Safety and Efficacy of Apical Resection Following Growth-friendly Instrumentation in Myelomeningocele Patients With Gibbus

Baş, Can Emre; Preminger, Jonathan; Olgun, Z. Deniz; Demirkıran, Gökhan; Sponseller, Paul D.; Yazıcı, Muharrem

doi:10.1097/bpo.0000000000000419

Cited by 19 publications

(14 citation statements)

References 21 publications

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“…Besides, for a child younger than 10 years, chosen vertebral column resection and long fusion are needed cautiously evaluate, in the risk of insufficient thoracic development. As a well-designed strategy, VCR following growth-friendly instrumentation in the younger patient was reported to preserve spinal growth [ 22 ]. Jeszenszky et al [ 23 ] performed PVCR in early-onset spinal deformities and advocated that additional surgical procedures are often necessary during growth, and hence, nonfusion instrumentation beyond the vertebral resection site is advantageous, as it permits spinal growth and the later addition of fusion.…”

Section: Discussionmentioning

confidence: 99%

Posterior Vertebral Column Resection for Severe Spinal Deformity Correction: Comparison of Pediatric, Adolescent, and Adult Groups

Song

Zhang

Yang

et al. 2022

Computational Intelligence and Neuroscience

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We compared the pre-, intra-, and postoperative characteristics among three groups of patients who underwent posterior vertebral column resection (PVCR) to clarify age-related characteristics and to guide patient management, surgical planning, and complication avoiding. We compared and analyzed the etiology, surgical events, outcomes, and complications among pediatric, adolescent, and adult patients who underwent PVCR in a single-center database retrospectively. Patients were categorized into pediatric (0–12 yr), adolescent (13–19 yr), and adult (>20 yr) cohorts. Demographics, surgical events, clinical and radiographic results, and major complications were compared between groups. A total of 87 patients with a mean follow-up 42 (24–96) months were identified. Pediatric group (14) had a high frequency of congenital vertebral and cardiac abnormal, adolescents (47) presented more intracanal malformations, and idiopathic was common in the adult group (26). Although pediatric patients had shorter fusion levels than adolescent and adult, their mean resected vertebrae (1.91), percentage of blood loss (estimated blood loss per total blood volume) (201.9%), and operative time were much higher. The coronal/sagittal correction rate was significantly higher in the pediatric group (73.6%/72.3%). Overall, surgical complications were more frequent in adults, particularly neuromonitoring alert and implant failure. However, more severe complications were noted in younger patients. For pediatric patients with PVCR, poor physiological conditions and frequent comorbidities indicated cautious patient selection and sufficient preoperative preparation. The higher correction rate may be due to the excellent compliance of the spinal cord. For adult patients, preoperative traction and adjusting the tension of the spinal cord during surgery could contribute to neurological safety.

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Section: Discussionmentioning

confidence: 99%

Posterior Vertebral Column Resection for Severe Spinal Deformity Correction: Comparison of Pediatric, Adolescent, and Adult Groups

Song

Zhang

Yang

et al. 2022

Computational Intelligence and Neuroscience

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“…Выраженные вторичные изменения позвонков усложняют интерпретацию лучевых данных (КТ), в связи с чем для планирования операции рекомендуют применять 3D-модели позвоночника [12,19,20]. При этом кифэктомии с удалением от одного до пяти позвонков [21] и многоуровневой стабилизацией позвоночника [22] металлоконструкции [14,23] и переломами ее элементов [23], формированием псевдоартроза [24], дисфункцией имеющегося вентрикулоперитонеального шунта [22]. Значительную часть таких пациентов в дальнейшем оперируют неоднократно [14].…”

Section: Discussionunclassified

Kyphosis correction as an option for surgical treatment of meningomyelocele in a newborn: immediate results of two clinical cases and literature review

et al. 2022

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Objective. To analyze immediate results of meningomyelocele closure with simultaneous kyphectomy in newborns.Material and Methods. In two newborns, correction of kyphosis by vertebrectomy and decancellation of the apical vertebral body was performed simultaneously during surgery for meningomyeloceleResults. In both cases, extensive mobilization of soft tissues to close the skin defect was not required, while a significant correction of kyphoticdeformity was noted. The postoperative wound healed by primary intention on days 9–11. The follow-up period was 11 and 8 months.Only 34 such operations in newborns were reported in the literature. All the authors noted the absence of postoperative wound complications typical for meningomyelocele repair without an orthopedic stage. In small series with a long follow-up period there was a gradual loss of correction after such operations, but without the formation of angular kyphosis requiring repeated kyphectomy.Conclusion. Kyphectomy in newborns with meningomyelocele provided the possibility of effective closure of the skin defect and uncomplicated healing of the postoperative wound.

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“…These authors showed a height of 1.05 cm per year between T1 and T12 in patients with growing rods and 0.84 cm per year between T1 and T12 who underwent the Luque technique. According to the study, the growing rod technique emphasized that this technique provides better lengthening than the Luque technique, but surgery should be performed every 6 months for lengthening [5]. In these patients, torocal stability was only achieved by placing pedicle screws at T2 and T3.…”

Section: Discussionmentioning

confidence: 99%

“…In the literature, complication rates in MMC patients have been reported as very high after kyphectomy. Whether a long segment fusion is performed or the growing rod lengthened, comparison of these techniques also results in 50% complications [5,22,23]. The most common complications were wound infections and implant failures.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2020

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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

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Safety and Efficacy of Apical Resection Following Growth-friendly Instrumentation in Myelomeningocele Patients With Gibbus

Cited by 19 publications

References 21 publications

Posterior Vertebral Column Resection for Severe Spinal Deformity Correction: Comparison of Pediatric, Adolescent, and Adult Groups

Posterior Vertebral Column Resection for Severe Spinal Deformity Correction: Comparison of Pediatric, Adolescent, and Adult Groups

Kyphosis correction as an option for surgical treatment of meningomyelocele in a newborn: immediate results of two clinical cases and literature review

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

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