well. Although pedicle screws appear to provide good radiographic results, correlation with clinical outcomes is necessary to determine the true impact of pedicle screw constructs on SCI-related scoliosis correction.

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“…McCarthy et al . treated 14 children with scoliosis secondary to spinal cord injury or myelodysplasia with a nonfusion vertebral wedge osteotomy technique 51 . Their indications for surgery included: (i) diagnosis of progressive thoracolumbar or lumbar paralytic scoliosis secondary to myelodysplasia or spinal cord injury (SCI); (ii) diagnosis of SCI or myelodysplasia (at L3 or above); and (iii) Cobb's angle >35°.…”

Section: Multi‐vertebral Wedge Osteotomymentioning

confidence: 99%

Advances in nonfusion techniques for the treatment of scoliosis in children

Liu

Shen

2010

Orthopaedic Surgery

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Scoliotic deformity in young children is a challenge for the spinal surgeon. Though traditional spinal correction and fusion techniques can improve these deformities, they inhibit growth of the spine. Nonfusion technologies are an effective approach to this problem. They not only correct the spinal deformity, but also allow the spine to keep growing and developing. These techniques include the growing rod, stapling, pedicle screw tethering, the vertical expandable prosthetic titanium rib (VEPTR), and multi-vertebrae wedge osteotomy. This is a review of advances in nonfusion techniques for the treatment of scoliosis in children.

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Clinical Efficacy of the Vertebral Wedge Osteotomy for the Fusionless Treatment of Paralytic Scoliosis

Cited by 7 publications

References 30 publications

27 Correction Without Fusion

27 Correction Without Fusion

Management of spinal cord injury–related scoliosis using pedicle screw–only constructs

Advances in nonfusion techniques for the treatment of scoliosis in children

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