Authors: Benjamin Bouyer Manon Bachy Redoine Zahi Camille ThéveninLemoine Pierre Mary Raphaël Vialle
Publish Date: 2013/07/17
Volume: 23, Issue: 1, Pages: 163-171
Abstract
We present the results of a prospective series of 60 patients treated for neuromuscular spinal deformities with an original spinopelvic construct using two sacral screws and two iliac screws Clinical and radiological results obtained with this new surgical technique were studied and discussed according to the epidemiological data and relevant literatureSixty patients were operated on during the study period Spinal correction and fusion was performed by posterior approach In six patients with a residual spinopelvic imbalance more than 15° on lateral preoperative bending films an anterior release of the thoracolumbar junction was performed on the same day before posterior correction Preoperative pelvic obliquity PO ranged from 4° to 44° mean 216° Postoperative pelvic obliquity ranged from 0° to 14 mean 46° No significant loss of correction was noted at the last followup One patient died 3 months after the initial procedure due to respiratory compromise 11 patients had early postoperative infections of the posterior approachDespite a high rate of infectious complications optimal correction of pelvic obliquity requires extension of spinal instrumentation to the pelvis Spinopelvic fixation remains a difficult challenge in neurological patients with hypotrophy We think that pelvic fixation with the “T construct” did provide effective and improved spinal stabilization in these patients while reducing the need for a postoperative cast or brace As a result patients had a favourable postoperative course with early mobilization and return to a comfortable sitting position
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