Spinal fusion for spastic neuromuscular scoliosis: is anterior releasing necessary when intraoperative halo-femoral traction is used?

Retrospective radiographic and clinical study. To compare the complications and radiographic outcomes of 2 types of surgical treatments, posterior-only fusion and circumferential fusion, in patients with nonambulatory quadriplegic cerebral palsy treated with adjunctive intraoperative halo-femoral tr...

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Bibliographic Details
Published in:Spine (Philadelphia, Pa. 1976) Pa. 1976), 2010-05, Vol.35 (10), p.E427-E433
Main Authors: Keeler, Kathryn A, Lenke, Lawrence G, Good, Christopher R, Bridwell, Keith H, Sides, Brenda, Luhmann, Scott J
Format: Article
Language:English
Subjects:
Adolescent
Cerebral Palsy - complications
Child
Disease Progression
External Fixators - standards
Female
Humans
Internal Fixators - standards
Intraoperative Period
Lumbar Vertebrae - pathology
Lumbar Vertebrae - physiopathology
Lumbar Vertebrae - surgery
Male
Muscle Spasticity - complications
Muscle Spasticity - physiopathology
Postoperative Complications - etiology
Postoperative Complications - prevention & control
Quadriplegia - etiology
Quadriplegia - physiopathology
Quadriplegia - surgery
Respiration, Artificial
Retrospective Studies
Scoliosis - etiology
Scoliosis - physiopathology
Scoliosis - surgery
Spinal Fusion - instrumentation
Spinal Fusion - methods
Spine - pathology
Spine - physiopathology
Spine - surgery
Thoracic Vertebrae - pathology
Thoracic Vertebrae - physiopathology
Thoracic Vertebrae - surgery
Traction - instrumentation
Traction - methods
Traction - standards
Treatment Outcome
Young Adult
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Description
Summary:Retrospective radiographic and clinical study. To compare the complications and radiographic outcomes of 2 types of surgical treatments, posterior-only fusion and circumferential fusion, in patients with nonambulatory quadriplegic cerebral palsy treated with adjunctive intraoperative halo-femoral traction. Circumferential anterior-posterior spinal fusion (A/PSF) has been used to improve deformity correction and rate of fusion in patients with neuromuscular scoliosis (NMS) but is associated with increased morbidity. Anterior procedures may increase operative time (OR time) and estimated blood loss (EBL) as well as compromise pulmonary function. Posterior-only spinal fusion (PSF-only) may be sufficient, thereby forgoing the need for the anterior approach without sacrificing deformity correction or outcome. Twenty-six patients (age
ISSN:0362-2436
1528-1159
DOI:10.1097/BRS.0b013e3181d9527e