Is It Better to Resect a Bony Spur Before Corrective Surgery for Congenital Scoliosis with Type I Split Cord Malformation?

OBJECTIVE: To compare bony spur resection (BR) with bony spur nonresection (BN) treatment in patients with congenital scoliosis and type I split cord malformation.
METHODS: Patients with congenital scoliosis and type I split cord malformation who underwent corrective surgery in a single institution from 2008 to 2015 were retrospectively evaluated. Patients were divided into 2 groups according to whether BR was performed or not: the BR group included 12 patients, and the BN group included 20 patients. Complications and perioperative and radiographic data were recorded and compared.
RESULTS: The study included 32 patients. Mean age at surgery was 14.3 years, and average follow-up period was 2.8 years. There were no statistically significant differences in correction rate of the major curve or other radiographic parameters at final follow-up. Preoperative concerns (6.8 vs. 5.8, P = 0.006), operative times (508.5 minutes vs. 311.3 minutes, P = 0.009), blood loss (1433.3 mL vs. 1015.8 mL, P = 0.064), and hospital charges ($22,387.80 vs. $15,706.8, P = 0.032) were lower in the BN group than in the BR group. Total and major complication rates were higher in the BR group than in the BN group, even though there were no statistically significant differences (58.3% vs. 30.0% and 8.3% vs. 5.0%, respectively).
CONCLUSIONS: In patients with congenital scoliosis and type I split cord malformation, not resecting the bony spur can achieve satisfactory radiographic and clinical outcomes with potentially fewer complications.