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Minimally Invasive Scoliosis Surgery: A Novel Technique in Patients with Neuromuscular Scoliosis.

Sarwahi V, Amaral T, Wendolowski S, Gecelter R, Gambassi M, Plakas C, Liao B, Kalantre S, Katyal C - Biomed Res Int (2015)

Bottom Line: However, despite these significant benefits, MIS approach has not been reported in neuromuscular scoliosis patients.We feel that MIS is not only a feasible but also a superior option in patients with neuromuscular scoliosis.Long-term results are unavailable; however, short-term results have shown multiple benefits of this approach and fewer limitations.

View Article: PubMed Central - PubMed

Affiliation: Division of Pediatric Orthopedics, Cohen Children's Medical Center, New Hyde Park, NY 11040, USA.

ABSTRACT
Minimally invasive surgery (MIS) has been described in the treatment of adolescent idiopathic scoliosis (AIS) and adult scoliosis. The advantages of this approach include less blood loss, shorter hospital stay, earlier mobilization, less tissue disruption, and relatively less pain. However, despite these significant benefits, MIS approach has not been reported in neuromuscular scoliosis patients. This is possibly due to concerns with longer surgery time, which is further increased due to more levels fused and instrumented, challenges of pelvic fixation, size and number of incisions, and prolonged anesthesia. We modified the MIS approach utilized in our AIS patients to be implemented in our neuromuscular patients. Our technique allows easy passage of contoured rods, placement of pedicle screws without image guidance, partial/complete facet resection, and all standard reduction maneuvers. Operative time needed to complete this surgery is comparable to the standard procedure and the majority of our patients have been extubated at the end of procedure, spending 1 day in the PICU and 5-6 days in the hospital. We feel that MIS is not only a feasible but also a superior option in patients with neuromuscular scoliosis. Long-term results are unavailable; however, short-term results have shown multiple benefits of this approach and fewer limitations.

No MeSH data available.


Related in: MedlinePlus

Preoperative radiographs showing a 100-degree scoliosis deformity in a severely involved cerebral palsy patient. The patient has pelvic obliquity of 15 degrees with significant coronal decompensation. Patient is nonambulatory with unilateral hip dislocation.
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fig9: Preoperative radiographs showing a 100-degree scoliosis deformity in a severely involved cerebral palsy patient. The patient has pelvic obliquity of 15 degrees with significant coronal decompensation. Patient is nonambulatory with unilateral hip dislocation.

Mentions: In our second case, a 13.5-year-old girl with a 100° right-sided main thoracic curve (T6-L1) underwent minimally invasive surgery for correction of her spinal deformity. She presented with cerebral palsy in addition to a history of seizures, developmental delay, and a recent diagnosis of obstructive sleep apnea (Figure 9).


Minimally Invasive Scoliosis Surgery: A Novel Technique in Patients with Neuromuscular Scoliosis.

Sarwahi V, Amaral T, Wendolowski S, Gecelter R, Gambassi M, Plakas C, Liao B, Kalantre S, Katyal C - Biomed Res Int (2015)

Preoperative radiographs showing a 100-degree scoliosis deformity in a severely involved cerebral palsy patient. The patient has pelvic obliquity of 15 degrees with significant coronal decompensation. Patient is nonambulatory with unilateral hip dislocation.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4663285&req=5

fig9: Preoperative radiographs showing a 100-degree scoliosis deformity in a severely involved cerebral palsy patient. The patient has pelvic obliquity of 15 degrees with significant coronal decompensation. Patient is nonambulatory with unilateral hip dislocation.
Mentions: In our second case, a 13.5-year-old girl with a 100° right-sided main thoracic curve (T6-L1) underwent minimally invasive surgery for correction of her spinal deformity. She presented with cerebral palsy in addition to a history of seizures, developmental delay, and a recent diagnosis of obstructive sleep apnea (Figure 9).

Bottom Line: However, despite these significant benefits, MIS approach has not been reported in neuromuscular scoliosis patients.We feel that MIS is not only a feasible but also a superior option in patients with neuromuscular scoliosis.Long-term results are unavailable; however, short-term results have shown multiple benefits of this approach and fewer limitations.

View Article: PubMed Central - PubMed

Affiliation: Division of Pediatric Orthopedics, Cohen Children's Medical Center, New Hyde Park, NY 11040, USA.

ABSTRACT
Minimally invasive surgery (MIS) has been described in the treatment of adolescent idiopathic scoliosis (AIS) and adult scoliosis. The advantages of this approach include less blood loss, shorter hospital stay, earlier mobilization, less tissue disruption, and relatively less pain. However, despite these significant benefits, MIS approach has not been reported in neuromuscular scoliosis patients. This is possibly due to concerns with longer surgery time, which is further increased due to more levels fused and instrumented, challenges of pelvic fixation, size and number of incisions, and prolonged anesthesia. We modified the MIS approach utilized in our AIS patients to be implemented in our neuromuscular patients. Our technique allows easy passage of contoured rods, placement of pedicle screws without image guidance, partial/complete facet resection, and all standard reduction maneuvers. Operative time needed to complete this surgery is comparable to the standard procedure and the majority of our patients have been extubated at the end of procedure, spending 1 day in the PICU and 5-6 days in the hospital. We feel that MIS is not only a feasible but also a superior option in patients with neuromuscular scoliosis. Long-term results are unavailable; however, short-term results have shown multiple benefits of this approach and fewer limitations.

No MeSH data available.


Related in: MedlinePlus