Norman Ramirez1, Gerardo Olivella2, Omar Rodriguez3, Pablo Marrero4, John Smith5, Sumeet Garg6, Michael Vitale7, Tricia St Hilaire8, Randal Betz9. 1. Pediatric Orthopedic Department, Hospital de la Concepción - San German, P Box 6847, Mayagüez, 00681, Puerto Rico. Normanpipe@aol.com. 2. Surgery Department, Ponce Health Sciences University, Ponce, Puerto Rico. 3. Medicine Department, Universidad Central del Caribe, Bayamón, Puerto Rico. 4. Orthopedic Department, UPR Medical Sciences Campus, San Juan, Puerto Rico. 5. Children's Center, Salt Lake City, UT, USA. 6. Pediatric Orthopedic Department, Children's Hospital, Aurora, CO, USA. 7. Pediatric Orthopedic Department, New York-Presbyterian University Hospital of Columbia, New York, NY, USA. 8. Children's Spine Foundation, Valley Forge, PA, USA. 9. Orthopedic Department, Institute for Spine and Scoliosis, Lawrenceville, NJ, USA.
Abstract
PURPOSE: The purpose of this study is to evaluate whether patients with high-tone neuromuscular early-onset scoliosis have different surgical outcome and complication rate, when compared to patients with low-tone neuromuscular early-onset scoliosis treated with a rib-to-pelvis rib-based dual growing system. METHODS: This is a retrospective cohort study of 67 neuromuscular early-onset scoliosis patients, collected from a multicenter database, treated with a rib-to-pelvis rib-based dual growing system. All patients were divided into two groups: high tone and low tone. Pre-, intra- and postoperative data were compared between both groups. Complications were reported by a standardized system. RESULTS: Twenty-six high-tone and 41 low-tone patients were found homogeneous regarding gender, age at surgery, weight, height, estimated blood loss and surgery time. High-tone group (19/26 = 73.1%) experiences more postoperative complications than low-tone group (22/41 = 53.7%). Most common complications were infection, device migration, death and hardware failure. Permanent abandonment of rib-based growing technique and device removal was required in 21% of high-tone patients (P < 0.001). None of the low-tone patients required abandonment. CONCLUSION: High-tone patients had more complications than those with low tone in management of neuromuscular early-onset scoliosis treated with a rib-to-pelvis rib-based dual growing system. A different surgical approach may be required to treat the high-tone neuromuscular early-onset scoliosis.
PURPOSE: The purpose of this study is to evaluate whether patients with high-tone neuromuscular early-onset scoliosis have different surgical outcome and complication rate, when compared to patients with low-tone neuromuscular early-onset scoliosis treated with a rib-to-pelvis rib-based dual growing system. METHODS: This is a retrospective cohort study of 67 neuromuscular early-onset scoliosispatients, collected from a multicenter database, treated with a rib-to-pelvis rib-based dual growing system. All patients were divided into two groups: high tone and low tone. Pre-, intra- and postoperative data were compared between both groups. Complications were reported by a standardized system. RESULTS: Twenty-six high-tone and 41 low-tone patients were found homogeneous regarding gender, age at surgery, weight, height, estimated blood loss and surgery time. High-tone group (19/26 = 73.1%) experiences more postoperative complications than low-tone group (22/41 = 53.7%). Most common complications were infection, device migration, death and hardware failure. Permanent abandonment of rib-based growing technique and device removal was required in 21% of high-tone patients (P < 0.001). None of the low-tone patients required abandonment. CONCLUSION: High-tone patients had more complications than those with low tone in management of neuromuscular early-onset scoliosis treated with a rib-to-pelvis rib-based dual growing system. A different surgical approach may be required to treat the high-tone neuromuscular early-onset scoliosis.
Entities:
Keywords:
Early onset scoliosis; Neuromuscular scoliosis; Rib-based growing system
Authors: Mark J McElroy; Adam C Shaner; Thomas O Crawford; George H Thompson; Rishi V Kadakia; Behrooz A Akbarnia; David L Skaggs; John B Emans; Paul D Sponseller Journal: Spine (Phila Pa 1976) Date: 2011-07-15 Impact factor: 3.468
Authors: Norman Ramirez; Gerardo Olivella; Ryan E Fitzgerald; John T Smith; Peter F Sturm; Paul D Sponseller; Lawrence I Karlin; Scott J Luhmann; Norberto J Torres-Lugo; Tricia St Hilaire Journal: J Am Acad Orthop Surg Glob Res Rev Date: 2022-05-01