Management of Spinal Deformity in Adult Patients With Neuromuscular Disease

被引:9
作者
Protopsaltis, Themistocles S. [1 ]
Boniello, Anthony J. [2 ]
Schwab, Frank J. [1 ]
机构
[1] NYU Langone Med Ctr Hosp Joint Dis, Dept Orthopaed Surg, New York, NY 10003 USA
[2] Drexel Univ, Coll Med, Dept Orthopaed Surg, Philadelphia, PA 19104 USA
关键词
PARKINSONS-DISEASE; BOTULINUM TOXIN; RISK-FACTORS; CAMPTOCORMIA; SCOLIOSIS; SURGERY; PARAMETERS; DYSTONIA; FUSION;
D O I
10.5435/JAAOS-D-15-00421
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
A wide range of neuromuscular diseases, including Parkinson disease, cerebral palsy, multiple sclerosis, and myopathy, are associated with spinal deformities. The most common postural deformities include anterocollis, Pisa syndrome (pleurothotonus), scoliosis, and camptocormia. Nonsurgical management of spinal deformity in patients with neuromuscular disease centers on maximizing the medical management of the underlying neurodegenerative pathology before surgical intervention is contemplated. Surgical management can include decompression alone, or decompression and fusion with short or long fusion constructs. Patients with neuromuscular disease are susceptible to postoperative medical complications, such as delirium, epidural hematomas, pulmonary emboli, and cardiac events. Compared with outcomes in the typical patient with spinal deformity, postoperative outcomes in patients with neuromuscular disease have higher rates of surgical complications, such as instrumentation failure, proximal junctional kyphosis, loss of correction, and the need for revision surgery, regardless of the magnitude of surgical treatment.
引用
收藏
页码:634 / 644
页数:11
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