Operative Strategien bei der Versorgung neuromuskulärer Skoliosen

Schömig, Friederike; Fussi, Jasmin; Pumberger, Matthias; Putzier, Michael

doi:10.1007/s00132-021-04128-2

Cited by 3 publications

(4 citation statements)

References 25 publications

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“…Early surgery, associated with less pelvic obliquity, seems to be associated with a higher degree of deformity. 2,9,12 In this study, greater curve correction was observed in the traction group, which had greater pelvic obliquity, though not statistically significant. In this case, however, there is a similarity with the Tøndevold et al study 11 in which neither group obtained a notable change in pelvic obliquity, which may be explained by the greater rigidity of the curvature in the traction group.…”

Section: Discussionmentioning

confidence: 46%

“…While age was not a decisive criterion in defining the moment of surgery, 9 it was observed that the ISST group was younger and with more severe curves, though without a statistical difference, than the without traction group. The decisive factor for a surgical indication was that the progression of the disease was more severe and earlier, with a high preoperative Cobb angle (86.28º ± 25.51 -ISST vs. 67.15º ± 13.35 -Group without ISST), with mean ages of 13.78±3.27 and 16.88±5.64 years, respectively.…”

Section: Discussionmentioning

confidence: 94%

“…In NMS, surgery is the treatment indicated for structural and progressive spinal deformities, as well as for pelvic obliquity that compromises balance or positioning when standing or sitting, aiming for erect posture. 2,9 Considering the different techniques and levels of fixation described in the literature about this treatment, this study analyzed patients who underwent corrective scoliosis surgery with and without intraoperative skull-skeletal traction.…”

Section: Discussionmentioning

confidence: 99%

“…As regards caudal fixation, in the group with traction there was a predominance of lumbar fixation, between L4 and L5 (66.7%) and only 2 iliac fixations (22.2%), agreeing with the surgical indication due to the greater angle of pelvic obliquity present in these cases. 2,9,11,12 Pelvic fixation may be associated with a slowing of pelvic obliquity progression and a reduction in complications. 13 This type of fixation predominates surgical interventions in patients with NMS.…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Analysis of Patients Submitted to Surgical Treatment for Neuromuscular Scoliosis With and Without Intraoperative Traction

Nunes¹,

Zanotto²,

Lima³

et al. 2022

Coluna/Columna

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Objectives: To compare the surgical treatment of neuromuscular scoliosis (NMS) with and without intraoperative skull-skeletal traction (ISST) in terms of the degree of curve correction, surgical time, hospitalization time, screw density, use of blood products,and complications. Methods: A comparative retrospective study, in which we analyzed the medical records and radiographs of 17 patients who underwent surgical treatment for neuromuscular scoliosis (NMS). They were divided into two groups, with 9 and 8 patients operated with and without ISST, respectively, at a referral hospital specialized in the treatment of spinal deformitiesfrom 2019 to 2021. The categorical variables were analyzed using the Chi-squared test. Results: Among the 17 patients included in the study, there was a higher prevalence of women in the group without ISST (6 and 2) and of men in group with ISST (5 and 3). The ages of the patients in the two groups ranged from 8-19 years and from 11-29 years, respectively. The screw density used in the traction group averaged 66.33%±8.49 and 82.63%±17.25 in the non-traction group, a statistically significant differencewith a P-value of 0.036. The average percent correction was 76.81%±15.61 in the traction group as compared to an average of 66.39%±12.99 in the non-traction group. In addition, there were complications in 1 patient in each of the groups. Conclusions: Surgical treatment for NMS with ISST allows surgery using fewer blood products to maintain the same hematimetric level in the postoperative period. ISST also allows the use of a lower screw density to correct more severe deformities. Level of evidence III; Comparative retrospective study.

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