Surgical Correction of Spinal Deformity in Patients With Cerebral Palsy Using Pedicle Screw Instrumentation

Tsirikos, Athanasios I.; Mains, Edward

doi:10.1097/bsd.0b013e318227728c

Cited by 54 publications

(36 citation statements)

References 16 publications

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“…Modi et al (74) reported a satisfactory decrease in the magnitude of coronal and sagittal curves with a reduced rate of major complications over 3 years follow up. In a retrospective analysis of 45 patients on which pedicle screw instrumentation was performed, a favorable correction of scoliotic curve and pelvic obliquity was reported with a high carer/parent satisfaction rate (75). Although this data is promising, more work is required to assess the long-term efficacy of pedicle screw constructs.…”

Section: Spinalmentioning

confidence: 99%

The management of scoliosis in children with cerebral palsy: a review

Cloake¹,

Gardner²

2016

J. Spine Surg.

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Children who suffer with cerebral palsy (CP) have a significant chance of developing scoliosis during their early years and adolescence. The behavior of this scoliosis is closely associated with the severity of the CP disability and unlike idiopathic scoliosis, it continues to progress beyond skeletal maturity. Conservative measures may slow the progression of the curve, however, surgery remains the only definitive management option. Advances in surgical technique over the last 50 years have provided methods to effectively treat the deformity while also reducing complication rates. The increased risk of surgical complications with these complex patients make decisions about treatment challenging, however with careful pre-operative optimization and post-operative care, surgery can offer a significant improvement in quality of life. This review discusses the development of scoliosis in CP patient, evaluates conservative and surgical treatment options and assesses post-operative outcome.

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Section: Spinalmentioning

confidence: 99%

The management of scoliosis in children with cerebral palsy: a review

Cloake¹,

Gardner²

2016

J. Spine Surg.

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“…5,13,19,26,29,30,34,40 According to a recent study, approximately 15% of ambulatory patients undergoing pelvic fixation with iliac screws below an extensive thoracolumbar fusion will develop pseudarthrosis with broken implants. 11 Nonunion in the lumbosacral region will occur in approximately onethird of such cases, with an estimated incidence of 6.4%.…”

Section: 14mentioning

confidence: 99%

Combined S-1 and S-2 sacral alar-iliac screws as a salvage technique for pelvic fixation after pseudarthrosis and lumbosacropelvic instability

Mattei

Fassett²

2013

SPI

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Lumbosacropelvic pseudarthrosis after long spinal fusions for treatment of adult degenerative scoliosis remains a challenging condition. Moreover, although pelvic fixation with iliac screws is widely used in deformity surgery to provide a biomechanically strong distal anchor for long thoracolumbar constructs, there are very few options available after failed pelvic fixation with iliac screws. The authors conducted a retrospective review of the surgical charts and imaging findings of patients subjected to revision surgery for lumbosacropelvic pseudarthrosis from August 2011 to August 2012. This review identified 5 patients in whom a salvage technique combining both S-1 and S-2 sacral alar-iliac (SAI) screws had been performed. In this technical note, the authors present a detailed anatomical discussion and an appraisal of the sequential intraoperative steps of this new technique involving a combination of S-1 and S-2 SAI screws. The discussion is illustrated with a surgical case in which this technique was used to treat a patient with pseudarthrosis that had developed after fixation with classic iliac screws. In conclusion, although S-2 SAI screws have previously been reported as an interesting alternative to classic iliac wing screws, this report is the first on the use of combined S-1 and S-2 SAI screws for pelvic fixation as a salvage technique for lumbosacropelvic instability. According to the reported experience, this technique provides a biomechanically robust construct for definitive pelvic fixation during revision surgeries in the challenging scenarios of pseudarthrosis and instability of the lumbosacropelvic region.

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“…Together with the recent trend to treat neuromuscular scoliosis patients with pedicle screws instrumentation through a posterior-only approach, the use of screws instead of smooth rods to anchor the ilium is increasingly documented in the literature [32,33,67,68]. It offers the theoretical advantage of diminishing implant pullout or cutout associated with a smooth rods inserted in the iliac wings.…”

Section: Iliac Screwsmentioning

confidence: 99%

“…Pelvic obliquity correction associated with such techniques range from 59 to 83.3 % with no pseudarthrosis reported [32,67,68,71,72]. Complications directly involving iliac screws are mainly rod disengagement from the lateral connector and radiolucencies around the screws [67,71].…”

Section: Iliac Screwsmentioning

confidence: 99%

Pelvic fixation for neuromuscular scoliosis deformity correction

Dayer¹,

Ouellet

Saran

2012

Curr Rev Musculoskelet Med

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Pelvic fixation is most frequently indicated in the pediatric population for the treatment of neuromuscular scoliosis with significant pelvic obliquity. Neuromuscular scoliosis surgery is associated with a high risk of complications, and this is further increased by extension of fusion to the sacrum. Numerous techniques have been described for pelvic fixation associated with a long spine fusion each with its own set of specific benefits and risks. This article reviews the contemporary surgical techniques of pelvic fixation used to extend a spine fusion to the sacrum and pelvis focusing on the management of neuromuscular scoliosis, including their biomechanical rationale, results, and complications.

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Surgical Correction of Spinal Deformity in Patients With Cerebral Palsy Using Pedicle Screw Instrumentation

Abstract: Pedicle screw instrumentation can achieve excellent correction of spinal deformity in quadriplegic cerebral palsy with low complication and re-operation rates and high parent satisfaction.

Cited by 54 publications

References 16 publications

The management of scoliosis in children with cerebral palsy: a review

The management of scoliosis in children with cerebral palsy: a review

Combined S-1 and S-2 sacral alar-iliac screws as a salvage technique for pelvic fixation after pseudarthrosis and lumbosacropelvic instability

Pelvic fixation for neuromuscular scoliosis deformity correction

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