Spine · 2006
Surgical treatment of scoliosis with pelvic obliquity in cerebral palsy: the influence of intraoperative traction.
Оценочное исследованиеСтатьяНазвание и аннотация: Перевод в очереди
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Vialle Raphaël, Delecourt Christophe, Morin Christian
Аннотация
STUDY DESIGN: Continuous retrospective series.
OBJECTIVES: To compare two techniques sequentially used for surgical correction of neuromuscular scoliosis with pelvic obliquity in children with cerebral palsy.
SUMMARY OF BACKGROUND DATA: In nonwalking patients with cerebral palsy, scoliosis is frequently associated with pelvic obliquity. We compared intraoperative traction with no traction with instrumentation to the pelvis to correct pelvic obliquity.
METHODS: The initial 59 patients had surgery in the knee-chest position with pelvic obliquity correction by posterior vertebral instrumentation distraction, rotation, and compression. The sequential 51 patients were placed prone and had asymmetric traction applied between a halo and the high pelvic side lower extremity with pelvic correction maneuvers done before posterior surgery and instrumentation.
RESULTS: Anesthetic duration was longer in Group 1 because of complexity of the intraoperative correction maneuvers, which also produced less correction of scoliosis and pelvic obliquity compared with the asymmetric traction technique. At 8.6 years of follow-up, frontal and sagittal plane correction improved in all surviving patients.
CONCLUSION: We think that intraoperative reduction by asymmetric traction is a reliable and safe technique to correct neuromuscular scoliosis and pelvic obliquity in nonwalking spastic quadriplegic patients.
OBJECTIVES: To compare two techniques sequentially used for surgical correction of neuromuscular scoliosis with pelvic obliquity in children with cerebral palsy.
SUMMARY OF BACKGROUND DATA: In nonwalking patients with cerebral palsy, scoliosis is frequently associated with pelvic obliquity. We compared intraoperative traction with no traction with instrumentation to the pelvis to correct pelvic obliquity.
METHODS: The initial 59 patients had surgery in the knee-chest position with pelvic obliquity correction by posterior vertebral instrumentation distraction, rotation, and compression. The sequential 51 patients were placed prone and had asymmetric traction applied between a halo and the high pelvic side lower extremity with pelvic correction maneuvers done before posterior surgery and instrumentation.
RESULTS: Anesthetic duration was longer in Group 1 because of complexity of the intraoperative correction maneuvers, which also produced less correction of scoliosis and pelvic obliquity compared with the asymmetric traction technique. At 8.6 years of follow-up, frontal and sagittal plane correction improved in all surviving patients.
CONCLUSION: We think that intraoperative reduction by asymmetric traction is a reliable and safe technique to correct neuromuscular scoliosis and pelvic obliquity in nonwalking spastic quadriplegic patients.