P J Grass1, A V Soto, H P Araya. 1. Spinal Surgery Department, Hospital Luis Calvo Mackenna, Hospital Clínico Universidad de Chile Jose Joaquin Aguirre, Santiago, Chile.
Abstract
STUDY DESIGN: Report of three cases of severe congenital scoliosis corrected by a new device. OBJECTIVES: To show a new, safe alternative for treatment to achieve and maintain correction of the most severe spinal deformity. SUMMARY OF BACKGROUND DATA: Because of neurologic risk, severe congenital scoliosis is usually not instrumented. Gradual correction seems to be safer for the spinal cord and to produce more efficient results because of the viscoelastic properties of the spine. METHODS: A new device was used in three patients with congenital scoliosis. This device is placed by a posterior approach and permits correction of the scoliosis by slow, intermittent distraction. The gear of the elongation mechanism is activated by an extender placed subcutaneously. The correction takes place in the conscious patient, under rigorous neurologic control. RESULTS: At the end of the distraction procedure, corrections of the scolioses in the three patients were from 118 degrees to 45 degrees, 104 degrees to 47 degrees, and 137 degrees to 71 degrees, respectively CONCLUSIONS: The new device has proved useful for correcting, efficiently and without neurologic damage, severe scoliosis in three patients, and may be helpful in those curves with high neurologic risk.
STUDY DESIGN: Report of three cases of severe congenital scoliosis corrected by a new device. OBJECTIVES: To show a new, safe alternative for treatment to achieve and maintain correction of the most severe spinal deformity. SUMMARY OF BACKGROUND DATA: Because of neurologic risk, severe congenital scoliosis is usually not instrumented. Gradual correction seems to be safer for the spinal cord and to produce more efficient results because of the viscoelastic properties of the spine. METHODS: A new device was used in three patients with congenital scoliosis. This device is placed by a posterior approach and permits correction of the scoliosis by slow, intermittent distraction. The gear of the elongation mechanism is activated by an extender placed subcutaneously. The correction takes place in the conscious patient, under rigorous neurologic control. RESULTS: At the end of the distraction procedure, corrections of the scolioses in the three patients were from 118 degrees to 45 degrees, 104 degrees to 47 degrees, and 137 degrees to 71 degrees, respectively CONCLUSIONS: The new device has proved useful for correcting, efficiently and without neurologic damage, severe scoliosis in three patients, and may be helpful in those curves with high neurologic risk.