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.
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页码：59 / 67
页数：8
相关论文
共 33 条
  • [21] Marks D.S., Sayampanathan S.R., Thompson A.G., Et al., Long-term results of convex epiphysiodesis for congenital scoliosis, Eur Spine J, 4, pp. 296-301, (1995)
  • [22] Thompson A.G., Marks D.S., Sayampanathan S.R., Et al., Long-term results of combined anterior and posterior convex epiphysiodesis for congenital scoliosis due to hemivertebrae, Spine (Phila Pa 1976), 20, pp. 1380-1385, (1995)
  • [23] Asher M., Lai S.M., Burton D., Manna B., The reliability and concurrent validity of the Scoliosis Research Society-22 patient questionnaire for idiopathic scoliosis, Spine, 28, 1, pp. 63-69, (2003)
  • [24] Bago J., Ramirez M., Pellise F., Villanueva C., Survivorship analysis of Cotrel-Dubousset instrumentation in idiopathic scoliosis, European Spine Journal, 12, 4, pp. 435-439, (2003)
  • [25] Cook S., Asher M., Lai S.-M., Shobe J., Reoperation after primary posterior instrumentation and fusion for idiopathic scoliosis: Toward defining late operative site pain of unknown cause, Spine, 25, 4, pp. 463-468, (2000)
  • [26] Luhmann S.J., Lenke L.G., Bridwell K.H., Schootman M., Revision surgery after primary spine fusion for idiopathic scoliosis, Spine (Phila Pa 1976), 34, pp. 2191-2197, (2009)
  • [27] Dias R.C., Miller F., Dabney K., Lipton G.E., Revision spine surgery in children with cerebral palsy, Journal of Spinal Disorders, 10, 2, pp. 132-144, (1997)
  • [28] Hell A.K., Campbell R.M., Hefti F., Neues therapiekonzept für kinder mit thoraxinsuffizienz-syndrom aufgrund von wirbelsäulenfehlbildungen, Klinische Padiatrie, 217, 5, pp. 268-273, (2005)
  • [29] Thompson G.H., Akbarnia B.A., Campbell Jr. R.M., Growing rod techniques in early-onset scoliosis, Journal of Pediatric Orthopaedics, 27, 3, pp. 354-361, (2007)
  • [30] Suk S.I., Kim J.H., Cho K.J., Et al., Is anterior release necessary in severe scoliosis treated by posterior segmental pedicle screw fixation?, Eur Spine J, 16, pp. 1359-1365, (2007)
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