Outcome of revision surgery in pediatric spine deformity patients

被引：12
作者：
Yagi M. [1 ,2 ]
King A.B. [1 ]
Kim H.J. [1 ]
Cunningham M.E. [1 ]
Boachie-Adjei O. [1 ]
机构：
[1] Department of Adult and Pediatric Spine and Scoliosis Surgery, Hospital for Special Surgery, New York, NY 10021
[2] National Hospital Organization Murayama Medical Center, Tokyo
来源：
Spine Deformity | 2013年 / 1卷 / 1期
基金：
日本学术振兴会;
关键词：
Complication; Crankshaft; Deformity; Revision surgery; Scoliosis;
D O I：
10.1016/j.jspd.2012.10.002
中图分类号：
学科分类号：
摘要：
Study Design: Retrospective case series. Objectives: To report the complications and outcomes of pediatric revision spine surgery and review the surgical indications and treatment methods. Background Summary: Recent reports have shown the necessity of revision spine surgery for pediatric deformities. Many reports have shown the result of revision surgery for pediatric spinal deformity. Materials and Methods: We conducted a retrospective review of 638 patients with pediatric spinal deformity who were treated with surgery from 1996 to 2007. We identified 50 patients who underwent revision spinal fusion surgery with a minimum of 3 years of follow-up. Results: Mean follow-up was 4 years (range, 3-8.3 years). The diagnosis at index surgery was idiopathic scoliosis in 18 patients, congenital scoliosis in 13, neuromuscular scoliosis in 13, tumor and spinal arteriovenous malformation in 4, burst fracture in thoracic spine in 1, and Scheuermann kyphosis in 1. The primary surgeries were 1 hemi epiphysiodesis, 3 anterior spinal fusions, 4 posterior decompressions, 8 combined anterior and posterior spinal fusions, and 34 posterior spinal fusions. A total of 16 patients had pseudarthrosis, 12 decompensation, 11 progressive kyphosis, 8 crankshaft phenomenon, 2 infections, and 1 junctional degeneration. All 50 reoperations included spinal instrumentation and fusion. The revision surgeries were 2 anterior spinal fusions, 14 posterior fusions, and 34 combined anterior and posterior spinal fusions. Spine arthrodesis was obtained in 98% of patients (49 of 50) and complications occurred in 14% of patients (7 of 50). The Scoliosis Research Society Patient Questionnaire outcomes at the latest follow-up were as follows: total 3.95, function 3.88, pain 3.83, self-image 3.98, and mental health 4.04. Conclusion: Pseudarthrosis was the most common indication for revision surgery, and bony union was achieved in 98% with revision surgery. Despite the complications, pediatric revision spine surgery can achieve successful outcomes. © 2013 Scoliosis Research Society.
引用
收藏
页码：59 / 67
页数：8
相关论文
共 33 条
  • [1] Benli I.T., Duman E., Akalin S., Et al., An evaluation of the types and the results of surgical treatment for congenital scoliosis, Acta Orthop Traumatol Turc, 37, pp. 284-298, (2003)
  • [2] Bernard Jr. T.N., Burke S.W., Johnston III C.E., Roberts J.M., Congenital spine deformities. A review of 47 cases, Orthopedics, 8, 6, pp. 777-783, (1985)
  • [3] Bowen R.E., Scaduto A.A., Banuelos S., Does early thoracic fusion exacerbate preexisting restrictive lung disease in congenital scoliosis patients?, J Pediatr Orthop, 28, pp. 506-511, (2008)
  • [4] Coran D.L., Rodgers W.B., Keane J.F., Hall J.E., Emans J.B., Spinal fusion in patients with congenital heart disease: Predictors of outcome, Clinical Orthopaedics and Related Research, 364, pp. 99-107, (1999)
  • [5] Garrido E., Tome-Bermejo F., Tucker S.K., Et al., Short anterior instrumented fusion and posterior convex non-instrumented fusion of hemivertebra for congenital scoliosis in very young children, Eur Spine J, 17, pp. 1507-1514, (2008)
  • [6] Griss P., Huberti H., The operative treatment of congenital scoliosis. A review of 26 cases, Archives of Orthopaedic and Traumatic Surgery, 98, 4, pp. 241-246, (1981)
  • [7] Holte D.C., Winter R.B., Lonstein J.E., Et al., Excision of hemivertebrae and wedge resection in the treatment of congenital scoliosis, J Bone Joint Surg Am, 77, pp. 159-171, (1995)
  • [8] Keller P.M., Lindseth R.E., DeRosa G.P., Progressive congenital scoliosis treatment using a transpedicular anterior and posterior convex hemiepiphysiodesis and hemiarthrodesis: A preliminary report, Spine, 19, 17, pp. 1933-1939, (1994)
  • [9] McMaster M.J., Singh H., The surgical management of congenital kyphosis and kyphoscoliosis, Spine (Phila Pa 1976), 26, pp. 2146-2226, (2001)
  • [10] Noordeen M.H., Garrido E., Tucker S.K., Et al., The surgical treatment of congenital kyphosis, Spine (Phila Pa 1976), 34, pp. 1808-1814, (2009)
1234